As a future parent eagerly awaiting the birth of your child, you have probably done a lot of preparation to ensure your child’s health. One of the things many experts recommend is that you understand what herpes simplex virus (HSV) is. In adults, infections from this common virus usually have mild symptoms. In infants, however, HSV infection can cause a rare but serious illness.
How can herpes simplex be transmitted to an infant?
If HSV is present in the birth canal at the time of delivery, the baby can become infected as it passes through the birth canal. This is the most common situation in which HSV is transmitted to an infant.
HSV can also be transmitted to an infant if the infant is kissed by a person with herpes labialis.
In rare cases, HSV can also be transmitted by touch if a person touches an infant immediately after touching an active herpes lesion.
What are the risks of herpes to children?
HSV can cause neonatal herpes, which is a rare but life-threatening disease. Neonatal herpes can cause skin, eye or mouth infections, damage to the central nervous system and other internal organs, mental retardation and even death. If given early, medication can help prevent or reduce this permanent damage.
How many children have neonatal herpes?
Although genital herpes is common, the risk of your child developing neonatal herpes is not significant, especially if you develop genital herpes before the second trimester (7th to 9th month of pregnancy). The incidence of neonatal herpes in live births: 1 in 1,800 to 5,000 in the United States, 1 in 60,000 in the United Kingdom, 1 in 10,000 in Australia and France, and 1 in 35,000 in the Netherlands. this means that most women with genital herpes are able to have healthy children.
What kind of child is at greatest risk of developing neonatal herpes?
The risk of neonatal herpes is greatest in children whose mothers develop genital herpes during the last trimester of pregnancy. This is because a mother who has recently contracted herpes has not yet developed enough antibodies to fight the virus and thus is not naturally protected before and at the time of the child’s birth. In addition, newly acquired genital HSV infections are usually active, so it is likely that the virus will be present in the birth canal during delivery.
Can neonatal herpes also occur in the child of a pregnant woman with a previous history of genital herpes?
Women who have had genital herpes prior to pregnancy are at low risk of transmitting HSV to their babies. This is because their immune system has developed antibodies that are able to pass from the bloodstream to the fetus through the placenta. Even if there is HSV activity in the birth canal at the time of delivery, the antibodies help protect the child. In addition, if a mother knows she has genital herpes, her doctor will take steps to protect her child.
What can a woman with genital herpes do to protect her child?
If you are pregnant and you also have genital herpes, you may be concerned about the risk of spreading herpes to your child. Be sure that the risk is minimal, especially if you have had herpes for a long time. The following measures will help make this risk even smaller.
Discuss with your family doctor, obstetrician or midwife to let them know that you have genital herpes.
At the time of delivery, self-examine the genital area for any symptoms of herpes, such as herpetic lesions, itching, tingling sensation or tenderness. Your doctor will also examine you under bright light to detect any signs of herpes recurrence.
Early in your pregnancy, your obstetrician will discuss with you the options for delivery if an active herpes flare-up occurs during labor. This choice is whether to continue with a vaginal delivery (avoiding the routine use of instruments) or to have a cesarean section. There is not enough information to definitively support one option or the other. On the one hand, the risk of transmission of herpes to the baby in a vaginal delivery is minimal, while on the other hand, the risks to the mother of a cesarean section must be weighed.
Ask your doctor not to break the amniotic membrane that surrounds the fetus, except when necessary. The amniotic membrane helps to protect the fetus as much as possible against any viruses that may be present in the birth canal.
Ask your doctor not to use a fetal scalp monitor (scalp electrodes) to monitor the fetal heart rate during delivery unless it is medically necessary. Such devices can create tiny breaks in the fetal scalp, making it easy for HSV to invade. In most cases, an external heart rate monitoring method can be used.
Ask your physician not to use a vacuum suction or forceps during delivery unless it is medically necessary. These devices can also cause a break in the fetal scalp, making it easy for HSV to invade.
After the child is born, monitor it closely for 4 weeks. Symptoms of herpes in newborns include blisters on the skin, fever, weakness (poor spirits), irritability (crying easily), or poor appetite. At first, these symptoms may be mild, but it is important not to wait to see if your child gets better and to take him or her to the doctor immediately. Be sure to tell your doctor that you have genital herpes.
You have to believe! Your chances of having a healthy child are excellent.
What can women who do not have genital herpes do to protect their children?
Children born to mothers who developed genital herpes during the last trimester of pregnancy are at the greatest risk of developing neonatal herpes. Although neonatal herpes is rare, when it does occur, it can lead to a serious, even life-threatening, disease for the baby. The best thing you can do to protect your child is to know the truth about HSV and how to protect yourself. The first step is to find out if you are already carrying the virus. If your partner has genital herpes and you don’t know if you also have it, you need to talk to your doctor about it.
How do I get tested for genital HSV infection?
