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How to treat herpes during pregnancy: local and systemic therapy, consequences for the child. Is genital herpes dangerous during pregnancy. How is the virus detected in the blood of a pregnant woman

Modern pharmaceuticals have several drugs that help to quickly and effectively treat herpes during pregnancy, which is in active form. But the virus cannot be completely eradicated. Once entering the human body, it settles in it forever. Drugs for the treatment of the disease are mainly used locally. It is also recommended to take a course of immunomodulatory vitamins.

Medicines for the treatment of this disease are available without a prescription in every pharmacy. But it is recommended to carefully choose how to treat herpes on the lips during pregnancy.

Being in an interesting position, a woman should understand that any medicine can adversely affect the health of her and the child's body.

To treat herpes during pregnancy, you need to see a doctor (just get an appointment with your gynecologist). The doctor will not only be able to recommend suitable drugs, but also confirm the correctness of the diagnosis.

If the expectant mother has never been sick with herpesvirus, then she should especially carefully monitor the slightest signs similar to the signs of this infection. It should be understood that the immune defense of the body of a pregnant woman is especially vulnerable. And at this time, almost every woman in position can initially become infected with the virus.

The worst thing is that the primary infection with this virus has a lot of negative consequences for the health of the unborn child. Often there is an abortion, miscarriage, the development of serious pathologies.

In this article you will learn:

Treatment Methods

Many drugs that are commonly prescribed are potentially dangerous for the development of the fetus and the course of pregnancy. For the expectant mother and her baby, experts recommend choosing medicines carefully. It is important that the risk of negative effects on the fetus and the female body is minimal.

Therefore, the method of strengthening immunity, antiviral therapy and local impact on the focus of the disease is usually chosen. There is a practice of using folk methods. But, before resorting to them, you should discuss all the components and the very method of treatment with a doctor, since often folk methods can be based on unjustified legends.

How to treat herpes during pregnancy

In order to minimize the risk of pregnancy complications and the development of pathologies in the child, the prescription of drugs occurs after the doctor has studied the test results.

To confirm the presence of herpesvirus, determine the form of the disease, the following tests may be prescribed:

  1. ELISA - enzyme immunoassay to determine the amount of antibodies to the virus
  2. PCR - a polymerase chain reaction method for detecting virus DNA in saliva, mucus, in the patient's blood
  3. An immunoassay test to confirm the presence of a virus and determine its specific type.

Only after these analyzes it will be possible to select the correct treatment.

It is especially important to choose a safe but effective treatment for herpes early in pregnancy. In particular, special attention should be paid to the treatment of women in a position who initially contracted the virus.

Timely, properly selected therapy will not only save the pregnancy, but also prevent the development of pathologies in the fetus.

Tablets

The following tablets are mainly prescribed:

  • Acyclovir - 200 mg five times a day, the duration of treatment is from 5 to 10 days
  • Valocyclovir or Valtrex - 500 mg twice a day. Duration of treatment 5-10 days
  • Complexes of vitamins to strengthen the immune system

You should drink tablets regularly, strictly following the instructions. If it is prescribed to use 10 days, then it is impossible to reduce the duration of treatment, even if the infection is visually eliminated.

It should be understood that this virus has not only a long incubation period, but also periods of extinction and recovery.

The disease can last 30-40 days. Therefore, it is impossible to lose vigilance. In the event that the slightest deterioration in well-being from the prescribed pills is noticed, you should immediately contact your doctor.

Ointments - gels

The most common treatment for herpes during pregnancy is with topical medications.

The use of ointments and creams for herpes during pregnancy allows you to do the following:

  • localize the infected area
  • stimulate the rapid elimination of infection
  • promote speedy recovery.

The most effective and safe for pregnant women and their babies is Acyclovir ointment.

For high efficiency, it should be applied to the affected area up to five times a day. Especially important is the fact that this ointment is effective in primary infection. It not only helps to extinguish the infection, but also prevents its further manifestation.

The following ointments and gels have justified themselves in practice:

  • Oxolinic ointment
  • Foscornet cream
  • Tetracycline ointment
  • Cream Biopin
  • Tykveol
  • Gel hyporamine.

It is important to use creams and gels purchased at specialized points of sale. It is also not recommended to take open tubes. When buying, be sure to pay attention to the expiration date and store in acceptable conditions.

Immunomodulatory

If a severe form of the course of an infectious disease is observed, then immunomodulatory medications can be prescribed. It is especially important to start their timely intake in the first weeks of pregnancy. After all, it is up to 12 weeks that the main organs and systems of the baby are laid. If the virus penetrates the placenta to the fetus, then it will be almost impossible to avoid the abnormal development of individual organs or systems as a whole.

Therefore, immunoglobulin can be prescribed for the treatment of herpesvirus. In the first weeks of pregnancy, it is recommended in ointments, after the 14th - in the form of suppositories. In the course of such treatment, the necessary amount of vitamins and minerals enters the body.

Folk remedies

Mostly, folk remedies are based on the use of herbs, decoctions, compresses. For example, it is believed that aloe leaves can treat herpes in pregnant women by acting on the affected area locally. After two procedures, the pain sensation is significantly reduced, and rapid healing of wounds is observed. Essential oils are also used (fir, sea buckthorn, green tea), calendula flowers, soda and salt, etc.

But female representatives, wanting to undergo herpes treatment with folk remedies quickly, often make too much effort.

There are many cases when victims of self-treatment according to folk recipes turned to doctors with burns, allergic reactions.

