Hospitals 

What is HSV and why is it dangerous for a pregnant woman? The main manifestations of the disease. Treatment of herpes during pregnancy folk remedies

Herpes infection is a common disease caused by the herpesvirus family. When infected, the bacterium enters the cell and changes it at the genetic level. Only an organism with a developed immune defense aimed at recognizing and destroying modified cells can cope with the disease.

Hormonal restructuring, unstable emotional state significantly weaken the immunity of expectant mothers, making them defenseless against the insidious virus. The danger cannot be underestimated: the virus can provoke severe malformations.

Causes of herpes during pregnancy

Infection with a herpes infection occurs by airborne droplets or through contact (including household). Herpes can be in a woman's body in a latent state for a long time, without manifesting itself. A number of factors contribute to the activation of the virus against the background of weakened immunity:

  • hypothermia or long stay in a hot climate;
  • viral diseases (, SARS);
  • , overwork, nervous breakdown;
  • improper nutrition.

Signs of herpes infection in pregnant women

The symptoms of herpes are not unambiguous: the manifestation can be individual.

The most typical signs of herpes simplex virus type 1 or 2 (genital) are:

  • the appearance on the lips, nasal fold, mucous membrane of the eyes of rashes in the form of bubbles;
  • painful rashes on the genitals, redness of the skin, itching (with genital herpes);
  • cold symptoms: fever, weakness, chills.

An accurate diagnosis will help to put a blood test for immunoglobulins Ig G and Ig M.

Diagnosis of herpes in early and late pregnancy

A pregnant woman at the first sign of herpes should consult a doctor.

important In the early stages, it is necessary to undergo a blood test for immunoglobulins (Ig). The analysis will show the presence of the causative agent of the virus in the body, determine whether the infection is primary (Ig M) or recurrent (Ig G).

It is possible to diagnose the virus with a multilevel laboratory study, which includes:

Herpes after childbirth: so that the baby is healthy

The risk of infection of the child from the mother in the process of passing through the birth canal is very high. The transmission of the virus occurs as a result of trauma to the birth canal and skin of the baby, especially if there was an instrumental intervention. The baby may be born with skin ulcers, cataracts, and other severe lesions.

To reduce the risk of infection, a woman is given antiseptic treatment of the birth canal. In some cases, a caesarean section is prescribed, but the operation is not a guarantee of excluding perinatal infection.

Signs of herpes may appear in a newborn after a few days:

  • bubble rashes;
  • intermittent breathing;
  • elevated temperature.

Premature babies may develop signs of brain damage (herpetic encephalitis): drowsiness, convulsions.

Treatment depends on the severity of the disease. Usually, drugs will be prescribed to increase immunity, suppress the vital activity of pathogenic microorganisms, and improve cerebral circulation. The woman is offered to continue taking Acyclovir. The same drug is given to the child.

important Do not refuse the medical measures prescribed by the doctor. Timely therapy of herpes gives a good chance to save the health and life of the baby.

Lives in the body of every second person. Pregnant women can become infected with it both during childbearing and before that. In the first case, intrauterine infection occurs in 30-50% of cases, and in the second - in 6%. It has been proven that infection with this virus in the first weeks of pregnancy in 30% of women provokes spontaneous abortion, and in the second and third trimesters, 50% have a late miscarriage. Every 4th child who was infected with herpes in utero has a latent carriage of the virus and dysfunctional disorders that appear with age. 70% of newborns are born already sick with herpes, if the mother has its atypical or asymptomatic form.

Important:every woman should know that herpes during pregnancy can be treated. And they do it at any gestation period. Preventive measures and therapy should be started as early as possible to avoid complications.

The herpes virus begins to activate in the body when the body's immune defenses are lowered. Pregnant women are especially vulnerable in this regard.

Table of contents:

Why is herpes dangerous during pregnancy?

During the period of pregnancy, a woman must take a blood test for, which are considered the most dangerous for her unborn child. Two of them are and . Both of them are varieties of herpes and do not have a negative effect on the woman herself, unlike the fetus. Bypassing the placental barrier, these viruses adversely affect the unborn child. The consequences of such infection depend directly on the gestational age and the period of pregnancy.

Risks to the fetus

The teratogenic effect of the virus is highest in the first trimester, when the placenta has not yet formed, resulting in the formation of various kinds of defects in many organs and systems. The main targets are the nervous and cardiovascular systems, the liver. When a child is infected, the development of such pathologies is possible.:

Note:the likelihood of contracting herpes in the fetus during pregnancy is actually not that high. The maximum danger is the primary infection with type 2 virus of the mother, when the risk of its transmission is 50%, as well as the period of exacerbation of herpes in a chronic form when it is released into the blood.

Usually, infection occurs during childbirth, both natural and by caesarean section.