If you have symptoms of genital herpes, the most common laboratory test is a viral culture, which detects HSV from the affected genital area; for this test, the doctor will collect a specimen from the site of the attack when the herpes is active, preferably on the first day of the attack. It takes about 7 days to get the results of the test.
If you have no symptoms, a blood test can tell you if you have HSV-2, a type of HSV that usually infects the genital tract. A blood test can also tell you if you have HSV-1, but in most cases, it just means that you have facial herpes.
The most accurate blood test is the protein blot test (Western blot), but this method is still used primarily as a research tool. Other tests, such as the simplified immunoblot test and the POCKit? test, are more widely used. Of these test methods, some can only detect HSV-2 infection, some can detect both HSV-1 and HSV-2 infection, and some are not specific. The usefulness of these tests varies from country to country, and some are not as accurate as others.
How can I be sure I don’t have genital HSV infection?
If you are tested negative for genital herpes, the following measures can help protect you from infection during pregnancy.
If your sexual partner has genital herpes, prohibit sexual contact during active herpes episodes. During intermittent episodes of herpes, your partner should use a condom from beginning to end of each sexual encounter. This should be done even if your partner is asymptomatic, as HSV can be transmitted when symptoms are not present. Have your partner see a doctor to discuss oral antiviral suppressive therapy for the duration of your pregnancy. During the second trimester (the last trimester), also consider abstaining from sexual contact.
If you do not know if your partner has genital herpes, you can ask him to be tested. If your partner has genital or facial HSV infection, you are at risk of acquiring the infection unless you take steps to prevent transmission.
If your partner has active oral or facial herpes, do not let him or her have oral sex with you. This could give you genital herpes.
What should you do if you get genital HSV in the second trimester?
If you have genital symptoms late in pregnancy, or if you do have genital HSV exposure, tell your obstetrician or midwife about this immediately. This is because the risk of HSV transmission to your child is greatest if you contract herpes during this time. However, it is important to know that herpes can remain latent for several years. What appears to be a newly acquired infection may actually be the first time that symptoms of a previous infection appear at this time. A blood test can find out if your symptoms are the result of a previous infection and if you have only recently acquired genital HSV infection.
Talk to your doctor about the best way to protect your child. When a pregnant woman does acquire a genital HSV infection late in pregnancy, some doctors will give her antiviral medication. Some doctors recommend delivery by cesarean section in these cases, even if there are no symptoms of an attack.
How can I protect my child after birth?
During the first few weeks after birth, a child may develop neonatal herpes. This infection is almost always caused by kissing the baby by an adult with herpes of the lips or face (mouth sores). To protect your child, do not kiss your child when you have facial or labial herpes, and ask others to do the same. If you develop herpes on the mouth and lips, wash your hands before touching your child.
If your sexual partner is pregnant and she does not have genital HSV infection, you can help ensure the safety of the child and keep the child away from infection. The first step is to find out if you have genital HSV infection (see “How do I get tested for genital HSV infection?”). . Remember, about 20% of sexually active adults have genital HSV infection, and most have no symptoms. If you find yourself infected with HSV, follow these guidelines to protect your pregnant sexual partner.
Use a condom from start to finish every time you have sexual contact, even if you are asymptomatic. HSV can be transmitted to a sexual partner even when there are no symptoms.
If you develop an episode of genital herpes, prohibit sexual contact until the episode is completely resolved.
discuss with your doctor the use of antiviral therapy to suppress herpes attacks; this measure may reduce the risk of HSV transmission occurring in between attacks
Consider abstaining from vaginal intercourse during the second trimester. Seeking alternative forms of sex, such as touching, kissing, fantasy and massage
avoiding oral sex with your sexual partner if you have active oral labial herpes (usually caused by HSV-1)
Your sexual partner needs to tell her doctor that you have genital herpes so that all herpes-related issues can be discussed.
Precautions during pregnancy
If a pregnant woman has genital herpes herself or her sexual partner, it is important to tell her doctor about this condition. When a male partner has genital herpes and the woman has no evidence of herpes infection, the following measures may help the woman avoid acquiring the virus during pregnancy.
Having blood tests to determine if the woman has antibodies to HSV
Using condoms after conception until delivery.
Treatment of her male partner with oral antiviral medication to suppress recurrence of genital herpes during pregnancy.
Avoiding oral sex during pregnancy if the sexual partner has facial herpes or oral labial herpes.
During the prodromal period, regular check-ups should be performed, while the pregnant woman and her doctor can discuss the possibility of a cesarean section or the use of antiviral medication. In addition, the pregnant woman should follow the general pregnancy health guidelines as closely as possible. During pregnancy, good nutrition and rest are probably even more important.
Recurrent genital herpes attacks pose minimal risk to the pregnant woman, but it can interfere with the joy a woman brings with pregnancy.
Bottom line, the best way to protect your child from neonatal herpes is to prevent genital HSV infection during the second trimester!