At the same time, the disease itself remained undefeated. Therefore, before filling the wound over the lip with salt, you should think about whether this is really the method that will allow you to defeat the virus.

If these symptoms have become a side effect of self-medication, then at the doctor's appointment one should not secretly hide the remedies that were used at home, because timely awareness can save time in identifying the true cause of the deterioration in health and its further treatment.

Attentive attitude towards yourself and taking care of the unborn baby will allow you to transfer the entire period of pregnancy easily, without harming maternal and child health. The main goal of a pregnant woman is to bear a healthy baby and at the same time maintain her health, because it is important for the further care of the newborn. However, by its nature, the body of a woman in a position is just the most vulnerable.

During this period, there is a high risk of infection with various viral and bacterial infections. One of the most common and dangerous for a pregnant woman is the herpes infection. This virus is massively distributed throughout the world and lives in an active or latent state in almost every person. According to various sources, 90-97% of people are its carriers. At the same time, doctors distinguish 8 forms, but three are most common: herpes simplex of the first and second types, as well as herpes zoster.

In our country, many women are faced with herpes of the first type. Its "calling card" can be considered the presence of rashes (watery blisters) on the lips or above them, on the mucous membranes of the mouth, nose. Over time, these rashes turn into sores, then crust over. Those who have experienced this disease know firsthand how long and painfully these wounds can heal. Indeed, with an unsuccessful movement of the lips, a smile or laughter, the wounds can open. And the food that gets on them, the liquid only adds to the painful sensations.

During pregnancy, this is a viral infection that women most often encounter during gestation, since there is a direct link between a decrease in immunity and its periodic relapses.

The level of infection with herpes simplex approaches 98% in reproductive age and its exacerbation is almost inevitable. In most cases, herpes does not pose a danger to a child developing in the womb.

The presence of prerequisites for immunodeficiency in a future mother dictates the need for a more thorough approach to the manifestations of herpes during pregnancy, implying preventive and therapeutic measures.

Herpetic infection is a widespread pathology of the skin and manifests itself as a group of vesicles on a hyperemic and edematous basis.

The disease develops as a result of infection (HSV), has a chronic course with periodic exacerbations.

To the question of whether herpes is dangerous during pregnancy, there are two answers:

  1. Primary infection with herpes during pregnancy is fraught with fetal death, developmental anomalies, or infection at birth.
  2. The recurrence of a viral infection is almost always not dangerous, since protective immunoglobulins are present in the mother's blood.

Pregnant women who by the time they reach the reproductive period have not met with HSV are considered a rarity.

Infection occurs in childhood, and exacerbations are not observed in everyone. At the same time, women are positive throughout their lives.

Why is herpes dangerous during pregnancy?

You can talk about the danger of this virus at the first meeting of a woman's body with HSV after conception, as well as with a generalized form of a secondary infection.

In such cases, HSV infection affects the developing fetus, as protective antibody molecules are absent. Herpes in the blood during pregnancy practically without obstacles penetrates through the placenta to the tissues of the embryo.

The consequences are determined by the timing of the primary infection. Herpes in early pregnancy almost always ends in miscarriage.

A woman carrier of HSV during pregnancy does not cause concern in terms of the disease of the child. Immunoglobulins or memory cells bind the virus and inactivate it.

But, since herpes affects pregnancy immunosuppressively, in patients with concomitant severe pathologies, antibodies can be determined in insufficient quantities.

Therefore, herpes during pregnancy does not lose its relevance and is considered an infection that requires control.

Herpes type 1 and 2 during pregnancy manifests itself in the labial or form. Most often, type 1 initiates inflammation of the skin and mucous membranes of the upper half of the body, and the second - the genital organs.

With primary infection, herpes during pregnancy is dangerous in both forms. In addition, the sexual form, even with relapses, is dangerous before delivery, since the child can become infected by contact when passing through the birth canal.

The incidence of herpes in newborns has quadrupled in the last 30 years. happens in the following ways:

  • through the cervix in the genital form;
  • through the system "mother-placenta-blood" by blood.

With an exacerbation of infection in the third trimester, premature rupture of the membranes is of particular danger. Such circumstances double the chances of infection.

Important!

The peak frequency of infection of a child with herpes occurs in the third trimester, in particular, in the process of delivery, when the skin and mucous membranes of the fetus are in direct contact with a rash on the woman's genitals.

Simple appears extremely rarely, so typical herpetic eruptions in this area are a suspicion of herpes zoster during pregnancy.

Herpes - as a sign of pregnancy

Many women believe that the appearance of herpetic eruptions is regarded as a sign of conception. If herpes aggravated during a delay in menstruation, pregnancy can actually be suspected.

As you know, the hormonal background and the reaction of the body systems change significantly after conception. Progesterone or the hormone of the corpus luteum has some immunosuppressive effect, and the introduction of the embryo into the uterine wall and its development causes immune suppression. Aggravated herpes can indirectly testify to the completed conception.

Herpes recurrence during pregnancy occurs in the first weeks, so it is not an early sign of gestation.

Modern test strips for determining the level of chorionic gonadotropin in the urine, as well as a blood test, will allow you to find out a reliable answer before the next menstruation.

Appearance in the 1st trimester

In women with a normal immune response and the absence of severe somatic pathology, an exacerbation of HSV in the first trimester of pregnancy will not lead to adverse consequences. If the primary infection occurred in the 1st trimester, then the following outcomes are possible:

  • miscarriage;
  • frozen pregnancy;
  • threat of interruption.

