Herpes during pregnancy - what is dangerous and how is it treated. How is childbirth going if there is a herpes infection. Planning for pregnancy in women carriers of HSV

13.10.2019

Any infection is undesirable during pregnancy. Of particular danger to pregnant women is the herpes virus, which requires attention and immediate treatment, as it potentially poses a threat to the fetus. To date, scientists have isolated 8 types of the virus. The most common types of virus are the herpes simplex virus of the first and second types, which will be discussed later. How to treat this viral disease and why is herpes dangerous during pregnancy?

About 95% of all inhabitants of our planet are carriers of herpes. Penetrating into the human body, it settles in it forever and can be in a “sleeping” latent state, not showing itself in any way until a certain moment. The impetus for its activation can be a weakening of the immune system, especially during pregnancy. Therefore, pregnancy is a favorable moment for the manifestation of the herpes virus. Hormonal changes and weakening of the immune system are the main reasons for its appearance. It is during this period that the causative agent of the virus makes itself felt. In addition, the virus can activate and become an unexpected "surprise" for the expectant mother against the background of the following factors:

overwork, stress;
colds, hypothermia;
hormonal imbalance;
after taking antibiotics;
with exacerbation of chronic diseases;
with vitamin deficiency.

Types of herpes during pregnancy, their symptoms

HSV1 - Herpes simplex virus type 1 or labial type. It provokes the appearance of characteristic blisters with liquid (vesicles) that affect the lips, mucous membranes of the mouth, nose, or the area of the nasolabial triangle. This type of virus is called "herpes on the lips." Anyone who comes into contact with a carrier can become infected with labial herpes. Infection with HSV1, as a rule, occurs even in childhood, at school age, by contact and household contact, by contact with other children, by sharing dishes, by kissing.

Herpes on the lips: symptoms

HSV1 goes through four stages of development. Its first manifestations are itching, burning, discomfort in the mucous membranes, on the lips, many have an increase in temperature, weakness, body aches, general malaise. The second stage is characterized by the appearance of swelling and pain in the lips, where itchy herpetic vesicles filled with liquid appear. Over time, they burst and a clear liquid is released from them. This is the third stage of the development of the disease, it is she who is dangerous in terms of infection, since the liquid from the bursting vesicles contains a large number of herpes embryos in its composition. After the fluid flows out, wounds remain in place of the bubbles. The final stage in the development of a viral infection is the formation of crusts (scabs) at the sites of injury.

HSV2 is herpes simplex virus type 2 or genital type. It affects the external or internal genital organs, is transmitted sexually from the carrier of this virus. When infected with a genital virus, vesicles begin to appear on the perineum, in the vagina, on the cervix, in the anus.

Symptoms of genital herpes

Outwardly, genital herpes looks like many small bubbles filled with liquid, swelling, itching or redness of the genital mucosa can be observed. After the liquid comes out of the blisters, sores appear in their place, which do not heal for a very long time, from two to four weeks. Wounds cause severe discomfort, itching and pain in the genital area.
It should be noted that both types of herpes simplex virus, depending on the form of their course, are dangerous for the unborn child and require immediate treatment.

Forms of the course of herpes of the 1st and 2nd type in pregnant women

In pregnant women, a viral infection can manifest itself in the following forms:

Primary infection (primary herpes) - when the infection with the virus first occurred during pregnancy and there are no antibodies to it in the body of the pregnant woman. Infection with the type 1 virus manifests itself in the form of a small rash, mainly in the lips, oral mucosa or nose. Bubbles cause itching, discomfort and burning, the body temperature rises to 38 degrees, the woman feels aches and pains in the joints, muscles, general malaise. If during pregnancy an infection with a genital virus occurs, in addition to malaise, body aches and fever, the expectant mother notices painful itchy vesicles in the perineum. Vaginal discharge and itching appear.
Recurrent (secondary) herpes - when a herpes infection occurred before pregnancy and a woman is a carrier of this virus, which became more active during pregnancy due to a weakened immune system. With recurrent herpes, intoxication of the body does not occur, and the virus manifests itself only in rashes on the mucous membranes of the skin, it does not pose a danger to the baby.
The asymptomatic course of the disease is the most dangerous form of the disease, when the virus spreads rapidly throughout the body, without causing any symptoms. A pregnant woman may not be aware of the danger that threatens her health and the development of the baby. Therefore, even during the planning of conception or at the very beginning of pregnancy, the expectant mother should be examined to determine if she has antibodies to the herpes virus of both types, which will protect her baby from infection.

What is the danger of herpes at different stages of pregnancy?

Herpes on the lips during pregnancy is not dangerous for the expectant mother and fetus only if the woman has previously shown symptoms of a viral infection, and she is its carrier. The fetus is protected by antibodies produced by the mother's body. In this case, it is enough to undergo a course of treatment. Primary herpes is a great danger if a pregnant woman has contracted it for the first time. There is a possibility of infection passing through the placenta and affecting the intrauterine development of the fetus.

What is dangerous virus in the 1st trimester

Herpes on the lip in early pregnancy is dangerous because in the 1st trimester there is an active laying of all systems and organs of the unborn baby, so infection of the fetus can lead to extremely undesirable consequences, such as spontaneous miscarriage or miscarriage. In addition, a primary herpes infection can cause severe pathologies and malformations of the fetus, such as developmental delay, disorders in the development of the brain and the nervous system, and provoke problems with hearing and vision.
In most cases, a newborn infected with herpes will be a carrier of the virus.

What is dangerous herpes in the 2nd trimester

Infection of a pregnant woman in the 2nd trimester is less dangerous for the fetus, since its main organs are already formed by 12 weeks. If a pregnant woman is a carrier of herpes, and in the 2nd trimester it became more active, the risk of developing fetal pathologies is negligible. However, in the second trimester, the virus infects the placenta, disrupting its functions, which can lead to fetoplacental insufficiency and cause oxygen starvation of the fetus. A baby infected in the 2nd trimester of pregnancy is born underweight and has a weak immune system. In addition, the 2nd trimester is an active period for the formation of the nervous and reproductive systems, bone tissue. There is a possibility of a violation of the development of these systems in the fetus. Herpes can cause premature birth.

What is dangerous virus in the 3rd trimester

Primary herpes in the 3rd trimester is dangerous not only for the unborn baby, but also for the mother. The body of a pregnant woman during the illness becomes too weakened and becomes vulnerable to contracting any infectious diseases that can further complicate the course of pregnancy. Infection of the fetus at a later date increases the risk of damage to the baby's nervous system and its internal organs. If a pregnant woman has a relapse of herpes in the 3rd trimester, you should not worry, as the mother's body secretes antibodies that reliably protect the baby from infection.