Risks for the mother

In a pregnant woman, herpes can cause such complications:

  • termination of pregnancy in the form of early and late abortion;
  • freezing of the fetus;
  • the birth of a dead child;
  • premature birth.

Of particular danger is hamerican pregnancy, then the fetus is already dead, but its rejection and expulsion from the uterine cavity did not occur. In this case, a woman can feel normal, while the decay products of the embryo cause intoxication of the female body. This provokes , .

Nevertheless, the birth of a healthy child in the presence of herpes is quite real, because the main factor in protecting the fetus in this case is the mother's antibodies to the virus, which act even after birth for several months.

Herpes type 1 during pregnancy and its treatment

It is also a virus, which is manifested by rashes on the mucous membranes and skin around the lips and nose. The rash looks like bubbles with liquid, which cause itching and pain, and when opened, leave erosion and crusts. Often for the first time it manifests itself in women during the period of bearing a child. There is no direct threat to the fetus in this situation, but there is also no 100% guarantee that the virus does not enter his body by the hematogenous route.

If there are single rashes on the lips of a woman, do not worry, as this is not a terrible threat to a developing child. In such cases, the natural immune defense mechanism is enough to defeat herpes.

In any case, in the presence of herpetic eruptions of any localization, it is worth visiting a doctor so that he assesses the real degree of risk to the fetus and, if necessary, prescribes therapy. Usually, treatment comes down to increasing the woman's immunity by prescribing immunoglobulins that are allowed during pregnancy, as well as vitamins.

There is no drug that can cure herpes. The means used to prevent the appearance of rashes and their spread. In particular, local treatment is prescribed in the form of applying Panavir gel, which is one of the few drugs approved for use during pregnancy. It is applied to rashes up to 5 times a day. From traditional medicine, cauterization is used with propolis infusion, fir oil, (pharmacy),.

Herpes type 2 (genital herpes) during pregnancy and its treatment

With confirmed type 2 herpes during pregnancy, especially if it was detected for the first time, the doctor will definitely prescribe treatment. It will help stop the reproduction of the virus, thereby reducing the likelihood of its transmission to the fetus. In practice, antiherpetic drugs are indicated during the period of exacerbation after 36 weeks. Usually prescribed:

  • Famciclovir;
  • Valaciclovir;

Dosage, frequency and method of application is always determined individually by the attending physician. The course of therapy is up to 2-3 weeks. The above funds are class B safe during pregnancy. That is, during the study on animals, their negative effect on the fetus was not noted, but there is no exact data on their effect on pregnancy in humans.

Herpes type 3 (chickenpox) during pregnancy and its treatment

This type of virus causes primary contact, and if a woman has already been ill with it, then herpes Zoster is secondary. In the first case, there will be a picture of a characteristic rash all over the body, with itching, and erosions at the site of the blisters. In the second, a rash appears along the large nerves (on the abdomen, back, limbs, head) and causes severe pain.

A real threat exists if a woman becomes infected with chickenpox for the first time during pregnancy, since she does not have active immunity to this disease.

Note:studies have shown that chickenpox in a pregnant woman after contact with a sick person is more dangerous for the fetus than chickenpox, which developed as a result of contact with a sick herpes zoster.

That is why, with the appearance of a rash similar to herpes zoster, it is important to contact an infectious disease specialist as early as possible. When confirming the diagnosis, the appointment of Acyclovir is indicated to stop the reproduction of the virus in order to reduce the risk of complications. Also, in the absence of immunity to chickenpox, the introduction of anti-herpes serum is indicated, especially if the woman had contact with a patient with chickenpox or herpes zoster. For its introduction to be effective, this should be done within 4-5 days after contact with the patient.

Type 4 herpes (Epstein-Barr virus) during pregnancy and its treatment

This type causes such a pathology as. The latter, in turn, provokes. Once in the body, it remains in it forever, and periodically makes itself felt when the immune defense is reduced. It affects the internal organs, nervous and lymphatic tissues, it is characterized by a sluggish course.

Infection with it during pregnancy is more dangerous than before it, since the consequences in this case can be completely different. This is due to the fact that the presence of antibodies to the virus in the mother's blood will also protect the fetus during repeated contact with this type of herpes from developmental defects, intrauterine death. If the Epstein-Barr virus is in a woman's body in a latent form, then it does not cause miscarriages and fetal abnormalities, it is not transmitted to the child. That is, it has an asymptomatic course or a typical picture of a mild degree.

In 0.1% of infected women, against the background of an already existing immunodeficiency, it proceeds in an acute form and is called infectious mononucleosis. As a result, recovery, chronic infection or asymptomatic virus carriage can be observed. It all depends on the state of immunity of the pregnant woman. In relation to the fetus, EBV can provoke such pathologies:

  • chroniosepsis of recurrent type;
  • premature termination of pregnancy;
  • damage to the nervous system;
  • hepatopathy;
  • fetal hypotrophy;
  • pathology of the organs of vision;
  • respiratory distress syndrome.