In the early stages, spontaneous abortion most often develops.

The consequences of herpes in early pregnancy after 10 weeks are described by severe malformations.

Genital herpes in the first weeks of pregnancy is the most dangerous manifestation of infection. The frequency of severe consequences in this case doubles.

Single episodes of recurrence of the sexual form are not dangerous. This is especially true for skin manifestations, when herpetic elements appear on the external genital organs without involving the vagina and cervix.

In the 2nd trimester

In the 2nd trimester, the outcome of infection is determined by the gestational age. So, at week 14, herpes in pregnant women leads to the death of the fetus, and at week 26-28 - to intrauterine infection with an outcome in the form of malformations of the eyes, the organ of hearing, and the brain.

In the second trimester of pregnancy, infection or frequent recurrences of genital herpes lead to the penetration of the virus through the fetal membranes and the implementation of intrauterine infection, which can be diagnosed by ultrasound:

  • polyhydramnios;
  • thickening of the placenta;
  • amnionitis;
  • strands and suspensions in the waters;
  • disorders in the organs of the fetus (liver, intestines, brain, eyes).

After 30 weeks, the most common consequence of a genital infection is rupture of the membranes and early birth with infection through the birth canal.

In the 3rd trimester

The variety of clinical manifestations of herpes in late pregnancy is due to several factors:

  • duration and form of infection;
  • individual properties and degree of HSV virulence;
  • the state of the placenta;
  • the presence of immunodeficiency.

Important!

Preeclampsia, diabetes, pathologies of blood clotting, premature aging of the placenta, fetal hypoxia aggravate the course and contribute to the development of consequences.

In the third trimester, primary infection or a generalized form can lead to:

  • damage to the eyes, nervous system, skin,;
  • stillbirth;
  • fetal asphyxia during childbirth.

Local forms of infection in newborns with herpes in the 3rd trimester are more common during exacerbation. Latent carriage is also recorded, as a result of an infection during childbirth.

If herpes came out during late pregnancy, then it is dangerous not only for the child. A woman may develop the following consequences:

  • protracted labor, including lengthening of the anhydrous period;
  • premature birth;
  • weakness of the mechanism of childbirth;
  • sepsis;
  • inflammation of the inner layer of the uterus;
  • inflammation of the mammary glands;
  • slowdown of uterine contraction after childbirth.

A child infected with HSV while passing through the birth canal of a mother with genital rashes may have a disease in the form of a local skin form, ophthalmic herpes, mouth lesions, as well as more severe forms and consequences:

  • pneumonia;
  • icteric skin;
  • mental retardation;
  • hearing loss;
  • visual impairment;
  • immunodeficiency.

Recurrence of a genital infection at 39 weeks and later is considered a reason for hospitalization in a maternity hospital. The decision on the method of delivery is made by a council of doctors.

What tests do moms need to take?

Pregnant women must donate blood for the presence of antibodies to HSV types 1 and 2.

A positive rHSV IgG antibody result during pregnancy is good and indicates protection for the baby.

Upon receipt of such a result, relapses of herpes are no longer considered so dangerous. If the number of exacerbations does not exceed 3 episodes per pregnancy, then there is no reason for concern.

The herpes virus in pregnant women in the blood is also determined and quantified. By means of PCR, it is possible to fix the viral load and prescribe treatment tactics.

An analysis of herpes during pregnancy from the cervical canal by PCR allows you to identify virion DNA and take measures to eliminate it.

How to treat herpes during pregnancy?

Treatment of herpes in pregnant women is determined by the form of pathology. The exacerbation of herpes is most often managed by local therapy of rashes, and with frequent relapses, courses of suppositories with interferon are used.

Primary infection should be treated with antiherpetic drugs - Acyclovir preparations. In addition, Acyclovir is prescribed for secondary generalized herpes and very frequent recurrences of infection (more than 4 times).

How to smear and how to treat herpes during pregnancy topically:

  • treatment of herpes during pregnancy excludes rashes in places;
  • the skin around the areas is lubricated with salicylic alcohol;
  • for drying and for the purpose of antiseptics, rashes are treated with brilliant green, fucorcin, hydrogen peroxide, methylene blue;
  • antiviral ointment for herpes based on acyclovir can be used on limited areas of the skin;
  • from herbal remedies, according to the reviews of pregnant women, calendula tincture, decoction of oak bark, Kalanchoe juice, St. John's wort tincture, decoction of sage leaves are recommended. The products are harmless for external use;
  • to accelerate the healing of rashes, sea buckthorn oil, rosehip oil are used. In the oral cavity, lesions are treated with Solcoseryl (dental paste).

In the 2nd and 3rd trimesters, there are practically no contraindications to the medical treatment of herpes; in the first trimester, funds are used after weighing all the risks.

Prevention of relapses

The possible negative impact of herpes on pregnancy necessitates the observance of preventive measures in the aspect of preventing frequent recurrences of infection.

Recurrent exacerbations associated with chronic infectious and non-infectious diseases can lead to immune deficiency, risk of interruption, and infection of the fetus.

The basis of the prevention of HSV during pregnancy is the strengthening of immune forces and the constant maintenance of the body's resistance to infections.