What is the danger of genital herpes during pregnancy

If the mother already had the second type of herpes before pregnancy, the fetus is protected by her antibodies and you should not worry about its development and health. A blood test for antibodies to HSV2 should be taken by both partners. If it turns out that only a man is a carrier of the virus, protection will be required during sexual intercourse throughout pregnancy. In case of infection during pregnancy? genital herpes poses a great threat to the fetus. Infection with herpes can cause pathologies of intrauterine development, fetal death in the first months of pregnancy. Therefore, at the first suspicion of infection with genital herpes, you should immediately consult a gynecologist who will prescribe emergency treatment with antiviral drugs. If an exacerbation of the disease occurred before childbirth, most likely the woman will be prescribed a caesarean section so as not to infect the baby through the birth canal.

How to treat herpes during pregnancy: drug treatment

When herpes is detected, with an exacerbation of the disease, the main goal of treatment during pregnancy is to eliminate the external symptoms of the virus and reduce relapses. With primary herpes - carrying out therapeutic measures aimed at preventing infection of the fetus. It should be noted that there is no medicine that can completely get rid of a herpes infection during pregnancy. All drugs used are aimed at strengthening the immune system, facilitating the general well-being of the pregnant woman, as well as reducing the risks of affecting the fetus. As a rule, antiviral creams, ointments are used that stop individual symptoms, and drugs are prescribed that weaken the virus during primary infection or during an exacerbation of the disease. Treatment during childbearing is complicated by the fact that not all drugs used to eliminate the infection are allowed for pregnant women, so self-medication in this case is unacceptable.

How to treat herpes on the lips during pregnancy

If herpes appears on the lips, ointments and creams approved for use by pregnant women help to eliminate its external manifestation. Herpes should be treated as early as possible. As soon as you feel discomfort, itching, burning or inflammation in the lips, you should immediately treat the affected area of the lips with an antiviral drug.
Among the most effective ointments against the virus are:

Acyclovir;
Zovirax;
Acigerpin;
Panavir;
Viferon;
Penciclovir.

They help to remove puffiness, reduce the activity of herpetic eruptions. Ointments and creams based on acyclovir do not penetrate into the blood, providing a therapeutic effect only on the surface of the mucosa. If it is necessary for the drug to have a therapeutic effect on the fetus, medications are used in the form of tablets that already cross the placenta. Ointments are used for a week, lubricating the lesions of herpes up to 5 times a day.

In addition to the above drugs, ointments are used:

Oxolinic;
Tetracycline;
Tebrofen.

The doctor may also prescribe preparations containing herbal ingredients aimed at eliminating the main symptoms of the infection. They are absolutely harmless to the fetus:

Cream Lomagerpan;
Biopin;
Gel hyporamine.

To support the body's defenses, pregnant women are often prescribed vitamin complexes with vitamin E and zinc. Immunity strengthening is promoted by plant-based immunostimulating preparations: tincture of Eleutherococcus, ginseng, echinacea.

Treatment of herpes during pregnancy folk remedies

Folk methods of treating a viral infection are natural and safe for the unborn baby. However, it is worth remembering that folk recipes only help to eliminate the external symptoms of the manifestation of the disease, providing an anti-inflammatory effect on the focus of infection. These methods do not have an antiviral effect.

Aloe juice. Cut a mature aloe leaf, peel it and cut it lengthwise. Apply a fresh cut of the plant to the affected areas of the skin for at least 30 minutes. To eliminate pain, itching, two applications will be enough.

Fir oil. You can buy fir oil in a pharmacy. Treat herpetic eruptions with it every two hours.
Tincture of calendula, chamomile, tansy or licorice root. Brew one of the medicinal herbs. Apply a cotton pad soaked in tincture to the site of infection.
When the wounds are covered with a crust, their healing is facilitated by rubbing with tea tree essential oil or sea buckthorn oil.
In addition, foci of herpetic vesicles can be treated with strong tea leaves, as well as a solution of salt or soda.

Herpes during pregnancy. Precautionary measures

When herpetic blisters appear on the lips, try not to wet the sores with water or touch them with your hands, as you can infect other parts of the face or body.
In no case do not open the bubbles yourself, this will only increase inflammation and may provoke further spread of the infection.
It is forbidden to use someone else's cosmetics, especially lipstick.
To avoid becoming a source of infection, wear a medical bandage.
When you go outside, lubricate your lips with a special anti-herpetic lipstick. It contains tea tree oil in its composition and serves as an excellent prophylactic for the appearance of rashes.

Prevention of herpes before and during pregnancy

No one wants to get sick, especially during a wonderful period in the life of every woman - bearing a baby. Therefore, in order to exclude the possibility of herpes during pregnancy or to avoid infection with the virus if you have never had it, the expectant mother should undergo a complete examination before pregnancy, apply all measures to strengthen immunity, and take preventive measures:

Give up bad habits, go in for active sports and hardening the body. Avoid hypothermia or overheating.
If you are prone to recurrence of herpes, use sunscreen to protect your skin when going out, as ultraviolet light activates the virus.
Do not contact people with obvious signs of herpes lesions on the skin. It is especially dangerous to share household items, towels and bedding. Always follow the rules of personal hygiene.
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Strengthen your immune system by including chicken meat, vegetables, and fruits in your diet. Eliminate the use of chocolate and raisins - they contain the amino acid arginine, which activates the virus. Drink more water, juices and drinks containing a large amount of vitamin C. Rosehip broth, green tea with lemon, freshly squeezed juices are useful.
Avoid nervous tension, stressful situations, good rest and sleep are also important.

Herpes during pregnancy should not be ignored and self-medicate. Doctor's consultations are mandatory. The doctor will prescribe laboratory tests to clarify the type of herpetic viral infection, and also reveal its nature (primary herpes or relapse). In case of primary infection, in addition to blood tests, the gynecologist prescribes additional ultrasound examinations of the fetal condition to detect the presence of intrauterine herpes infection. Timely treatment and prevention of a viral infection during pregnancy will help to avoid dangerous consequences and give birth to a healthy baby.

The fact that herpes during pregnancy can be very dangerous is a proven fact. But you need to be afraid not of "colds" on the lips, but of some other types of illness. They can lead to severe disorders and even death, not only of the fetus, but also of the mother.

During pregnancy during pregnancy Dangerous virus
virus multiplication disease is difficult to determine

Eight types of virus

More than 90% of the world's population has herpes, and it often appears not during pregnancy, but much earlier, imperceptibly. How the rest developed immunity is unknown.