With intrauterine infection of the fetus and latent infection, after birth, the child may develop lymphadenopathy, hepato- and splenomegaly. Treatment is carried out only in case of clinically expressed symptoms in a hospital.

Type 5 herpes (Cytomegalovirus) during pregnancy and its treatment

This is one that has a great affinity for the spleen, liver, and nervous tissue. This type of herpes can adversely affect pregnancy, as it crosses the placental barrier. The main ways of its transmission: contact and airborne. Today, the cause of death of newborns and neonatal pathologies is often cytomegalovirus. He provokes the development of various defects:

Herpes during pregnancy - what kind of disease is it, how is it transmitted, how is it treated and can it affect the health of the unborn child?

A rash on the lips, which manifests itself in the form of bubbles, is nothing more than herpes. This is a disease of viral origin, according to the statistics of the World Health Organization, 95% of the population of the entire planet is infected with it. The virus is transmitted not only by physical contact: a kiss, cosmetic accessories and household items, but also by airborne droplets, as well as from mother to child in utero or during childbirth. In this regard, genital herpes gives risks during pregnancy, that is, when the virus directly affects the internal and external genital organs.

Virus types and complications

There are several types of virus. They are associated with various complications. Often there is herpes on the lips during pregnancy, this is the so-called labial type. Doctors consider him safe for the unborn child. Especially in cases where a woman has had rashes for many years in a row. It causes such manifestations, as a rule, herpes type 1 during pregnancy. Its symptoms are swelling, redness, inflammatory reaction, followed by the appearance of a group of bubbles on the lip. They pass in 1-2 weeks with more or less normal immunity and compliance with the rules for preventing the spread of infection.

Herpes type 2 during pregnancy is more often localized on the mucous membrane of the genital organs. Infection occurs during sexual intercourse. Therefore, some doctors suggest that this disease be classified as a sexually transmitted infection. And it is with this localization that the herpes simplex virus during pregnancy can harm the baby. The infection can enter the child's body by penetrating from the vagina through the cervix directly into its cavity, into the amniotic fluid. Often, infection occurs during childbirth, in case of activation of the virus at that time.

Herpes in the first trimester of pregnancy can lead to miscarriage and severe malformations of the fetus, its organs and systems, deafness. If such a child is born and survives, he will be disabled. That is, whether herpes is dangerous during pregnancy can not even be said. Of course yes. But the risks are especially great with the initial manifestation of infection during this period. Then some doctors even recommend an abortion. But if there is a relapse, there is every chance to endure and give birth to a healthy baby.

When the 2nd trimester of pregnancy, herpes does not give up. It can cause sepsis, anemia, jaundice in the fetus. Performing an ultrasound, the doctor can note signs of intrauterine infection, such as: calcifications in the organs of the fetus, stretching of intestinal loops, hydrocephalus, etc.

Herpes during pregnancy 3rd trimester is polyhydramnios, premature birth, edematous syndrome, intrauterine growth retardation.

Of course, it is impossible to determine the same polyhydramnios or problems with blood circulation in the loops of the umbilical cord - these are the consequences of herpes during pregnancy or not. But if during the period of bearing a child, a woman often has relapses of the disease, and even more so if the infection occurred after conception, natural childbirth is a huge risk for the child. Do a caesarean section. Although the operation is not a guarantee that the baby will be born healthy.

That's why herpes is dangerous during pregnancy at different times. Therefore, it is so important to become pregnant during the remission of the disease, at least relative, and, if necessary, be treated. And healthy women should prevent infection after the conception of a child. By the way, the onset of pregnancy with genital herpes is quite possible. Only in severe forms, this virus can affect a woman's reproductive abilities and lead to infertility.

How to be treated

Unfortunately, it is generally accepted that a rash on the lips in the autumn-winter period is normal. But not all people suffering from herpes know that treatment with folk methods can lead to serious complications. So how to be? How to avoid fatal mistakes in the treatment of this disease?

Dangerous treatments for herpes

Since in the first weeks after conception the formation of all organs and systems occurs in the child, some “folk healers” advise treating herpes in the early stages of pregnancy with the following means.

Iodine and alcohol. This method is unsafe in that it can cause a rather severe burn on the affected area of ​​the skin, and it will heal up to two weeks. In this case, it is better to use sea buckthorn oil.

Toothpaste. Contained in toothpaste, menthol creates only the illusion of getting rid of or curing herpes. In fact, this is not so, and this method is dangerous. This is due to the fact that almost all toothpastes contain titanium dioxide, and it, in turn, getting after menthol on the area of ​​​​the skin affected by herpes, begins to corrode the wound from the inside, which will only delay the healing process. But such an ingredient as a detergent, it is added to the paste so that it foams more strongly, can cause a violation of the vital functions of the body.