Since pregnancy is a time of physiological decline in immunity, it becomes more difficult to cope with viruses. For the prevention of secondary herpes, pregnant women need:

  1. Monitor hemoglobin levels. Anemia of any severity leads to hypoxia and a decrease in anti-infective immunity. A decrease in hemoglobin below 110 g / l should be the reason for revising the diet, and below 100 g / l - for taking drugs that increase this indicator (Totema, Maltofer and others).
  2. Pay special attention. It is necessary to consume a sufficient amount of protein through meat (beef, veal, turkey), fish (white and red sea fish 2 times a week), dairy products (fat content 3-6%), eggs (no more than one per day). Animal fats should be limited, giving preference to vegetable (linseed, olive, sunflower oils), nuts and seeds (in the absence of allergies) will be useful. The necessary vitamins, minerals, trace elements to strengthen the immune system can be obtained by consuming green vegetables, blue-colored fruits and vegetables.
  3. If you need to follow diets (for example, protein restriction), you should take multivitamin complexes for pregnant women or monopreparations, dietary supplements in consultation with your doctor (omega 3 acids, Femibion ​​and others).
  4. Timely correct exacerbations of other infectious diseases (tonsillitis, pyelonephritis, sinusitis, bronchitis and others). For this, it is necessary to regularly observe the relevant specialists. Throat swabs for flora, urinalysis, including bac. culture, in case of chronic infectious inflammation, must be taken more often than with a physiologically proceeding pregnancy.
  5. Avoid overheating. Vacation in hot countries during pregnancy is better to postpone, as climate change and intensive lower immunity. For recreation, you should choose countries with a similar familiar climate.
  6. Avoid hypothermia. To do this, you need to dress according to the weather, reduce the likelihood of prolonged drafts. Bathing in cold waters can provoke a recurrence of genital herpes.
  7. During the cold season, reduce the number of visits to public places (markets, hypermarkets, children's parties, etc.) in order to reduce the likelihood of ARVI. Respiratory viral infections cause an exacerbation of herpes during pregnancy. If you need to visit places where people are likely to gather, you should use a respirator.

HSV when planning pregnancy

Prevention of herpes recurrence when planning pregnancy occupies a special place in the prevention of adverse effects on the fetus. At the planning stage, a woman needs to visit many specialists in order to find out which infectious diseases in a sluggish chronic form may be present in the body.

Before pregnancy, it is necessary to undergo a minimal examination to determine the presence of chronic. Ultrasound of the internal organs, blood and urine tests, swabs and bacteriological cultures from the nose, throat allow you to draw up a general picture of the body's resistance to infections.

If there are more than 4 recurrences of herpes per year before pregnancy, it is necessary to visit an infectious disease specialist and an immunologist.

Frequent exacerbations of herpetic eruptions require prophylactic use to stabilize virus replication. Against the background of the normalization of the immune response, conception and gestation will not lead to a pronounced activation of HSV.

Treatment of herpes before pregnancy involves the appointment of medications:

  • antiherpetic drugs (Acyclovir, Valaciclovir, Famciclovir) courses;
  • immunocorrectors (Likopid, Polyoxidonium, Isoprinosine, thymus-based agents, interferon preparations and inducers). For a full-fledged preventive course of treatment, it is necessary to examine the indicators of cellular and humoral immunity by a blood test;
  • vaccination (Vitagerpovak, Gerpovax).

Genital herpes deserves special attention at the planning stage. Its frequent relapses before pregnancy indicate vaginal dysbiosis and a decrease in local immunity.

Against the background of HSV, chlamydia, papillomavirus infection, often occurs. Therefore, genital herpes is a reason for extended gynecological diagnostics:

  • analyzes for STIs by PCR;
  • microscopy of a smear from the vagina;
  • tank. sowing discharge on flora and sensitivity to antibiotics;
  • colposcopy;
  • smear for oncocytology.

The more pronounced vaginal dysbiosis, the more likely the herpes virus to penetrate through the cervix to the fetal membranes.

For most pregnant women, HSV is not dangerous; single recurrences of secondary herpes do not affect the fetus.

Particular attention is paid to women with immunodeficiency and aggravated obstetric history, as well as exacerbations of genital herpes before childbirth.

Herpes during pregnancy can be prevented and, with the help of modern methods of diagnosis and treatment, a negative effect on the fetus can be prevented.

The state of health of a pregnant woman directly affects the intrauterine development of her baby. It is important for expectant mothers to know how dangerous herpes is during pregnancy and whether it is dangerous for a child at all.

The herpes virus lives in the human body in a latent form, that is, hidden. It may never appear, but if it has already happened, relapses of the infection should be expected. Therefore, expectant mothers, who from time to time have "" in the corners of the lips or painful rashes in intimate areas, are worried whether the dormant form of the virus can affect the development of the embryo, or whether it is still the active form of infection that should be feared. Let's take everything in order.

Some statistics

Unfortunately, the fears of girls planning a pregnancy are far from unfounded. The herpes virus is a very dangerous biological agent that can have a teratogenic effect on living cells. This means that an active herpes infection in the mother can lead to the development of deformities in the fetus. In terms of teratogenic properties, the herpes virus is second only to the rubella virus.

Understanding the danger of herpes during pregnancy, doctors have studied for many years whether herpes infection affects pregnant women. Therefore, today a large amount of material has been accumulated about the features of the course of this disease.

The effect of herpes on pregnancy is well revealed by the following statistics:

To reassure expectant mothers, you need to know that herpes in pregnant women is not such a rare occurrence, but for the most part, their babies are born quite healthy. According to the latest WHO data, every second inhabitant of the Earth suffers from herpes on the lips, every fifth from genital herpes. But in order to protect your child, you must carefully monitor your own health. Herpes infection is treated at any stage of pregnancy, but the sooner action is taken, the lower the risk of infection of the fetus and miscarriage.

