In the ordinary sense of “herpes” – it’s unpleasant rashes on the lips. But this is a serious illness, which is very common. The sad consequences are herpes in pregnant women. It is a viral disease that makes itself felt by specific rashes both on the skin integuments and on the mucous membranes of the human body. Herpes can be sick people of any age and sex.
What is Herpes? Types of Infection
The disease is incurable. The virus can “sleep” in the body for years. But, as soon as for some reasons the defenses of the body weaken, the clinical picture of the disease will manifest itself. There are 2 types of herpes virus:
- VPG-1 (the so-called, labial)
- HSV-2 (genital: rashes appear on the genital area of a person)
The second type of herpes is very dangerous for those who are carrying a child. This is a TORCH infection. On a number of such infectious diseases a woman must necessarily be checked at the stage of pregnancy planning, because they can damage the development of the fetus.
Ways of Disease Spread
VPG-1 is transmitted in such ways:
- contact-household
- airborne
Air droplet transmission means that the virus is transmitted from the infected person to the healthy person through touch (only through those areas where there are rashes), kisses, etc. Using personal things of an infected person, you have every chance of getting infected. Therefore, the pregnant woman should only use her cosmetics, a toothbrush, a washcloth for the body, towels and dishes.
HSV-2, that is, the genital type of herpetic infection, is transmitted sexually (coitus). In half the cases a woman becomes infected from a partner who does not have any bright symptoms at the moment, but there can be only small rashes, mild pain and slight burning, no more. Such symptoms often seem to the man not threatening health, and he does not address the doctor, infecting his partner with kisses, touches and unprotected sexual acts.
If a pregnant woman becomes infected with herpes for the first time, the fetus will catch 50-60 cases out of 100. This is a very high chance of getting sick. Also, vertical transmission of genital herpes (through the placenta or during childbirth) is possible. in the process of childbirth the baby passes through the birth canal in which the virus is localized and there are eruptions. His immunity is still too weak to resist such an infection, and infection occurs in just a few minutes.
Most of the population is sick with herpes because it is very simply transmitted. Therefore, those who wait for a child need to be checked before pregnancy and monitor their immunity for 9 months.
Symptoms (Manifestations)
The two above described types of herpes give rashes in different parts of the body. But the symptomatology is similar:
- rashes similar to vesicles
- burning and itching of the mucous membranes of the genital organs
- headache
- muscle pain
- weakness in the body
- temperature about 38 – 39 degrees
In the place through which the pathogen got into the woman’s body, the burning and itching begins first. And only after a while there is a rash. Bubble rashes are called “vesicles”. They are filled with serous content, which has no color. Bubbles with labial herpes are mainly on the lips, sometimes on the nose. When genital herpes, respectively, the rashes will be on the labia, in the vagina, on the neck and even in the anus.
It takes several days before the bubbles open and their contents come out. On the site of the rash there are small sores. If you touch them, there will be pain. Heal wounds for a long time. In genital herpes, pregnant women may have 5-7-day vaginal discharge of a watery consistency. This is one of the symptoms of the genital herpes type.
Recurrent genital herpes during pregnancy in the clinical picture resembles the primary, but the symptoms are not so obvious. As we know, in pregnancy, the woman’s immunity decreases (so she can bear the child, and his body does not reject), because the disease resumes. Physicians call such relapses relapses. After an exacerbation the stage of remission usually follows.
Remission means that the causative agent remains in the body, but there is no typical obvious symptomatology. Relapses in symptomatology are similar to the primary herpes clinic.
Herpes Zoster
This is a very dangerous form of the disease for pregnant women. The causative agent is also a virus. On the skin appear unilateral rash, similar to those with herpes. In the places of the rash, there are painful sensations, which are explained by the localization of the virus-pathogen in the human nerve cells.
Herpes zoster is provoked by the varicella-zoster virus. It latently exists in the body for a certain period, and with a decrease in protective forces begins to attack the body. Forms of the disease:
- motor
- ophthalmologically
- Ramsey-Hunt syndrome
Atypical forms of herpes zoster include:
- hemorrhagic
- gangrenous
- abortive
- vesicular
Accordingly, the manifestations may be different. But in all cases there is a rash along the course of large nerve trunks and nerves. The nature of the defeat, as already noted above, is one-sided. At the same time the patient feels bad, she has a fever.
After some time, there are neuralgic pains in the affected areas. First, spots of pink hue are visible on the skin, and a few days later, erythematous papules and vesicles in which there is a serous liquid form on the background of them. When the type of rash changes, an increase in the number of located lymph nodes occurs. Also, the pain sensations along the nerves become even more tangible, causing discomfort to the sick woman.
After about 7 days the erupted rash dries up, crusting. After some time, the crusts fall off, in their place remains pigmented skin. When the symptomatology of herpes has disappeared, pain can still be felt along the nerves, which is called postherpetic neuralgia. It is very difficult to cure her.
Diagnostics
Immunoenzymatic analysis is a very reliable diagnostic method. It allows you to detect both the labial and genital herpes in a woman. ELISA detects immunoglobulins of class G and M in the patient’s blood. After infection, Ig M appears first in the blood. And after 2-4 weeks, Ig G can be detected (after the initial infection or the resumption of a pre-existing disease).
Types of ELISA:
- qualitative
- quantitative
The last of these gives information on the titre of immunoglobulins, that is, their number. Quantitative ELISA allows to assess whether a patient has immunity to the causative agent of herpes.
In addition to ELISA, the diagnosis is carried out by PCR or virological sowing. The fact that a woman has herpes, the doctor says symptomatology, indicating exactly this disease.