Earwax. It is not known who came up with this method of treating herpes, but by resorting to this method, there is a risk of an inflammatory process. Because earwax contains a lot of bacteria. These microbes and bacteria will only prolong the disease.

Precautionary measures

If herpes began to appear on the lips, then in no case should you scratch it and touch it with your hands so as not to spread its viral cells all over the lips. Always remember how herpes affects pregnancy, what it can lead to. Moreover, herpes can appear not only on the lips. For example, if it gets into the eyes, ophthalmic herpes will occur, and if it gets on the genitals, genital herpes.

Help from a doctor and products containing lysine

If the body is affected by the herpes virus, it is necessary to consume foods that contain the amino acid lysine as much as possible. It is found in lactic acid products, fish, eggs, meat and hard cheeses.

And how to treat herpes during pregnancy depends on the period. Until 36 weeks, it is recommended to use only creams and ointments. These are "Acyclovir" and "Zovirax" of the most famous. They can be applied to the lips and genitals. The only common side effect when used correctly is a slight burning sensation if the cream is applied to an ulcerated mucosa.

Question: Hello! The child on the 21st day of birth had herpes meningoencephalitis. During pregnancy, there were G titers for all infections, the pregnancy proceeded perfectly, the delivery was on time, according to the doctors, the child was born healthy. Could you tell me if this is an intrauterine infection or not?

Answer: Intrauterine herpetic infection manifests itself in the first 24-48 hours of a child's life. Later development of neonatal herpes (14-21 days) is usually associated with infection of the child during childbirth during the passage of an infected HSV birth canal. A more complete answer could be obtained by a comparative study of IgM and IgG antibodies in the blood sera of mother and child. Doctor of the highest category, obstetrician-gynecologist, virologist E.V. Borisova

Question: Hello! I'm planning to get pregnant! Ig G antibodies to HSV 1 and 2, titer 1:6400 (strongly positive). I know that G shows that a person has had a virus, and he is in a chronic form. Does this situation require treatment with antiviral drugs or is it necessary to pass an analysis for class M antibodies? Thanks in advance for your reply.

Answer: IgG only indicate that a person is a carrier of HSV infection. High titers of IgG indirectly indicate that HSV infection may be active. IgM - are rapidly destroyed and may not be detected even with active HSV infection. To determine the activity of the virus, it is necessary to donate blood, urine, saliva, a smear for HSV by the sowing method (CD). Herpes is often combined with CMV infection. So, when preparing for pregnancy, we recommend excluding it as well. Doctor of the highest category, obstetrician-gynecologist, virologist I.A. Dolgopolova

Question: Good day! I'm 12 weeks pregnant and HSV-2 recurs almost every week. A couple of weeks ago there was an IgG titer of 1:160, now 1:6400 - what does this mean, a reaction to a relapse or a serious threat of pregnancy?

Answer: The indicated increase in IgG is significant (provided that the analyzes were performed in the same laboratory). And even without this examination - weekly recurrences of herpes - a bad sign. You need to contact a gynecologist-virologist, who will prescribe the necessary (and acceptable for the duration of pregnancy) course of treatment. Doctor of the highest category, obstetrician-gynecologist, virologist, MD N.V. Dolgushin

Question: Good evening! During the first month of pregnancy there were 2 recurrences of genital herpes. Tell me, how dangerous is this relapse for the further development of the fetus? Does something need to be done?

Answer: The frequency of relapses is not the only and not the most important criterion in assessing the possible complications of herpes during pregnancy. The virus can infect the skin and mucous membranes, but not "exit" into the blood, namely, viremia is the main danger to the fetus in any form of herpes. To clarify the activity of a viral infection, you need to donate blood, urine, a smear for the isolation of HSV (and / or CMV) in the crop. If a virus is detected, a pregnant woman is recommended to be treated with drugs approved for use at this stage of pregnancy. Doctor of the highest category, obstetrician-gynecologist, virologist O.A. Lutovinova.

Question: Hello, I am 9 weeks pregnant. Pregnancy desired!! Has handed over analyzes on a cytomegalovirus and a virus of a herpes simplex. Cytomegalovirus was not detected, but about the herpes virus it is written IgG titer AT 1:1000. The gynecologist from the antenatal clinic sends for an abortion. What to do? Help!

Answer: Herpesvirus infection (HSV or CMV) is not an indication for abortion. However, the detection of HSV or CMV in the blood (in saliva, urine, smear) during pregnancy (in culture or by PCR) is an indication for a pregnant woman (according to the results of virological monitoring) of a complex of therapeutic measures aimed at preventing the development of pathology of pregnancy, the fetus and newborn Doctor of the highest category, obstetrician-gynecologist, virologist I.A. Dolgopolova.

Question: How does the herpes virus spread?