What is more dangerous: relapse or primary infection?

As it turned out in the course of numerous observations, recurrent herpesvirus is less dangerous for a woman in position than the primary manifestation of the disease. The fact is that when the body encounters a viral infection for the first time, it does not produce antibodies to it. Therefore, the clinical manifestations of pathology are especially vivid. The most dangerous is infection in the third trimester. So, in the first stages, a miscarriage or missed pregnancy may occur, in the later stages - a violation in the work of the internal organs of the fetus.

Unfortunately, all currently known measures for treating a patient with primary infection cannot prevent the sad consequences of herpes for the fetus.

With herpes, especially in expectant mothers, one should clearly distinguish between the phenomena of primary infection and the first relapse. It happens that the first episode of the disease proceeds unnoticed by a person, without any characteristic symptoms.

However, the immune system, once faced with an infectious agent, learns to produce specific antibodies to it, and if it flares up again, they will fight the disease.

To determine what exactly the doctor is dealing with, you can use a blood test. When herpes simplex virus particles enter the human body for the first time, class M immunoglobulin is found in his blood. If the disease recurs, the immune system will actively secrete.

A pregnant woman may not be infected, but her husband / sexual partner may be a carrier of the infection, and in a latent form. With unprotected sexual contact, herpes can be passed from an infected man to a healthy pregnant woman. To avoid this, couples must pass a series of tests together to eliminate all possible risks of infection transmission.

How to identify primary genital herpes during pregnancy

If, nevertheless, a woman, while pregnant, became infected with the herpes simplex virus in its most dangerous form - she will be able to understand this by the following signs:

External manifestations of the disease disappear completely after 1-2 weeks, leaving no noticeable traces. In the future, relapses of the disease from 1 to several episodes per year are possible. To achieve a stable remission is possible only by maintaining immunity at the proper level, which will contain the herpes virus in an inactive state.

Recurrent herpes infection in a pregnant woman

A secondary episode of the disease causes doctors much less concern than a primary infection. If the expectant mother suffered from the manifestations of the disease before pregnancy, then her body went through the most difficult stage and learned to defend itself by producing antibodies. These same antibodies protect the fetus inside the womb from the teratogenic effects of viral particles. The probability of transmission of the disease from mother to child with a relapse is no more than 1%.

However, the exacerbation of the infectious process causes a lot of discomfort and even pain, which is highly undesirable for a pregnant woman to endure. Therefore, it is important to prevent herpes when planning a pregnancy. To this end, the girl must cure all foci of chronic infections, if any. These include gastritis, caries, sinusitis, etc.

If the patient has bad habits, they will have to part with them and undergo a course of restorative treatment, after which you can become pregnant without fear.

As a preventive measure, doctors suggest that the patient take antiviral drugs, for example, Acyclovir. The dosage of drugs is calculated by the doctor in whom the woman is being observed.

Today, herpes during pregnancy is a very relevant topic, due to more frequent infections and relapses. If you are wondering if herpes is dangerous during pregnancy - yes, it is dangerous, but not always. Below we will talk about how a herpes infection affects pregnancy, whether there can be a miscarriage if herpes is detected in early pregnancy, and what drugs are used in its treatment.

Herpes and pregnancy is a rather serious phenomenon, which is scrupulously kept under the supervision of infectious disease doctors. The herpes simplex virus is a huge danger for the proper maturation and formation of the fetus. For example: according to teratogenic initiative, of all viruses, the ability to inflict ugliness on an embryo is only in the rubella virus.

As a result, the distinctive features of herpes, especially during pregnancy, have always been carefully examined. To date, scientific medicine has collected quite extensive material on this disease.

People are faced with a herpetic infectious disease much more often than one might imagine. Herpes in pregnant women is a particular threat to both the woman and the fetus.

Localization and types

Herpes during pregnancy behaves as usual in relation to the pregnant woman herself, the most common strains are:

  1. Herpes type 1. during pregnancy, everything is also localized in the form of bubbles near the labial borders and on the lips. more often transmitted through close contact with a virus carrier.
  2. Herpes type 2 during pregnancy is the cause of the same herpetic rash in the groin and genitals, which brings much more discomfort while in position. One of the varieties is, during pregnancy, it can lead to infection of the fetus.
  3. Type 3 virus - chickenpox and. Herpes zoster during pregnancy forms a rash around the trunk, less often it forms around the legs or around the forearms and arms. In the primary viral infection, shingles is a well-known chicken pox.
  4. Type 4 virus () - excites. The disease does not form a blistering rash.
  5. 5th type of herpes. runs without spillage. A characteristic manifestation is fever and symptoms of colds. Diagnosis - laboratory examination of a blood test.

Why do pregnant women have reduced immunity and how does herpes react to it

A possible relapse or secondary reproductive activation of a herpes infection invariably occurs against the background of a significant decrease in immunity. During pregnancy, a decrease in the protective functions of the body is called physiological and is considered a completely normal phenomenon.

As a rule, often the disease of herpes manifests itself during pregnancy. This is due to a significant decrease in immunity in women. Such a phenomenon occurs in the body in order to bear and preserve the fetus. In the event that the immunity of a pregnant woman functioned to the fullest extent possible, then the fetus would simply be rejected.