Its favorite habitat in the state of "hibernation" is the nerve fibers of the peripheral system near the spinal column. The carrier is every second person, the virus is found in fluids: spinal, lymphatic, lacrimal, salivary, blood, urine, semen. He is able to penetrate DNA, change it and multiply.

Eight types of this infection are now distinguished. They cause various diseases. The unifying factors are not only belonging to the same order and family, but also the ability to live secretly inside the body, waiting for a decrease in immunity. Then reproduction begins, symptoms characteristic of each type appear.

There are several types

The activity of the herpes virus increases not only during pregnancy, when there is a decrease in immunity provided by nature in order to preserve the fetus. In general, any facts of suppression of the body's defenses, for example, hypothermia or overheating, colds, chronic diseases, diseases of the immune system, are disposed to this. Modern medicine is not able to completely destroy the virus in the body; it is only possible to “lull” it.

You can “catch” this infection not only from a sick person, but also from an outwardly healthy carrier. Transfer methods:

contact (kissing, using common things, and so on);
sexual (including oral-genital);
airborne;
transplantation (blood transfusion, organ transplantation);
intrauterine or ancestral.

The first two types are called herpes simplex viruses, the second is more dangerous during pregnancy. Abbreviated designations - VPG1 and VPG2.

HSV1, or labial type, provokes a rash in the area of the nasolabial triangle. It affects the lips, nose, mucous membranes of the mouth and nose, causing "cold" acne and herpes stomatitis.

HSV2 is a genital type that affects the external and internal genital organs, the anal area. Moreover, these two types are able to "swap places". HSV1 causes about a fifth of genital herpes, HSV2 about the same amount of labial. Also, these two types affect the eyes, meninges, newborns.

The third type of herpes - zoster - during the initial infection causes chickenpox, which is also dangerous during pregnancy. It is suppressed by the immune system, but remains in the body forever. Recurrent disease develops in the form of herpes zoster, a rash along the nerve trunks. Everything about .

The fourth type is the Epstein-Barr virus. It leads to mononucleosis, diseases of the mucous membranes and lymphatic system. The liver and spleen may be affected. Adolescents and youth suffer from them. This type of virus can cause the development of Burkitt's lymphoma.

The fifth is called cytomegalovirus, this herpes during pregnancy is the most common cause of congenital pathologies. It affects the nervous system, including in utero, leading to malformations of the brain. Causes diseases of the eyes, lungs, liver, salivary glands. The disease often goes unnoticed.

The sixth type is one of the causes of multiple sclerosis in adults. The seventh often accompanies it, provoking chronic fatigue syndrome, oncology of the lymphatic system.

The eighth type causes Kaposi's sarcoma. Primary lymphoma, Castleman's disease, may also develop.

Types of virus dangerous for pregnant women

Genital herpes during pregnancy affects the intimate area. In eight cases out of ten, the causative agent is HSV2, in the rest - HSV1. It reproduces in the cells of the nervous and reproductive systems.

Infection can occur through sexual contact and through a kiss.

It is manifested by the formation of vesicles - pimples filled with fluid. They can hurt, itch, the skin turns red. They are located more often on the labia, can be found in the vagina, around the anus, on the cervix. Over time, they burst, leaving small ulcers that become covered with crusts. Heal without a trace in two weeks.

This herpes can also appear during pregnancy:

painful urination;
secretions;
enlarged lymph nodes;
deterioration of the general condition - fever, weakness, fever.

The most dangerous is the primary infection in a pregnant woman. If the virus was present in the body before, antibodies have already been developed to it. They also protect the fetus, so the risk of intrauterine infection is less than 0.5%. It increases with a relapse, that is, the appearance of symptoms, up to 5-8%.

The main cause of herpes recurrence is a decrease in immunity during pregnancy. The provoking factors are:

overwork;
nervous tension;
abuse of tanning under the sun or in a solarium.

During the initial infection, antibodies are absent. Even if the disease first appears in an already pregnant woman, it is possible to determine whether the infection has just occurred or much earlier by a blood test. If IgG antibodies are detected, then immunity has already been developed. 80% of women have antibodies to HSV1, and a third to HSV2.

But the primary infection with herpes during pregnancy, even in the early stages, does not necessarily lead to serious consequences. It is necessary to carry out treatment and monitor the development of the fetus.

Take tests and consult a doctor

Current data indicate a very low incidence of neonatal herpes infection. But a lot depends on the gestational age.

Consequences of primary infection with herpes in the 1st trimester of pregnancy.

Anomalies in the development of the skull, bones of the eyes.
Anembryony, missed pregnancy.
Spontaneous abortion.
Very rarely - severe damage to the internal organs of the woman herself, even less often with a fatal outcome.

The penetration of herpes into the body during pregnancy in the 2nd trimester leads to slightly different consequences.

Pathologies of the brain, cardiovascular system, lungs, liver in a newborn.
Stillbirth.
Death in the neonatal period.

Primary infection with herpes during pregnancy in the 3rd trimester can cause the following complications.

Lag in development.
premature birth.
postpartum viral infection.

If at the beginning of the term, the infection will most likely lead to a miscarriage, then closer to the birth, the fetus survives with a probability of 60%. The defeat in the last months of pregnancy is about half of all children born with this infection, its consequences.

The third type of virus that causes chickenpox also poses a risk of consequences. How the woman became infected is of some importance. If from a patient with shingles, then the risk is less than when infected from a patient with chickenpox.

This type of herpes is dangerous in the first and second trimesters of pregnancy.

Rarely, complications develop with damage to the brain or lungs of a pregnant woman.
In a quarter of cases, intrauterine infection occurs.
No more than 3% of cases develop abnormalities in the fetus.

Possible malformations appear one at a time or all together.

Deformation of the skull.
Developmental disorders of the limbs.
eye anomalies.
Malformations of the brain.

Cytomegalovirus, the fifth type of herpes, is dangerous during pregnancy with primary infection or reactivation of a previous illness. Up to 4% of healthy women become infected. Consequences are observed in about 40-50% of cases.

Loss of pregnancy.
Severe fetal malformations affecting internal organs.
Death of a child shortly after childbirth.
Visual and hearing impairments as they grow older.

How to keep healthy?

Before starting treatment, it is necessary to do tests. The causative agent of the disease will be identified, and it will also be determined whether this infection is primary or relapse. Depending on this, the doctor makes appointments.

