Herpes Infection during Pregnancy

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KEY POINTS

• If you are pregnant and have had herpes, tell your healthcare provider so that steps can be taken to avoid infecting the baby. Antiviral medicine is a safe medical treatment for infected pregnant women.
• If you get a herpes infection for the first time during the first 3 months of pregnancy, it might cause a miscarriage or problems with the baby.
• Follow the full treatment prescribed by your healthcare provider. Be sure to take all of your medicine as prescribed by your provider. Always practice safe sex.

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What is herpes infection?

Herpes is a common infection by the herpes simplex virus, or HSV. It causes painful blisters that break open and form sores.

How does a herpes infection during pregnancy affect the baby?

If you get a herpes infection for the first time during the first 3 months of pregnancy, it might cause a miscarriage or problems with the baby. If you get infected for the first time later in the pregnancy, it may cause premature labor and delivery.

Your baby is most at risk of getting infected with the virus if you have sores in the genital area during labor. The baby has a good chance of coming in contact with the virus and getting infected when your bag of water breaks or during delivery through the birth canal. The herpes virus could cause a serious infection of your baby’s liver, brain, or other organs.

If you are pregnant and have had herpes, tell your healthcare provider so that steps can be taken to avoid infecting the baby. Antiviral medicine is a safe medical treatment for infected pregnant women. It can help prevent an active infection that could be passed to your child during birth. However, if you have sores at the time of delivery, antiviral medicine will not keep the infection from being passed to the baby and your provider may suggest a C-section to avoid infecting the baby during a vaginal delivery. If you don’t have any sores at the time of labor, you may have a vaginal birth.

Breast-feeding is safe as long as you don’t have sores on or around your breast.

What is the cause?

You can get infected with the herpes virus if you touch blisters or sores on the genitals, mouth, or rectal area of someone who is infected. The virus can spread to others by kissing or sharing food or drink, or during sex. You may spread it from one part of your body to another if the virus gets on your hands such as after touching a blister.

Once you are infected, the herpes virus stays in your body, even after the sores are gone. Most of the time the virus is inactive, but the virus can become active again and cause an outbreak of sores. Repeat outbreaks of genital herpes are particularly common during the first year of infection.

What are the symptoms?

Some people infected with herpes have no symptoms. If you do have symptoms, they usually start within 2 weeks after the virus first enters your body. The symptoms of a herpes infection in the genital area may include:

• Painful sores around your vagina, thighs, or buttocks
• Vaginal discharge
• Pain when you urinate or have sex
• Trouble urinating
• Itching in the genital or anal area that starts suddenly
• Muscle aches and feeling tired
• Fever (usually only with the first outbreak of blisters)
• Tender, swollen lumps in your groin

If a newborn is infected with herpes simplex, the baby may have the following signs of infection during the first month after birth:

• Constant crying and resistance to comforting
• Breathing problems
• Fever
• Seizures
• Yellowing of the skin and eyes (jaundice)
• Bruising or sores on the skin

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Infection can be confirmed with lab tests. Cells or liquid from a sore will be tested in the lab for the virus. You may have blood tests to see if you have had a herpes infection before.

The baby can be diagnosed with blood tests, or tests of samples of fluid from the baby's nose, throat, mouth, and eyes.

How is it treated?

If you are pregnant and have had herpes, tell your healthcare provider so that steps can be taken to avoid infecting the baby. Antiviral medicine is a safe medical treatment for infected pregnant women. It can help prevent an active infection that could be passed to your child during birth. However, if you have sores at the time of delivery, antiviral medicine does not keep the infection from being passed to your baby. If you have an active herpes infection when you go into labor, your provider may suggest a C-section to avoid infecting the baby during a vaginal delivery. If you don’t have any sores at the time of labor, you may have a vaginal birth.

If your newborn gets infected, the baby can be treated with antiviral medicine. The medicine will increase the chances that your child will recover and develop normally.

Repeat outbreaks of sores tend to be milder than the first outbreak and the sores heal more quickly. Repeat outbreaks of herpes simplex are not as likely to infect the baby.

How can I take care of myself?

Follow the full treatment prescribed by your healthcare provider. Be sure to take all of your medicine as prescribed by your provider.

When you have an outbreak of sores:

• Wear loose clothing, preferably cotton, to keep pressure off your skin. Pressure can cause more blisters.
• Sit in a bathtub of warm water 2 or 3 times a day to help soothe the pain.
• Don’t use douches, perfumed soaps, sprays, feminine hygiene deodorants, or other chemicals in the genital area.
• Avoid a lot of sunlight and heat. They may cause more blisters.
• Ask your healthcare provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

There are many support groups for people who have herpes. You can get more information by calling the National Sexually Transmitted Disease Hotline at 1-800-227-8922.

How can I help prevent genital herpes?

• Practice safe sex:
  • Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.
  • Have just 1 sexual partner who is not having sex with anyone else.
  • If you have had sex and are worried that you may have been infected, see your healthcare provider even if you don’t have any symptoms.
  • If you have been sexually assaulted, you may need to be treated to prevent sexually transmitted infections. You should have an exam within a few hours of the assault and before showering or bathing.
• Ask your partners if they have herpes because herpes may be spread from areas not protected by a condom, such as the groin, thigh, and rectum. Avoid sexual contact if you or your partner has any sores.
• Avoid oral sex with someone who has fever blisters (cold sores) in the mouth. Cold sores are caused by a related virus that can infect the genitals.