Based on the foregoing, we conclude: a reduced immune system during pregnancy is necessary. But at this point, the body is very susceptible to infection, especially in the second trimester. The fact is that during pregnancy in the 2nd trimester, a woman’s well-being becomes better, respectively, sex returns. And genital herpes, as a rule, is most often transmitted sexually.

The deterioration of immunity in the second trimester of pregnancy is due to a lack of a vitamin complex, which is energetically spent in the body during the formation and maturation of the fetus. In the third trimester, immunity decreases for the same reasons.

Statistics on the danger of herpes for the fetus

Consider the danger of herpes during pregnancy. It is pointless to object to medical statistics on herpes during pregnancy. In relation to this disease, she provides the following information and figures:

  • the carrier of the herpes virus of the first type, as well as the second type is literally 90% of the people on Earth;
  • with primary infection, the risk of infection of the fetus in utero is thirty to fifty percent, in recurrent herpes three to seven percent;
  • herpes in early pregnancy becomes the basis of spontaneous miscarriage in thirty percent of cases;
  • herpes during pregnancy in the 3rd trimester will cause a late miscarriage in fifty percent of cases;
  • in 40% of newborns, intrauterine infection actively leads to the formation of a carriage of a latent virus with the possible development of dysfunctional disorders at a later age;
  • in women who have had diseases asymptomatically or in atypical forms, sick children are born in seventy percent of cases. Infant mortality in this group itself is approximately fifty to seventy percent of cases. About fifteen percent of babies are born healthy.

It is important to take into account that the treatment of herpes during pregnancy can be carried out at any time. The more timely the expectant mother turns to the clinic to an obstetrician-gynecologist, the more timely the diagnosis will be carried out and both therapeutic and preventive measures will be prescribed. Otherwise, numerous complications of a different nature may arise.

With extensive rashes on the lips, in the nose, face, possibly on the mucous membrane of the genital organs or in the area of ​​any other part of the body, the attending physician directs the pregnant woman for additional studies, the purpose of which will be to identify the type of herpes virus that has entered the body. Herpesvirus type 1 is not as dangerous as the genital one. In this case, it is clear how herpes affects the condition of the pregnant woman and that the virus can bring serious complications.

Treatment methods for herpes during pregnancy

Let's analyze what goals the treatment of herpes infection during pregnancy pursues:

  • significantly reduce symptoms;
  • accelerate regeneration (restoration) processes;
  • reduce the duration of the acute period;
  • significantly reduce the severity of the release of an infectious virus in the affected areas;
  • reduce the number of relapses.

No therapeutic measures lead to the absolutely complete and final disappearance of the virus from the body for one simple reason - it always lives in a person. Nevertheless, it is realistic to eliminate symptoms as much as possible and reduce the number of secondary relapses.

Treatment with drugs

Of course, women need to know how to treat herpes during pregnancy, but do not use these drugs without consulting a specialist. The main drugs for combating herpes during pregnancy are a group of specialized drugs to increase the efficiency of the immune system:

  1. Interferon. Viferon - candles, gel, ointment. Immunomodulatory drug with antiviral effects. Pregnant women are allowed to use the drug for herpes in the second trimester;
  2. Interferon. Genferon - candles. Immunomodulatory drug with antiviral effects. It is used when absolutely necessary in the second and third trimesters.

Let's analyze which medications today have effective results, but with caution and only after the appropriate recommendations of the attending physician:

  1. Famciclovir-teva- tablets. An antiviral drug is used to treat diseases caused by the Varicella zoster virus and the Herpes simplex virus.
  2. Fenistil Pencivir- cream. An antimicrobial, antiviral drug is used in the treatment of recurrent herpes simplex - skin diseases for external use. Pregnant women use only on the recommendation of the attending physician;
  3. Valaciclovir. Antiviral drugs in the form of tablets are prescribed by the attending physician for systemic use. It can be used during pregnancy only if the expected benefit of therapy for a woman outweighs the potential risk to the fetus;
  4. Acyclovir - lyophilisate, cream, ointment, tablets, powder. An antiviral drug is used in the treatment, prevention of exacerbations or primary and recurrent herpes infections.

If before pregnancy, the expectant mother was already sick with genital herpes, then she needs to inform the gynecologist observing her about this. It is necessary to inform the doctor immediately when the first symptoms of exacerbation appear. Herpes during early pregnancy is dangerous for miscarriage of the fetus.

Early treatment will be more effective. The maximum effectiveness of the effects of antiherpetic drugs is noted before the appearance of a rash or within a day after the onset.

Prevention

In case of relapses, it is recommended to take sitz baths with herbal infusions of chamomile flowers and string, followed by the application of drying ointments. Doctors also strongly recommend that you seriously think about a healthy lifestyle: walk more often in the fresh air, maintain a calm psychological environment, and avoid stressful situations and depression.

It is necessary to include in your diet foods containing lysine (one of the amino acids that is part of proteins). Lysine slows down the mass reproduction of the virus. This amino acid is found in large quantities in fresh fruits and fresh vegetables, as well as chicken and fish. Sources of lysine are dairy products, legumes, some grain products, chicken and quail eggs.

Herpes is a group of viral infectious diseases that are characterized by lesions of the skin and mucous membranes, as well as the central nervous system, eyes, and internal organs. In recent years, more and more widespread genital herpes. The frequency of detection of this disease in Moscow is 19.7%, and only 1-5% of the population has clinical manifestations, that is, rashes. This statistic is especially relevant for pregnant women, because the herpes virus is dangerous not only for the mother, but also for her unborn baby.

horizontal path.Herpes is transmitted with unprotected sexual intercourse, if one of the partners is a carrier of the virus without symptoms or is in a period of exacerbation of the infection. Possible infection through orogenital contact. Those. the virus can be "received" from the mucous membranes or from the skin.