Answer: According to numerous studies, by the age of 18, more than 90% of urban residents are infected with one or more strains of at least 8 clinically significant herpes viruses (herpes simplex types 1 and 2, varicella zoster, cytomegalovirus, Epstein-Barr, human herpes 6 and 8- types). In most cases, primary and re-infection occurs by airborne droplets through direct contact or through household and hygiene items (shared towels, handkerchiefs, etc.). Oral, genital, orogenital, transfusion, transplantation and transplacental routes of infection transmission have also been proven.
After infection of a cell, for example, with herpes simplex virus type 1 or 2, the synthesis of new viral proteins begins after 2 hours, and their number reaches a maximum after about 8 hours. The fastest rates of virion cloning occur in epithelial and mucous membrane cells, blood and lymphatic tissues.

Question: How long does the herpes virus live?

Answer: Completely formed and ready for subsequent reproduction, “daughter” infectious virions appear inside the infected cell after 10 hours, and their number becomes maximum after 15 hours. During its entire life, the primary (“mother”) viral particle reproduces from 10 to 100 “daughter” viral particles, and in 1 ml of the contents of the herpetic vesicle there are from 1000 to 10 million viral particles. Virions are extremely thermostable - they are inactivated (destroyed) at 50-52 degrees for 30 minutes, at 37.5 degrees - for 20 hours, stable at -70 degrees, stored in tissues for a long time. On metal surfaces (coins, door handles, water taps) herpes survives for 2 hours, on plastic and wood - up to 3 hours, in wet medical cotton wool and gauze during the entire time they dry at room temperature (up to 6 hours). A unique biological property of herpes viruses is the lifelong preservation of viruses in a modified form in the nerve cells of the regional (in relation to the place of herpes introduction) ganglia of sensory nerves. The most active in this regard are herpes simplex viruses (labial and genital), the least active is the Epstein-Barr virus.
All known varieties of herpes viruses are capable of recurring. For example, recurrence of infections caused by the herpes simplex virus is often observed against the background of stress, nonspecific endocrine disorders, changes in the geographical area of ​​residence, increased solar exposure, etc. Asymptomatic relapses of cytomegalovirus infection are most often observed in pregnant women and patients receiving immunosuppressive and hormonal therapy . In general, herpetic infections take a recurrent course in no more than 8-20% of patients with obvious malfunctions in the immune system.
The herpes virus is the most common sexually transmitted infection in pregnant women.
Studies conducted at the Moscow Herpetic Center have shown that the diagnosis of the herpes simplex virus is now complicated due to the fact that in 65% of cases the disease proceeds atypically.
Herpes viruses can lead to infection of the fetus transplacenally or ascending through the birth canal (more often in childbirth, but also possible during pregnancy). It should be noted that during pregnancy, anatomical changes occur in the woman's body, aimed at protecting the fetus from infection ascending from the lower genital tract.

Question: Why is herpes dangerous in a pregnant woman?

Answer: Primary genital herpes in the mother and exacerbation of chronic herpes, accompanied by the release of the virus into the blood, are very dangerous for the fetus. The risk of infection of the child in childbirth reaches 40%. Damage to the fetus and placenta can occur at any stage of pregnancy and lead to the formation of congenital malformations, fetal death, miscarriage or premature birth. Adverse outcomes for the fetus are mainly associated with the transplacental (hematogenous) transmission of herpes viruses. Infection of the fetus in the first trimester of pregnancy leads to hydrocephalus, heart defects, anomalies in the development of the gastrointestinal tract, etc., spontaneous abortion is often noted. Infection in the II and III trimesters leads to the development of herpetic hepatitis, pancreatitis, anemia, jaundice, pneumonia, herpetic meningoencephalitis, sepsis, and malnutrition in the fetus. With the ascending route of infection, the herpes virus multiplies and accumulates in the amniotic fluid, polyhydramnios is noted. It is also possible postpartum infection of newborns in the presence of herpetic manifestations on the skin of the mother, relatives or medical personnel. Thus, infection of the fetus before 20 weeks of gestation leads to spontaneous abortion or fetal abnormalities in 34% of cases. In terms of 20 to 32 weeks - to premature birth or intrauterine death of the fetus in 30 - 40% of cases. Primary infection of the mother with herpes after 32 weeks of pregnancy - to the birth of a sick child with skin lesions (herpetic eruptions, ulceration), which is quite rare, eyes (cataracts, microphthalmia, chorioretinitis), and the central nervous system (micro - and hydrocephalus, cerebral necrosis) . With severe lesions of the newborn (herpetic meningoencephalitis, sepsis), death occurs in 50% - 80% of cases. With timely initiation of treatment, mortality is reduced to 20%. Surviving children in the future have severe complications (neurological disorders, visual impairment, psychomotor retardation).

Question: Is pregnancy possible with herpes?