For example, after a primary infection with any type of herpes during pregnancy, the mother is treated with antiviral drugs. The development of the fetus is carefully monitored, if necessary, tests are prescribed to help determine whether the infection has penetrated to it. These can be punctures of the amniotic fluid, the umbilical cord.

A woman who has been in contact with someone who has chickenpox or shingles should see a doctor. She will be tested for antibodies. If they are present, no treatment is required, immunity protects both the mother and the child. If not, you can get vaccinated, but it is effective only in the first 4-5 days after contact.

Relapse of the disease with HSV2 or HSV1 is usually treated only locally. For its prevention, especially in the last month before childbirth, the doctor may prescribe antiviral drugs - acyclovir, farmvir, zovirax, valaciclovir. Childbirth is carried out either by caesarean section, or naturally, but with the treatment of the birth canal with antiseptics.

Ointments that can be used for herpes during pregnancy.

Stops the reproduction of the virus

Herpes infection during pregnancy can be a serious problem, and therefore is carefully monitored by doctors. The herpes simplex virus, as a biological agent, poses a great danger to the normal development of the fetus: for example, in terms of teratogenic activity - the ability to cause deformities in the embryo - of all viruses, only the rubella virus surpasses it.

That is why the features of the course of herpes during pregnancy have always been carefully studied, and today doctors have already collected quite extensive material on this disease.

Dry statistics

It's hard to argue with statistics. For herpes, she gives us the following figures:

the carrier of the herpes simplex virus is every second person on the planet;
with primary genital herpes, the risk of intrauterine infection is 30-50%, with recurrent herpes - 3-7%;
in the early stages, the herpes simplex virus causes spontaneous abortion in 30% of cases, and in the third trimester, late miscarriages occur in 50% of cases;
in 40% of surviving newborns, intrauterine infection leads to the development of latent carriage with the appearance of dysfunctional disorders at a later age;
from mothers with asymptomatic or atypical forms of the disease, sick children are born in 70% of cases. Mortality in this group is about 50-70%, only 15% of newborns remain healthy.

It is important to know that herpes can be treated at any stage of pregnancy, and the sooner preventive and therapeutic measures are started, the better. Otherwise, various complications may occur.

Occasional complications

During the period of bearing a child, all the forces of the body are directed to internal restructuring. The decrease in immunity that occurs in this case is a favorable factor for the manifestation of an insidious disease. Herpes is extremely dangerous during pregnancy, and should not be left unattended. The virus can not only provoke a spontaneous miscarriage, but also cause severe fetal malformations.

First of all, herpes affects the course of pregnancy itself, and for its reason, there may be:

frozen pregnancy;
spontaneous abortion;
premature birth;
stillbirth.

Missed pregnancy, or missed miscarriage, is the most common complication that occurs in the first trimester. Despite the fact that the pregnancy begins safely (the fertilized egg is securely fixed on the wall of the uterus), no further development is observed (only the fetal membranes develop). The difficulty is that the woman feels good at the same time, the rejection of the fetal egg does not occur. This can lead to intoxication of the female body with decay products, resulting in:

inflammatory processes of the endometrium;
violations of the hematopoietic system (thrombosis, bleeding).

It is important to notice the lack of fetal development in time. Extraction occurs medically (tablets are taken), or through vacuum extraction, performed under general anesthesia. Quite often, curettage, or curettage, becomes appropriate.

The period of subsequent treatment of genital herpes should be at least 6 months.

For the fetus, complications are manifested in:

heart defects;
developmental delay;
prolonged jaundice;
damage to the central nervous system;
hemorrhagic syndrome (external and internal bleeding);
blindness
deafness
epilepsy;
micro/hydrocephalus;
hepatosplenomegaly.

It must be emphasized that the probability of infection of the fetus with the herpes virus during pregnancy is low. The exception is the primary infection of the mother with genital herpes, when the risk of transmitting the virus to the fetus is 50%, and the exacerbation of chronic herpes, accompanied by the release of the virus into the bloodstream.

Most often, infection occurs during childbirth, while caesarean section does not always exclude perinatal infection.

When a herpes virus infects a newborn, it causes damage to the nervous system in 35% of cases, skin and eyes in 45% of cases, often leading to disability or death. In conditions of premature pregnancy, perinatal mortality occurs in 90% of cases. The defeat of the placenta can occur at any time. So infection with herpes in the first trimester leads to the development of heart defects, hydrocephalus, and anomalies in the development of the gastrointestinal tract. Infection in the II and III trimester causes herpetic hepatitis, anemia, pancreatitis, pneumonia, sepsis, malnutrition, herpetic meningoencephalitis.

With primary infection after 32 weeks, the child is most often born with skin ulcerations, cerebral necrosis, cataracts, chorioretinitis, microphthalmia. In severe lesions (sepsis, meningoencephalitis), death occurs in 50-80% of cases, with timely treatment, this figure decreases to 20%.

Immunity to herpes as a guarantee of child health

From the foregoing, one should not conclude that the disease of herpes and the birth of a healthy child are incompatible concepts. Only primary infection is dangerous. Most women who have had genital herpes give birth to absolutely healthy children, since the fetus is reliably protected by the mother's antibodies. It is noteworthy that the action of antibodies continues several months after birth.

The risk of infection of the newborn depends on the severity of the course of the disease in the mother, as well as on the duration of contact of the fetus with infected amniotic fluid and the birth canal. In order to prevent such phenomena, it is necessary during the planning of pregnancy and a few weeks before the birth to pass an analysis for the presence of a pathogen in the body. If the result of the studies turned out to be positive, then it becomes advisable to conduct a planned caesarean section.

In addition, the doctor prescribes drug therapy aimed at eliminating the manifestations of the disease, reducing the frequency of possible relapses, and increasing immunity. Preparations are selected individually, depending on the characteristics of the herpetic process and its severity.

Primary infection with herpes during pregnancy

As already noted, primary infection is of particular danger to mother and child. The manifestations of the disease are characterized in this case by particular distinctness, since there are no antibodies in the woman's body. Especially dangerous for the fetus is infection in the I and III trimesters of pregnancy. In the early stages, a missed pregnancy or miscarriage is most often diagnosed, and after 36 weeks - damage to internal organs (spleen, liver, kidneys).

Despite antiviral therapy, herpes in pregnant women in the primary form leads to the death or profound disability of the newborn.

Many confuse the initial episode of infection and the first recurrence of genital herpes, which was previously asymptomatic. These are completely different concepts. Primary infection means that the body has not yet developed protective antibodies, that is, it has encountered HSV for the first time. And with a relapse of the disease, antibodies are already present in the blood. Thus, it is the primary infection that is more dangerous for a pregnant woman.