Vertical transmission herpes during pregnancy from mother to fetus. during pregnancy herpes can penetrate the mother's blood through the placenta, affects mainly the nervous tissue of the fetus. Infection can also occur during childbirth if a virus is released from the genital tract during this period.

autoinoculation, i.e. self-infection. A person from one part of the body himself transfers the infection to others in case of violation of the rules of hygiene. For example, with lesions on the lips (with "labial fever"), if elementary hygiene rules are violated, the virus can be introduced into the genitals.

Herpes and pregnancy: how the disease proceeds

Genital herpes in modern conditions, it very often (in 2/3 of cases) proceeds with erased or atypical symptoms, that is, without pronounced rashes characteristic of herpes, and only in 1/3 of cases has a typical clinical picture.

With a typical genital herpes on the labia, on the skin of the perineum, pubis or around the anus, small grouped vesicles filled with a clear liquid appear. The rash is accompanied by discomfort, itching, burning, pain. A few days before the rash appears, there may be shootings along the nerve due to inflammation of the nerve caused by herpes virus, irritability, body aches, joint pain, fever (more often with primary infection with the virus). Then the bubbles burst, in their place first sores are formed, then crusts, which disappear without a trace after 2-3 days, leaving no trace on the skin.

It is very typical that:

  • with successive exacerbations, bubbles always appear in the same place;
  • sores that form after the opening of the vesicles are painful;
  • crusts after falling off do not leave any scars or pigmentation on the skin.

In addition to the typical flow genital herpes there is also an atypical variant, when there are no vesicles characteristic of this infection, but there are symptoms that are uncharacteristic of herpes, but caused specifically by it: discharge from the genital tract, itching, burning, cracks in the perineum, labia or anus, swelling, redness of the mucous membranes. Often with atypical herpes pregnant suspect that they have thrush and self-medicate to no avail.

Virus carrying has become widespread, when there are no manifestations of the disease, but herpes is actively isolated from the female genital tract. It is a potential source of infection for a partner, as well as a baby in childbirth, but there are no symptoms. For the developed countries of Europe and the USA, a typical form of genital herpes is more typical, while for developing countries with a low social level, an atypical form and virus carriage.

Herpes and pregnancy: diagnosis

If, with a typical clinical picture, the diagnosis of genital herpes does not present any difficulty for the doctor, then with an atypical herpes and virus carriers, laboratory tests are required to make a diagnosis.

The main laboratory research methods:

  1. Study secretions from the genitals ways to the virus herpes simplex by electron microscopy, PCR (polymerase chain reaction), ELISA (enzymatic immunoassay), etc. Recently, the polymerase chain reaction (PCR) method has become widespread, since it is available, highly sensitive, specific, and gives results quickly.
  2. Blood test for antibodies to the herpes simplex virus, in which immunoglobulins of classes M and G are determined. The method is less accurate, since it is not the virus itself that is determined, but the body's reaction to it. Antibodies to the virus after contact of the body with it can persist for a long time. If the presence of class M immunoglobulins is determined, then this indicates a primary infection or an exacerbation of the disease. If only class G immunoglobulins are detected, this indicates that the woman has long been infected with the virus.

Herpes and pregnancy: complications

During pregnancy, a virological examination of secretions from the genital tract is periodically carried out (this analysis detects the virus herpes during pregnancy), a blood test for immunoglobulins of classes M and G, ultrasound.

Signs of intrauterine infection by ultrasound can be a suspension in the amniotic fluid, a "thick" placenta, low and polyhydramnios, cysts of the fetal brain. If symptoms are suspicious, a more in-depth examination is performed, and if a simple virus is detected, herpes during pregnancy- treatment with control tests after its completion.

To avoid exacerbation herpes during pregnancy it is advisable to avoid stress, spend more time in the fresh air, take vitamins for pregnant women. But if, nevertheless, an exacerbation occurs, then it is necessary to undergo complex treatment. The sexual partner also needs to undergo a course of therapy if he has a virus from the genital tract. During an exacerbation of a herpes infection in one of the partners, sexual rest is necessary until the end of treatment and negative examination results.

At the time of exacerbation, sexual activity - even with the use of a condom - is excluded. If a woman is first infected herpes during pregnancy(i.e. if it was not an exacerbation of an already existing herpes), there is a possibility of malformations in the fetus, especially if the disease began in the early stages of pregnancy, when all organs and tissues of the fetus are being laid. In such a situation, it is necessary to take a blood test at 16-20 weeks of pregnancy for markers of possible malformations of the fetal neural tube (alpha-fetoprotein, beta-hCG, estriol), undergo an ultrasound scan at 18-24 weeks of pregnancy with an expert assessment of all organs of the fetus. Such a study is carried out on good equipment by highly qualified specialists. If necessary, a consultation with a geneticist is carried out.

The most common complication during pregnancy is the threat of miscarriage and the threat of premature birth. Spontaneous miscarriages, non-developing pregnancy for up to 16 weeks, prenatal rupture of amniotic fluid, premature birth, intrauterine fetal growth retardation are possible. If a woman has already had similar situations before, she should be examined for the herpes simplex virus before planning pregnancy, given the high frequency of atypical forms and virus carriers. When pregnancy occurs, it also becomes necessary to test for the herpes virus at least 3 times (in the first, second, third trimesters, and also on the eve of childbirth).