Answer: All these figures are disappointing. However, timely examination allows you to determine the presence, activity and course of herpes infection in the body. It is completely impossible to get rid of the virus, but it is possible to reduce its activity and increase the body's specific defense factors. It is especially important to conduct an examination and, if necessary, treatment in the event that a pregnancy is planned.
You should not think that only genital herpes is dangerous during pregnancy. During pregnancy, against the background of physiological immunodeficiency, in the event of a herpetic rash on the face, the herpes virus can be isolated in the mother's blood, which is the most dangerous for the fetus.
Cytomegalovirus, unlike the herpes simplex virus, does not have characteristic clinical manifestations and most often its activation is asymptomatic, less often under the guise of SARS. Women most often learn about their infection when they begin to be examined for infertility or pregnancy pathology. The Moscow Herpetic Center has developed new effective herpes treatment methods that allow women with herpes to prevent complications during pregnancy and give birth to a healthy baby.

Question: What to do if a herpes virus or cytomegalovirus is found in smears during pregnancy and there are no complaints from the genitals?

Answer: You should not be afraid of this even if you have never had clinical manifestations of a herpes infection (on the face or on the genitals). You should contact a virologist and conduct a comprehensive virological examination to make a correct diagnosis and detect virus activity. Only in this case it is possible to predict the situation. If the virus entered the body before pregnancy, and specific antiviral antibodies are present in the blood, then the risk of intrauterine infection of the fetus is 0.04-0.1%. The greatest danger to the fetus is the release of the virus antigen in the blood of a pregnant woman. However, in this case, the risk of infection of the fetus depends on many factors: the condition of the fetus and newborn, the activity of the pathogen, the state of the mother's immune defenses, the duration of pregnancy, etc. Carrying out the necessary preventive courses during pregnancy allows you to avoid infection of the fetus and newborn, even if the mother has an active herpesvirus.

Question: I am planning a pregnancy. During the examination, antibodies to cytomegalovirus were detected in my blood. What to do?

Answer: The wide and ubiquitous prevalence of cytomegalovirus in nature, the variety of ways and means of its transmission, the ability of the virus to persist for a long time in the host organism lead to almost total infection of the adult population with this virus. So, according to serological mass screening studies conducted in the United States, traces of the transferred cytomegalovirus are detected in 30-45% of people aged 20-25 years, and in people older than 40-50 years this figure reaches 70-80%. Human infection with cytomegalovirus usually goes unnoticed, and cytomegalovirus infection itself occurs without pronounced clinical manifestations and often remains unrecognized. Often, the detection of markers of a past cytomegalovirus infection is a diagnostic finding during an in-depth examination. The frequency of chronic forms of cytomegalovirus among the population is 15-18%. Chronic infectious process proceeds with periods of long remissions from several months to several years. In this case, we are talking about the so-called healthy virus carrier. To get a correct and competent assessment of the result of your blood test for the isolation of antibodies to cytomegalovirus and recommendations for pregnancy, you need to consult a specialist.

Question: I have recurrent genital herpes. My wife has not been diagnosed with herpes and is currently pregnant. How to save a child?

Answer: The risk to the fetus is especially high if the mother is first infected with any type of herpes during pregnancy. If this happens in the last few weeks, the risk of transmitting the virus is 50%. With primary herpes at any stage of pregnancy, there is the possibility of transplacental transmission of the virus to the fetus. Among children infected with herpes, this route of transmission is 5%. Therefore, if you have genital herpes (or any other herpes virus), you must take all possible precautions so as not to infect your spouse: exclude sexual intercourse during a relapse, conduct a semen test for virus isolation, use barrier contraception. It makes sense to seek advice from a doctor and undergo a full examination.

Question: I have been suffering from recurrent genital herpes for several years. I am currently pregnant. Do I have to have a caesarean section?

Answer: The risk of infection of a newborn when passing through the birth canal of a mother with recurrent genital herpes is 5-8%. In this way, 90% of newborns with herpes infection are infected. However, in recent years there has been a trend towards delivery through the natural birth canal under the cover of the drug Zovirax. As a rule, maternal protective antibodies transmitted to the fetus transplacentally starting from the 28th week of pregnancy, as well as the necessary preventive measures taken by the attending physician, can minimize the risk of infection with herpes in the newborn during childbirth.

Question: How can a newborn be examined if both or one of the parents have herpes?

Answer: Examination of a newborn allows you to determine whether he had contact with the virus in utero. For this, blood is taken from the vessels of the umbilical cord to isolate the antigen of the corresponding herpes virus and antibodies to it. In parallel, the detection of antibody titers in the mother's blood is carried out. The development of the fetal immune system begins at conception. At the 6-8th week of pregnancy, stem cells can be identified in the thymus cortex, and at the 12th week, IgM and IgG produced by B-lymphocytes in the peripheral blood of the fetus. However, the main source of fetal immunity is the transfer of maternal IgG antibodies across the placenta, starting at 28 weeks of gestation and continuing until delivery. Elevated levels of IgM in blood samples from the vessels of the umbilical cord is a sign of an intrauterine infection. Maternal antibodies of the IgG class protect the fetus from herpes during pregnancy and during the neonatal period. The absence of antibodies to herpes viruses in the mother can lead to infection of the fetus or newborn. Therefore, the susceptibility to herpes viruses in the fetus is inversely proportional to the level of immunity in the mother.