In case of primary infection, a blood test will show the presence of Ig M, and in case of relapse - Ig G. Not only the expectant mother, but also the father of the child should undergo the examination. If a woman is not a carrier of the virus, but a man has it, then infection can occur at any time. That is why couples in which only a man suffers from genital herpes are strongly advised by doctors to use a condom for any kind of sexual intimacy.

Primary genital herpes in pregnant women is characterized by heterogeneity of manifestations - the symptoms in different people can be radically different. The most typical symptoms include the following:

redness of the skin in the perineum, around the anus, or on the inner thighs;
the appearance of painful blisters filled with a clear liquid in the buttocks and genitals;
watery vaginal discharge;
pain when urinating;
enlarged inguinal lymph nodes;
cold symptoms (chills, fever, general weakness, headaches and muscle pain).

The first manifestations of genital herpes are redness of the skin, a burning sensation in the affected area. On the 3-7th day, the period of bubble rashes begins. Small bubbles can appear on the surface of the external genitalia, in the vagina, on the cervix, in the urethra. On the 5th day, they burst and painful erosive sores form in their place, which disappear after 1-2 weeks.

On average, the acute form lasts 10 days. The frequency of relapses can range from 1 time per month to 1-2 times per year. It all depends on the state of the immune system.

Methods for diagnosing herpes infection

Primary herpes can be identified using characteristic symptoms and laboratory tests:

blood test for antibodies;
virological examination of affected tissues;
immunofluorescence microscopy, PCR (quick tests);
cytomorphological study according to Wright (with staining).

Relapse of the disease during pregnancy

Recurrent herpes in pregnant women is the least of all worries. If a woman already had relapses before pregnancy, then antibodies blocking the action of HSV will provide reliable protection for the fetus. The risk of infection of a newborn from a mother suffering from recurrent herpes is only 1%.

So that the disease does not bring problems to the expectant mother and baby, a number of measures should be taken. During the planning period of pregnancy, it is necessary to eliminate foci of chronic infection (gastritis, sinusitis, bad teeth), get rid of bad habits and undergo a course of restorative therapy. Analysis for immunoglobulins Ig G and Ig M is required.

Preventive measures also include taking Acyclovir or Valaciclovir in combination with vitamin complexes.

Management of pregnancy adjusted for herpes

Herpetic infection during pregnancy requires dynamic monitoring. Ultrasound examination is performed 3 times:

for a period of 10-14 weeks (the thickness of the collar zone is estimated);
at 20-24 weeks (detection of echographic markers of chromosomal pathologies);
at 32-34 weeks (detection of developmental pathologies of late manifestation).

Intrauterine infection may be indicated by such signs as the presence of suspension in the amniotic fluid, a lot / oligohydramnios, thick placenta syndrome, brain cysts. In case of suspicious results, an additional in-depth examination is carried out. From 16 to 30 weeks, blood is taken for AFP and hCG. Antibody tests are taken 4 times: in each of the trimesters and on the eve of childbirth.

The most reliable diagnostic methods today are considered to be virological examination and gene diagnostics. Virological analysis involves placing the contents of the vesicles in chicken embryos or in special nutrient media that stimulate the reproduction of the virus.

During gene diagnostics (most often PCR), the presence of virus DNA in the secretions of a pregnant woman is detected. The advantage of the polymerase chain reaction is 100% sensitivity and the ability to distinguish the herpes simplex virus from other viruses. As additional methods, immunofluorescence reactions (RIF) and enzyme immunoassay (ELISA) are used.

ELISA reactions can be of 2 varieties: qualitative and quantitative. Qualitative ones make it possible to detect not only the presence / absence of Ig G and Ig M antibodies in the blood, but also to determine the type of virus that caused the disease (HSV-1 or HSV-2). Moreover, with the help of this analysis it is possible to determine whether relapses have occurred before.

Quantitative reactions determine antibody titers, which allows the doctor to assess the general state of the patient's immunity. You can take tests both before treatment and while taking antiviral drugs - drug therapy does not affect the test results.

Among other things, a clinical examination of the birth canal and vulva is carried out in order to identify latent herpetic foci. 2 weeks before delivery, women at risk are subject to hospitalization to collect the contents of the cervical canal.

Treatment

Treatment of herpes in a pregnant woman has the following goals:

relief of symptoms, shortening of the acute period;
acceleration of regeneration processes;
a decrease in the severity of virus isolation in the affected foci;
reducing the number of relapses.

Therapeutic measures do not lead to the complete disappearance of the virus, since this is simply impossible. However, it is quite possible to eliminate unpleasant symptoms as quickly as possible and reduce the number of relapses.

If a woman had manifestations of genital herpes before pregnancy, then the gynecologist observing her should be informed about this. When the first signs of exacerbation appear, you should immediately seek help.

It is important to remember that the earlier treatment begins, the higher its effectiveness. The greatest productivity of antiherpetic drugs is observed before the appearance of rashes or within 24 hours after their occurrence.

The main method of treating herpes in pregnant women is antiviral chemotherapy (the use of specialized antiherpetic drugs). To date, proven effectiveness has:

Acyclovir (Zovirax and its derivatives);
Valaciclovir (Valtrex);
Penciclovir (Denavir);
Famciclovir (Famvir).

The most commonly used is Acyclovir. This drug is active against cytomegalovirus, Epstein-Barr virus, Varicella zoster virus and Herpes simplex (types 1 and 2). In pharmacies, you can find many drugs in which Acyclovir acts as the base substance: Zovirax, Acic, Acigerpin, Acyclostad, Virolex, Gerpevir, Xorovir, Supraviran, Medovir.

In the annotations to the drugs, you can read that the use is justified only if the intended benefit outweighs the potential harm. This is disturbing to many. Indeed, experimental studies have shown that Acyclovir, when administered orally, crosses the placental barrier, but this medicinal substance cannot cause abortion.

The same studies have shown that the use of Acyclovir in the form of an ointment can not harm either the mother or her baby, since Acyclovir does not enter the systemic circulation with local exposure. To lubricate the affected areas, oxolinic, tetracycline, erythromycin and tebrofen ointments are also used.

In case of primary infection of the mother, Valaciclovir is administered orally at 500 mg twice a day for 10 days.

When relapses should be taken:

Acyclovir inside 200 mg 3 times a day for 5 days (with frequent relapses);
ointments based on Acyclovir (every 3 hours);
antibacterial ointments (Vidarabine, Riodoxol, Neosporin);
Xylocaine 2% (with severe pain syndrome);
sitz baths with herbs (chamomile, string) followed by the application of drying compounds (zinc ointment).