It should also be noted that very often the simplex virus herpes during pregnancy is detected not alone, but in combination with other pathogenic microbes, most often with cytomegalovirus and ureaplasma.

In recent years, numerous scientific studies have proven the relationship between herpes infection and blood clotting disorders. With this disease, increased blood clotting is detected as a result of autoimmune conditions, when the immune system "does not recognize" its own tissues and cells and produces antibodies to them, as to foreign proteins. Therefore, in women with genital herpes during pregnancy Periodic extended examination of blood for clotting is especially important. If violations are found, they are corrected.

How to treat herpes during pregnancy

Treatment of genital herpes during pregnancy is reduced mainly to immunotherapy, chemotherapy, or a combination of both. The most natural method is immunotherapy, since herpes is a disease of the immune system.

Immunotherapy. Many immunomodulators (drugs that correct the state of immunity) are prohibited during pregnancy: they are usually used to prepare for an upcoming pregnancy under the control of an immunogram - a blood test that reflects the state of the immune system. Interferon preparations are widely used to compensate for its insufficient production in the body. pregnant with herpes. Interferon is a protein that is normally produced in the body; it is able to fight all viruses - this is one of the mechanisms of non-specific defense of the body. With severe immunodeficiency, as well as with a significant number of rashes, immunoglobulin preparations can be used intravenously. Usually 3 courses of treatment are carried out - in the first, second and third trimesters. This method is used when there is insufficient production of one's own immunoglobulins - antibodies against the virus.

Chemotherapy. Patients are prescribed drugs that directly inhibit the reproduction of the virus (ACICLOVIR and its analogues). They are taken orally, although there are also intravenous forms for severe cases. The duration of therapy is not more than 5-7 days, with longer use, drugs can suppress the immune system. During pregnancy ACYCLOVIR prohibited until 34-36 weeks of pregnancy due to the alleged teratogenic effect (possibility of fetal malformations).

If in the third trimester the herpes simplex virus is released from the genital tract or an exacerbation of typical genital herpes (vesicles) occurs, then from 34-36 weeks you can use ACYCLOVIR before childbirth, in order to prevent operative childbirth, so in case of exacerbation of herpes at the time of childbirth, delivery is carried out by caesarean section to avoid infection of the baby.

Other methods. Recently, such methods of treatment as ozone therapy, hyperbaric oxygen therapy 1 , treatment with complex enzyme preparations that stimulate the immune system, strengthening the body's defenses in the fight against the virus, have become widespread. herpes during pregnancy.

Ozone therapy is a method of treatment with an active form of oxygen, which, on the one hand, suppresses the reproduction of the virus, and on the other hand, stimulates metabolic processes in the body, the immune system, which is important in the fight against viral infection. The method is used both before and after pregnancy, and, which is very important, it can be used from early pregnancy. Ozone therapy is used intravenously (usually 8-10 procedures per course of treatment), as well as irrigation of the vagina with ozonized solutions.

Herpes of the newborn

Usually (in 60-80% of cases of all neonatal infections) infection occurs from mothers with asymptomatic or unrecognized genital herpes. Most mothers were asymptomatic and did not know they were infected until the baby was infected.

Infection of the fetus occurs in several ways.

Ascending path - from the vagina and cervical canal herpes virus penetrates the fertilized egg. It is possible for the virus to enter the amniotic fluid through the fetal membranes. The embryo can be infected already at the time of implantation with a virus from the semen.

Transplacental transition - herpes virus penetrates to the fetus from the blood of a pregnant woman. From the blood, the causative agent of the disease enters the placenta, then into the vascular system of the fetus and spreads in its organs.

Intranatal (during childbirth) infection occurs when the fetus passes through the infected birth canal: in about 90% of cases of neonatal herpes, the situation is exactly this.

Postnatal infection herpes occurs after childbirth - with herpetic manifestations on the skin of the mother, medical personnel, and other relatives.

The frequency of neonatal herpes is from 1 case per 60-70 thousand births in England to 1 case per 1800 births in the USA. On average, the incidence of neonatal herpes ranges from 1 in 2500 births to 1 in 7500 births. The incubation period (from infection to the first manifestations of the disease) can last from several days to several weeks.

The manifestations of neonatal herpes infection are varied. There are various forms of this disease:

  • localized (skin, mucous membrane of the mouth and eyes are affected);
  • herpetic encephalitis- brain damage, which is characterized by convulsions, drowsiness, irritability, tremors, poor appetite, unstable body temperature. Surviving children have neurological damage in the form of delayed psychomotor development, brain cysts, visual impairments up to blindness;
  • generalized form which affects the internal organs and the brain.

Herpes and pregnancy: childbirth

Since the infection of the child mainly occurs intrapartum at the time of childbirth, during or on the eve of childbirth, it is necessary to check the woman for the isolation of the virus from the cervix. If the virus is not isolated, childbirth is carried out through the natural birth canal. If an infection is detected, then it is advisable to perform a caesarean section, provided that the fetal bladder is intact or the anhydrous interval is not more than 4-6 hours, since with a larger anhydrous interval, the probability of infection of the child is high even during surgical delivery.

In conclusion, I would like to remind you once again: genital herpes is a serious diagnosis, but it is by no means a sentence. With the timely detection of the disease in the expectant mother, the prognosis for the baby is usually favorable.

1 Hyperbaric oxygenation (HBO) - the use of oxygen under high pressure for medical purposes in a special pressure chamber.