Brief summary (for those who do not want to read a lot and long):

After meeting with the herpes simplex virus, he settles in the body forever. Therefore, you can get sick with this virus many times. An analysis of IgM and IgG antibodies to the herpes simplex virus can show the relationship between your body and this virus.

Blood is taken from a vein. Result: IgM - so much at such and such a norm (or "not detected"), IgG - so much at such and such a norm. I draw your attention to the fact that the concept of "norm" in this case should be understood as a "reference value", that is, a certain starting point, and by no means a "normal situation".

In your analysis for the herpes virus, it says:

  • No IgM, IgG below normal: your body has not yet encountered this virus.
  • No IgM, IgG above normal: your body has already met with this virus, but it is not known what form the virus is in now.
  • IgM above normal or "detected": active process, you had the first infection with the herpes simplex virus or its reactivation, you can not become pregnant until the IgM is gone. IgG antibodies are not important for pregnancy planning.

Let's take a closer look at the situation with the absence of IgM. What does "the body has not yet encountered the virus" mean? Is it good or bad?

This is good because you cannot reactivate the herpes virus during pregnancy. This is bad, because if a primary infection occurs, the likelihood of the virus affecting the development of the fetus is higher.

If the first herpes rash (anywhere) occurred during pregnancy, you need an urgent consultation with an infectious disease gynecologist!

And if the meeting with the virus has already taken place before pregnancy? Here the situation is mirrored - you are not afraid of the primary infection, but reactivation can occur.

Is it dangerous?- Yes, there are situations when it is dangerous for the fetus, but not often.

Is it possible to predict whether there will be a reactivation?- To some extent it is possible. If the level of IgG antibodies greatly (several times) exceeds the reference value or frequent recurrences of herpes occur, then your immune system has a tense relationship with this virus, and reactivation during pregnancy is likely. So, before pregnancy, you should consult with an infectious disease gynecologist.

Is it possible to know for sure if the reactivation is going on now?- Can. It is necessary to pass tests to search for the herpes simplex virus in the body, best of all by the method of cultural diagnostics (in other words, by sowing). In this case, many media should be examined: saliva, urine, blood, smear, even sometimes tears :)

What is the herpes simplex virus?

Among the Herpesviridae family, human pathogens include herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), zoster virus, human herpesvirus type 6 (HHV-6), human cytomegalovirus (), Epstein-Barr virus, herpesviruses 7 and 8.

Human herpes virus (herpes simplex virus) type 1 (HSV-1)- most often causes lesions of the mucous membrane of the mouth, eyes and skin (orofacial herpes, its recurrent form - herpes labialis) and much less often - damage to the genitals, as well as herpetic encephalitis and pneumonitis.

Human herpes virus (herpes simplex virus) type 2 (HSV-2)- causes damage to the genitals, herpes of newborns, disseminated herpes.

Human herpesvirus type 3 (HHV-3) or varicella zoster virus- Causes chicken pox and shingles.

Herpes is the second most common sexually transmitted disease after trichomoniasis. Diseases caused by HSV rank second (15.8%) after influenza as the cause of death from viral infections (excluding AIDS). In the US, the problem of herpes has been one of the leading medical and social problems for 25 years. Genital herpes affects all populations. 98% of adults worldwide have antibodies to HSV-1 or 2. In 7%, genital herpes is asymptomatic.

Genital herpes is caused by two different but related forms of the Herpes simplex virus (herpes simplex), known as herpes simplex virus type 1 (HSV-1) - it causes "fever" on the lips more often - and herpes simplex virus type 2 (HSV-2). The most common cause of lesions of the genitals is the second type. But the disease of the lips caused by the type I virus can gradually move to other mucous membranes, including the genitals. Infection can occur as a result of direct contact with infected genitals during sexual intercourse, by rubbing the genitals against each other, by oral-genital contact, anal intercourse or oral-anal contact. And even from a sick sexual partner, who has no external signs of the disease yet.

A common property of these viruses is the constant presence in the human body, from the moment of infection. The virus can be in a "sleeping" or active state and does not leave the body even under the influence of drugs. The manifest manifestation of any herpetic infection indicates.

The herpes simplex virus (Herpes simplex) of the first type is extremely common. Primary infection occurs, in most cases, at preschool age. In the future, the likelihood of infection drops sharply. A typical manifestation of infection is a "cold" on the lips. However, oral contact may damage the genitals. Internal organs are affected only with a significant decrease in immunity.