Doctors recommend including foods containing lysine in the diet. This amino acid inhibits the reproduction of the virus. Lysine is found in large quantities in chicken meat, fruits and vegetables. It is necessary to refrain from eating chocolate and raisins, which contain arginine, which stimulates the activity of the herpes virus. Healthy eating, outdoor walks and a calm psychological environment are also the most important preventive measures that should not be neglected.

Childbirth with a relapse of the disease

If during the bearing of the child the disease was in remission and did not manifest itself in any way, then you can give birth in the observational department of any maternity hospital. If there have been relapses, it is recommended to contact a specialized clinic in which a special observation will be carried out for the woman in labor and the newborn.

As for the method of delivery, when a herpes simplex virus is detected in a smear, there are two of them:

natural childbirth, involving antiseptic treatment of the birth canal (polyvidone iodine, vocadin, betadine);
C-section.

Separately, it should be said about the treatment of newborns infected with herpes from the mother.

Therapy of newborns in case of infection with herpes infection

Most often, herpes in newborns appears as a result of the development of genital herpes in the mother in the third trimester of pregnancy. Infection can occur:

during gestation, through the placenta (transplacental);
during childbirth - when passing through an infected birth canal;
after childbirth (through breast milk).

Signs of infection become apparent 2 weeks after birth. Bubble rashes appear on the skin, mucous membranes, conjunctiva of the eyes of newborns, which disappear after 10 days. In premature infants, the infection manifests itself more severely - herpetic encephalitis often develops. The following symptoms indicate brain damage:

increase in body temperature;
drowsiness;
convulsive syndrome;
difficulty breathing.

About 80% of premature babies with manifestations of herpes infection die in the absence of medical care. Timely implementation of therapeutic measures can save the life of 50% of sick newborns. They are prescribed Acyclovir at the rate of 50 mg/kg of body weight. The duration of treatment is at least 3 weeks. With the defeat of the conjunctiva of the eyes, Idoxyridine ointment is used.

To suppress the pathogenic flora, antibiotics are used, to increase the body's defense reactions - immunostimulants (Pentaglobin, Cytotec), to improve cerebral circulation - Actovegin, Instenon.

The appearance of herpes during pregnancy is not a sentence. Many women who suffer from this disease successfully live up to their due dates and give birth to healthy children. Do not leave the problem unattended - do not delay the visit to the doctor and follow all the recommendations.

Health to you and your kids!

Genital herpes during pregnancy: risk prevention

The greatest danger during pregnancy is genital herpes. Let's talk about it in more detail. Genital herpes usually appears 3-14 days after the virus enters the human body, most often after about a week. Sometimes it does not make itself felt in any way, and most often painful and itchy vesicles first appear on the skin or mucous membrane, and then sores, which then become covered with a crust. The size of the bubbles is 2-3 mm, they pour out, as a rule, in a group that occupies from 0.5 to 2.5 cm of the affected surface. This stage of the disease does not last long (2-3 days), then the bubbles burst, and ulcers form in their place. They are covered with a yellow coating, then heal without a trace within 2-4 weeks. If a secondary infection joins, then the wounds may not go away for a long time. In addition to complaints of itching, pain and burning, heaviness in the lower abdomen, frequent, painful urination are sometimes noted.

In some cases, specific rashes are absent. The disease can be manifested by discharge from the genital tract, itching, burning, the appearance of cracks in the genital area, and swelling. With this variant of genital herpes, the disease is similar to, which can lead to improper treatment if you self-medicate without prior diagnosis.

Interestingly, more than half of all patients with genital herpes are unaware of their disease. In this case, they are hidden carriers of herpes when there are no symptoms of the disease, but the virus is actively excreted from the woman's genital tract. In this case, it is a potential source of infection for the partner, as well as the baby in childbirth.

People with a good immune system tolerate a herpes infection more easily, they often have it in a latent form. But with a decrease in immunity, the disease is more often severe, prolonged.

To prevent the baby from contracting herpes
Newborn babies are prescribed antiviral treatment in the following cases: if the mother fell ill with herpes for the first time shortly before the birth and for some reason she could not have a caesarean section, or if the operation was performed 4-6 hours after the rupture of the fetal bladder.

Herpes during pregnancy: what is the danger?

Timely diagnosis of herpes in pregnant women is extremely important, since there is a risk of severe intrauterine infection with damage to the skin, liver and central nervous system of the fetus.

During pregnancy, both the primary infection of a woman with the herpes simplex virus and the activation of an existing infection (due to a decrease in immunity characteristic of a normal pregnancy) can occur. When infected with herpes during pregnancy, severe complications are possible, and the shorter the period, the more serious they can be.

Infection with herpes during pregnancy in the first 12 weeks very often leads to abortion, infection of the baby with damage to the skin, liver and nervous system and the development of malformations in him. At a later date, there is a risk of premature birth, polyhydramnios or oligohydramnios, and the likelihood of infection of the fetus also remains. The virus can enter the baby either through the placenta or by infecting the membranes of the fetal bladder.

If a woman has contracted herpes before conception, then the situation is not so dangerous. At the same time, the risk of fetal developmental disorders is minimal.

In chronic herpes infection during pregnancy, there are antibodies that, penetrating the placenta, protect the baby from exposure to the herpes virus. However, if exacerbations of the disease during pregnancy occur frequently, then this disrupts the work of the placenta, which, in turn, causes intrauterine growth retardation of the fetus and even sometimes miscarriage. In addition, if genital herpes during pregnancy worsens just before childbirth, there is a possibility of infection of the baby at birth.

Herpes during pregnancy: how is it diagnosed?

During pregnancy, an analysis for the herpes simplex virus is mandatory taken from a woman when registering. In case of complaints, specific rashes, the analysis is taken again at any stage of pregnancy. The following studies are used:

Detection of antibodies to herpes simplex virus types I and II. This is a blood test that detects immunoglobulins of classes M and G for herpes. That is, in this case, it is not the virus itself that is determined, but the body's reaction to it. If class G immunoglobulins for herpes are found in a woman's blood, this indicates that she has long been infected with the virus. The presence of class M antibodies indicates an acute process, that is, a primary infection or exacerbation of a chronic disease. In addition, to diagnose an exacerbation of a herpes infection during pregnancy, the doctor may prescribe a second test for class G antibodies after 10 to 12 days. An increase in the number of antibodies by 3-4 times indicates an exacerbation of the infection. The detection of antibodies of classes G and M most often indicates a recent infection, since after 3 months class M immunoglobulins are removed from the bloodstream. However, sometimes the period of circulation of antibodies M can be significantly lengthened depending on the infectious agent and the individual characteristics of the immunity of the expectant mother.