Methods of laboratory diagnostics:
- serology
- culture method
- immunofluorescence reaction
- microscopic examination
In 80 women of reproductive age out of 100 are found in the study of antibodies to the causative agent of herpes simplex of the first type. Antibodies in the same patients to the second type virus are found in 30 women out of 100. Those who want to conceive a child, and those who are already pregnant, are experiencing when an ELISA reveals herpes in the body. But you should not worry, because the herpes test shows whether there is protective antibodies in the blood.
If you have IgG, then the fetus is not in danger. This is even good, because herpes will not be transmitted to the child, because the mother has immunity. If they are found (IgM), then it can talk about the recurrence of herpes, which the woman once infected, and which was latent.
IgM persists in the body for only one or, at most, two months. IgG antibodies will be in the blood all life, which in medical language is called seropositivity. If primary infection occurs, IgM and 4-fold growth of IgG are detected, which are detected during studies with a break of 12 days.
About recurrence of the disease in a woman says a large amount of IgG and the appearance of IgM. If you have received doubtful results regarding IgM, you must again pass the test after 10 or 12 days.
Effect of Herpes on the Fetus
If there was a primary infection of a woman, then the infection of the child occurs in more than half of the cases. If the primary infection does not make itself known characteristic symptoms, then the risk of transmission to the fetus is 40%. If the current of herpes in a pregnant woman passes without clinical manifestations or there is a renewable infection, the transmission to the fetus occurs in only 0-4 cases out of 100.
Consequences of primary infection of a pregnant herpes zoster:
- disorders of the course of gestation (abortion, polyhydramnios, premature birth
- pathology of fetal development (birth of a dead child, intrauterine infection, spontaneous abortion)
- pathology of the newborn (various malformations, body weight below the norm, congenital form of herpetic infection, prematurity)
If the pregnant woman noticed herpes sores on her lips, you can not worry about the condition of the fetus. Immunity is created, which will prevent the infection of the child. But local therapy (ointments, etc.) is needed.
When primary infection with the pathogen, the consequences for the fetus depend on what month of gestation the women are. In the first trimester there is a high chance of miscarriage or a stagnant pregnancy. This means that a woman can not stand a child and does not give birth. At primary infection on the fourth, fifth or sixth month at the child development anomalies which will lead to destruction of a fruit can arise. If the infection occurs in the last 3 months of gestation, then there is a danger for both the future mother and the baby.
Consequences of infection of pregnant herpes at the 7th-9th month:
- disabilities of physical development
- severe lesions of the central nervous system
- pneumonia
- heart defects
- defects in the formation of the brain
- significant hearing and vision impairment
For the mother, infection in the last trimester is threatened with inflammation. A little less dangerous is the exacerbation of genital herpes. At childbirth in such cases the child risks to pick up herpes. Therefore, before the birth, special therapy is carried out for the mother. If therapy did not give the desired effect, then do cesarean section instead of natural delivery.
The fetus becomes infected through the eyes and the nasopharynx as it passes through the genital tracts of the sick mother. The first symptoms will not be specific. But the diagnosis can be made after a few days of the baby’s life in order to prescribe the right treatment.
Treatment of Herpes during Pregnancy
Any treatment during pregnancy can result in sad consequences for the fetus and for the mother. Medication is not recommended. But there are conditions that are better to treat. Apply Panavir internally and externally. Labial herpes can be cured with acyclovir, analogues of which are zovirax, vivorax and acygherpin. Any of these ointments lubricate the rash on the skin and mucous membranes. This should be repeated 3-5 times a day, the course is 7 days.
The doctor can prescribe pregnant and other local treatment with ointments:
- tetracycline
- erythromycin
- tebrofenic
- oxoline
- alizarinic
Active herpes during pregnancy needs treatment. The rash is lubricated with a solution of interferon and vitamin E. Thanks to it, the sores are quickly tightened with a crust. If the pregnant woman has very low immunity, she is prescribed the appropriate drugs:
- B-group vitamins
- echinacea
- eleutherococcus
- ginseng
In rare cases, treatment with immunoglobulins is necessary. As for folk methods, wounds on the genitals and on the lips smear with rosehip oil, sea buckthorn or fir. Also sometimes used ointment based on flowers of chamomile or calendula. This method helps the sores heal in a shorter time.
To give birth in a natural way, without doing cesarean, in the third trimester a woman for the treatment of herpes is prescribed Acyclovir. The course is 2-3 weeks before the planned delivery. Four times a day, 200 mg is administered. This is a fairly harmless method for the fetus. Also, the genital tract of a woman who will give birth without Caesarean is treated with a solution of Half-Blood. It kills the virus locally.
To understand whether a pregnant woman has herpes on the 9th month or not, the doctor checks herpes for the presence of a rash on the genitals. If a rash is found, most likely, a cesarean section will be recommended. Indications for surgical delivery are also:
- infection with herpes for the first time in life at the 9th month of gestation, when there are no antibodies to the pathogen in the blood
- detection of herpes in PCR from the cervical canal before delivery
- Herpes, leaking heavily, which can not be cured with acyclovir
Prevention
The main measures for the prevention of herpes in pregnant women are:
- an analysis of the herpes virus when planning conception (before you become pregnant)
- rejection of bad habits
- strengthening immunity (tempering, balanced nutrition, physical activity and healthy lifestyles in general)
If you know about your recurrent herpes, you need to be treated before the pregnancy with multivitamin complexes and immunomodulating medications as prescribed by the doctor. Laser therapy can also be recommended, which helps make the virus less active. Also, you need to give up contact with those who have recurrent herpes. Health to you and your baby!