Genital herpes is characterized by the appearance of clusters of small, painful blisters on the genitals. Soon they burst, leaving small sores. In men, blisters form most often on the penis, sometimes in the urethra and rectum. In women - usually on the labia, less often in the cervix or in the anal area. In 1 - 3 weeks the disease seems to disappear. But the virus penetrates the nerve fibers and continues to exist, hiding in the sacral spinal cord. In many patients, genital herpes gives relapses of the disease. They occur with varying frequency - from once a month to once every few years. They are provoked by other diseases, troubles, and even simply overheating in the sun.

The genital herpes virus Herpes simplex type 2 affects mainly the integumentary tissues (epithelium) of the cervix in women and the penis in men, causing pain, itching, the appearance of transparent vesicles (vesicles) in place of which erosions / sores are formed. However, oral contact may damage the integumentary tissue of the lips and oral cavity.

In 82% of patients with persistent, refractory colpitis, leukoplakia of the cervix, HSV is detected as one of the leading etiological factors. In this case, the course of infection is often atypical.

HSV is the etiological factor of 10% of the total number of encephalitis, accompanied by high mortality, in addition - polyradiculitis, meningitis. These patients do not receive proper treatment due to the lack of timely virological diagnosis.

Between HSV-1 and HSV-2 50% homology, which suggests the origin of one from the other. Antibodies to HSV-1 increase the incidence of asymptomatic disease caused by HSV-2. Infection in childhood with HSV-1 usually prevents the development of genital herpes, more often caused by HSV-2.

In pregnant women: the virus can cross the placenta into the fetus and cause birth defects. Herpes can also cause spontaneous abortion or premature birth. But the danger of infection of the fetus during childbirth, when passing through the cervix and vagina during primary or recurrent genital infection in the mother, is especially likely. Such infection increases the mortality of newborns or the development of severe damage to the brain or eyes by 50%. At the same time, there is a certain risk of infection of the fetus even in cases where the mother does not have any symptoms of genital herpes at the time of delivery. A child can become infected after birth if the mother or father has lesions in the mouth, or get the virus from mother's milk.

Herpes simplex virus type II appears to be associated with cervical and vaginal cancer and increases susceptibility to HIV infection that causes AIDS! In response to the introduction of HSV in the body, the production of specific class M immunoglobulins (IgM) begins. In the blood, they can be determined 4-6 days after infection. They reach their maximum value at 15-20 days. From 10 - 14 days, the production of specific IgG begins, a little later - IgA

IgM and IgA remain in the human body for a short time (1 - 2 months), IgG - throughout life (seropositivity). Diagnostic value in primary infection with the herpes virus is the detection of IgM and/or a fourfold increase in titers of specific immunoglobulins G (IgG) in paired blood sera obtained from the patient with an interval of 10 to 12 days. Recurrent herpes usually occurs against the background of high levels of IgG, indicating a constant antigenic stimulation of the body. The appearance of IgM in such patients is a sign of an exacerbation of the disease.

Factors contributing to the manifestation and / or recurrence of genital herpes are: a decrease in immunological reactivity, hypothermia or overheating of the body, concomitant diseases, medical procedures, including abortion and the introduction of an intrauterine device.

Why do you need a herpes virus test?

So, you have frequent recurrences of herpes. This is an unpleasant situation for your body, but a fairly safe situation for the fetus.

The structure of the incidence of herpes in newborns is as follows:
90% is infection within childbirth by contact when passing through the birth canal. Moreover, within these 90%: 50% - primary infection during pregnancy, 33% - primary infection with type II herpes during pregnancy against the background of already existing immunity to type I herpes, 0-4% - asymptomatic shedding of the virus or recurrence of genital herpes.
Thus, in your case, the probability of infection of the child during childbirth is 0-4% (according to various studies). The low incidence of herpes in newborns with recurrent herpes is explained by the presence of antibodies to herpes that cross the placenta and protect the fetus.

Intrauterine infection of a newborn is noted only in 5% of cases of herpes in newborns. It occurs only with a primary infection during pregnancy. This is not your case. (However, intrauterine infection is not the only unpleasant consequence of vitus reactivation. A complication of the appearance of any infection in the body can be the appearance of autoantibodies, which leads to feto-placental insufficiency.)
In another 5% of cases, neonatal herpes occurs as a result of postpartum infection of newborns. In the vast majority of cases, these are the children of women who have never had herpes. They do not have protective antibodies transmitted through the placenta and mother's milk to the child.
Therefore, women with no antibodies to herpes are at risk. It is they who, if infected during pregnancy, can transmit the virus to the fetus, and their children are most at risk of contracting herpes. In our population, this is approximately 20% of women of childbearing age.

In this regard, it is proposed to include testing for antibodies to herpes in early pregnancy to determine the status of immunity, and then monthly monitoring of the level of antibodies to herpes in women with no immunity.