Examination of secretions from the genital tract for the herpes simplex virus. The most common method for diagnosing the presence of the herpes virus during pregnancy is PCR (polymerase chain reaction method), as it is available, highly sensitive and quickly gives results. PCR is one of the modern and most reliable methods for detecting infections in the human body. It allows you to determine the presence of the causative agent of the disease, even if it is present in the test material in a very small concentration - only a few molecules of its DNA, which makes this method the most accurate.

The analysis is carried out as follows: in a test tube, a certain section of the DNA of a bacterium or virus is repeatedly copied, adding special reagents. Having thus propagated the cells of the causative agent of the infection, it is then easy to determine its presence.

The gynecologist takes it with a special brush from the cervical canal when the pregnant woman is in the gynecological chair. This is an absolutely painless procedure. The resulting material is placed in a test tube with a special medium and sent to the laboratory.

No special preparation for analysis is required. For a more accurate result, it is advisable not to douche for 2 days and avoid sexual contact. In addition, a smear is taken no earlier than 3 days after the end of the use of any vaginal suppositories.

Caesarean or natural childbirth?
If the expectant mother became infected with the herpes virus during the last month of pregnancy or she developed a rash on the genitals 2-3 days before the birth, then in order to avoid infection of the baby when it passes through the mother's affected birth canal, it is carried out. In all other cases, women give birth on their own.

Herpes during pregnancy: to treat or not to treat?

Antiviral therapy in most cases during pregnancy is not carried out. Such treatment can only be prescribed to women with very severe symptoms of herpes infection during pregnancy, usually in the II and III trimesters. But the use of antiviral agents in the form of ointments, applying them to the affected area, is allowed at all stages of pregnancy.

The expectant mother is most often prescribed (drugs that correct the functioning of the immune system) in suppositories or intravenously. Interferon preparations, which make up for its insufficient production in the body with herpes, are widely used during pregnancy. Interferon is a protein that is normally produced in the body. He is able to fight all viruses. With weakened immunity, as well as with a significant number of rashes, immunoglobulin preparations can be used intravenously. It is possible to use such methods of treatment as laser blood irradiation and ozone therapy.

Herpes during pregnancy: take care in advance

When planning pregnancy in women with frequent exacerbations of herpes, prophylactic administration of antiviral drugs and multivitamins is recommended. During pregnancy, women with frequent exacerbations of herpes should be more attentive to their health, avoid hypothermia, and take vitamin complexes. If it is known that the husband of a pregnant woman is infected with the herpes virus type II, which is prone to frequent exacerbations, and the future mother herself does not have antibodies to herpes, it may be worth abstaining from sexual activity during pregnancy or the partner should undergo long-term antiviral treatment. Naturally, you should follow the usual hygiene rules - do not use other people's towels, do not sit naked on any surfaces in pools, fitness clubs and baths.

What is herpes?

In nature, there are two types of herpes simplex virus: herpes type I (labial) and herpes type II (genital).

Herpes virus type I most often affects the mucous membranes and skin of the lips, eyes, nose, it can also cause damage to the brain, lungs, and only in 20-30% of cases, type I herpes virus can cause damage to the genital organs. Herpesvirus type I 70-80% of the population is infected in childhood by airborne droplets or contact (for example, when using a shared towel or utensils)

Herpes virus type II, on the contrary, most often affects the mucous membrane of the genitourinary tract. Infection with genital herpes, as you might guess, usually occurs with the onset of sexual activity.

Herpes infection (HSV) includes eight types of viruses that can cause various clinical manifestations of the disease. The best known and most common are sexual (type II) and labial (type I). Rashes in the form of bubbles filled with liquid appear during a period of weakened immunity, especially during pregnancy. Is the virus dangerous for the baby? When and how to be treated?

It is believed that the herpes virus type I is found only on the mucous membrane of the lips and oral cavity, and the genital - in the genital area. However, sexual emancipation has long removed these boundaries - both types of pathogen can appear anywhere on the body.

Kinds

This is a common virus, which, according to generally accepted statistics, is in the body in 90% of people. This concept most often refers to the herpes simplex virus (HSV types I and II). In fact, there are many more representatives of the Herpesviridae family.

I type. The most common type of disease, manifested by a rash of vesicles on the face. Particularly on the lips. Often referred to as the "cold".
II type. The next most common type of virus that affects mainly the genitals.
III type. Varicella zoster virus. At the first contact with the pathogen, chickenpox occurs, with a recurrence of a chronic infection, shingles occurs.
IV type. Epstein-Barr virus. It provokes Filatov's disease - acute mononucleosis.
V type. Cytomegalovirus, which has not been fully studied since it was discovered only in 1956. Infection during pregnancy can lead to intrauterine infection, fetal death, premature outflow of water.
VI type. It provokes the development of lymphoma, lymphosarcoma.
VII type. A poorly understood form of herpes. It is manifested by constant fatigue, drowsiness and lethargy that does not go away after rest.
VIII type. Information about such a virus is also scarce. But it is known that it affects white blood cells and is often diagnosed in HIV carriers.

Features and pathogenesis of HSV types I and II

After the first contact with the virus, which occurs in the first three years of a child's life, the pathogen "lives" in the body of most people. Moreover, women are more susceptible to it than men. It can exist in the human body for years without showing any signs, since its activity is suppressed by the body's defenses. When immunity is weakened, it comes out of suspended animation and makes itself felt with unpleasant symptoms. Often, the disease attacks pregnant women due to the peculiarities of physiological processes during this period.

The herpes virus enters the body in the following ways:

acquired - sexual, airborne, contact (through household items, handshakes, kisses) ways;
congenital - during fetal development or during childbirth.

The virus is able to penetrate through the mucous membrane of the oral cavity, upper respiratory tract, reproductive system and spread to various organs through the lymphatic and blood vessels. It “implants” into the genetic material of nerve cells and can remain there for years.

It is impossible to completely get rid of the virus. In response to the process of its introduction, the immune system produces special antibodies (immunoglobulins of class M, G, A), which suppress herpes and prevent it from progressing. When exposed to adverse factors, the virus is activated and multiplies in the epithelial cells of the skin and mucous membranes, affecting them and leading to death. Clinically, this is manifested by itching, burning, rashes, sores, and then crusts that form in this place.

The virus lives in human blood, lymph, cerebrospinal fluid, urine, semen, saliva.

Aggravation provocateurs

The main factor that provokes the development of herpes is the weakening of the immune system. Concomitant causes that affect the activation of HSV type I can be:

hypothermia;
colds, acute respiratory infections, flu;
past stress or trauma;
hypovitaminosis;
unbalanced diet;
passion for natural or artificial tanning.

The causes of the appearance and subsequent recurrence of HSV type II is unprotected sexual contact. Additional factors contributing to the activation and transmission of infection are:

infections of the genitourinary system;
hormonal disruptions;
weakening of the immune system;
physical and emotional stress;
hypothermia.

In patients with oncological diseases, AIDS, the disease often progresses against the background of a decrease in immunity. It has a more vivid clinical picture, affects several areas and is difficult to treat.

The main manifestations of the disease

HSV can affect the skin and mucous membranes anywhere on the body. The classic manifestation of herpes infection types I and II are as follows.

Herpes type I:

localization - the nasolabial part of the face, the mucous membrane of the nose, lips in the area of \u200b\u200bthe border with the skin, the mucous membrane of the oral cavity (stomatitis) and tonsils (tonsillitis);
the nature of the rash- small blisters with a clear liquid, after they are opened or when injured, a crust is formed;
additionally - itching and burning in the area of the affected areas.

Type II HSV, when localized on the mucous membrane of the vagina and cervix, does not have typical manifestations. It is found in the study of smears, with a targeted PCR examination. If the foci are located on the external genital organs, then the following are possible:

burning and itching;
swelling and redness;
painful sensations;
enlarged lymph nodes in the groin;
rashes in the form of bubbles with a colorless liquid;
the appearance of small ulcers in place of the bubbles.

Necessary examination

A comprehensive examination, which allows to establish the presence and type of HSV, includes two stages:

examination by a specialist;
laboratory research.

The main methods that can reliably confirm the presence of infection are the following.

Polymerase chain reaction (PCR). A simple way to determine the virus, even if it is in the body in low concentrations. The essence of the method consists in repeated copying of the DNA segment of the pathogen and further identification of its species. The material is taken from the alleged focus of infection - from the site of rashes on the lips, genitals, from the cervical canal. PCR allows you to indicate whether HSV is currently active. A negative result indicates no active infection, but not a complete cure.
Enzyme immunoassay (ELISA). Allows you to identify antibodies such as IgM and IgG, to establish their number. Thus, the phase of the disease is determined.
Immunofluorescence reaction (RIF). The taken biological material is treated with a special substance, after which the antigens begin to glow. This allows them to be detected under a microscope. Used less frequently.

The interpretation of the results of analyzes for HSV types I and II is presented in the table.

Table - Correct assessment of the results of analyzes for HSV types I and II

ELISA IgM	ELISA IgG	PCR	Result
Not performed	Not performed	Negative	- No active infection;
Not performed	Not performed	Positive	- Active infection; - immunity to pathogen unknown
Positive	Negative	Positive	- Active infection; - first contact with a pathogen
Positive	Positive	Positive	- Active infection; - exacerbation of the chronic form
Positive	Negative	Negative	- Acute infection, but there is no pathogen in the studied focus; - first contact with a pathogen
Positive	Positive	Negative	- Exacerbation of chronic infection; - there is no virus in the material for PCR
Negative	Positive	Negative	Infection in a depressed state
Negative	Positive	Positive	Subacute course

Additional research methods include the following.

Cultural. The biomaterial is placed in a nutrient medium where the growth of viruses is expected. If it is not there, there is no infection.
Immunogram. Blood test for the content of immune cells. Does not indicate the presence/absence of a virus.
Vulvocolpocervicoscopy. Inspection of the mucous membrane of the vagina and cervix with a colposcope. You can find signs of herpetic lesions.

When registering, a woman must pass an analysis to detect TORCH infections (toxoplasmosis, rubella, cytomegalovirus, herpes types I and II). And knowing the immune status before pregnancy, you can timely identify the pathogen and prevent primary infection during gestation.

Treatment

The virus is not amenable to radical therapy, it can only be stopped and immunity maintained, which suppresses the development and clinical manifestations of the pathogen. The task of the doctor and the pregnant woman is as follows:

don't get sick the first time- if there were no episodes of the disease before;
prevent rashes on the eve of childbirth- this is especially true for localization on the genitals, otherwise a caesarean section is indicated to prevent infection of the child;
treat exacerbations- if there are few of them, local remedies are sufficient, with frequent episodes, oral medication is indicated.

The range of antiherpetic drugs is small.

Outwardly. You can use Panavir, Acyclovir. When joining a bacterial infection - tetracycline, erythromycin ointment. Oxolinic ointment and preparations based on interferons are also prescribed topically. For rapid healing of the affected integuments, their treatment with vitamin E may be recommended.
Tablets inside. During gestation, only Acyclovir is allowed.
Droppers. Solutions "Acyclovir", "Panavir".

"Ganciclovir" is one of the most effective antiherpetic drugs, which is superior in its effect to "Acyclovir". However, its use is strictly contraindicated for expectant mothers.

Folk methods

The most gentle are natural remedies. But even their use in pregnant women requires agreement with a specialist. The following alternative treatment options are popular:

fir or castor oil- lubricate the lesions several times a day;
tea tree oil- helps to eliminate the rash with daily use;
calendula ointment - softens crusts and heals wounds;
Chamomile infusion or cream- contribute to the softening of keratinized skin, their disinfection and regeneration;
plenty of warm drink- teas and compotes with viburnum, cranberries or licorice root are needed for general immunity strengthening.

What is dangerous during gestation

At first glance, it may seem that herpes is not so terrible during gestation, if we are talking about types I or II. In a woman, it can manifest itself as rashes on the skin, lips, genitals. For maternal health, this, indeed, will not bring much harm, but the following situations are dangerous for the fetus:

if the mother fell ill with herpes for the first time;
if episodes of exacerbation are frequent;
if the rash appeared on the eve of childbirth.

At the initial meeting with the virus during pregnancy, the female body does not yet have protective antibodies, so HSV also enters the fetus, disrupting its development, and can cause malformations. First of all, the nervous system suffers. The virus infects and provokes pathologies of the heart (myocarditis, organ failure), liver (hepatitis, underdevelopment of the bile ducts), brain (increased intracranial pressure, hydrocephalus). In severe cases, it can provoke intrauterine fetal death. Similar consequences are also possible if the herpetic infection worsens frequently - several times a month.