REPROSAIT 4 U

Most women with genital herpes give birth to healthy babies. However, if you suffer from genital herpes there is a very small risk that your baby will catch the infection and if she does the results can be serious, even fatal. That's why it is important to tell your midwife if you or your partner have ever had an outbreak of genital herpes or if you think you have any of the symptoms. Extra care can then be taken of you and your baby.

What is genital herpes?

Genital herpes is caused by the herpes simplex virus which also causes cold sores around and in the mouth. Genital herpes is usually caused by herpes simplex virus type 2 (HSV-2), while cold sores are usually caused by herpes simplex virus type 1 (HSV-1). However, genital herpes can also be caused by HSV-1. Once you have been infected with a herpes virus it stays in your body for life, only becoming active every now and again.

How might genital herpes affect my pregnancy?

If you had genital herpes before you became pregnant then the risk of your baby becoming infected is very low, even if you have an outbreak during your pregnancy or during labour. This is because your body has had time to develop antibodies to the herpes simplex virus and this immunity is passed on to your baby during pregnancy. Your baby will continue to be immune for up to three months after the birth.

If you catch genital herpes for the first time in the first or second trimester of your pregnancy, there is a slight risk that it will affect your developing baby. The infection has been linked to :

1. Miscarriage,
2. Intrauterine growth retardation (IUGR),
3. Premature labour,
4. Microcephaly (where the baby's brain is underdeveloped) and
5. Hydrocephaly (where fluid builds up around the baby's brain) but this happens very rarely.

Your doctor will probably refer you to a genitourinary medicine (GUM) clinic where you will be given a 5-day course of an oral antiviral medicine, usually acyclovir.

The ACYCLOVIR wll help you to reduce your discomfort and speed up the healing or your sores. It is safe to use in pregnancy.

Your baby is at greater risk if you catch genital herpes for the first time in late pregnancy before you have had time to develop antibodies to the virus and to pass this immunity on to your baby. Your baby can catch the virus through direct contact with an active sore, which is weeping or inflamed, during birth. If a baby catches the infection at birth it is called neonatal herpes. About four in ten babies develop neonatal herpes when born vaginally to women with a first infection when they come to give birth.
In the UK, only one or two babies in 100,000 catch neonatal herpes, but it can be very serious and even fatal. Neonatal herpes can cause infection in a baby's skin, eyes or mouth and may damage the brain or other organs. If your baby does catch neonatal herpes, effective treatment with antiviral medicine for you and your baby can help prevent and minimise long term damage to your baby's health.

Will I need to have a caesarean?

If you suspect you have an active genital herpes infection in the last trimester of pregnancy it is vital that you tell your midwife or doctor. If you have never had herpes before then you will probably be advised to have a planned caesarean section, particularly if you have your first outbreak in the last six weeks of pregnancy. This is to minimise the risk of transmitting the virus to your baby.
If you want to go ahead with a vaginal delivery, then your obstetrician will try to avoid any invasive procedures such as ventouse or forceps and will give you intravenous acyclovir during labour and delivery as this may reduce the risk of your baby catching herpes. Your newborn baby will also be given acyclovir.
If it is not your first infection, you will probably be given acyclovir daily for the last four weeks of pregnancy. You will not be advised to have a caesarean as your baby will probably have immunity to the virus.

Can I breastfeed if I have herpes?

The herpes virus is not transmitted through breastmilk so having herpes shouldn't stop you from breastfeeding, providing you don't have any sores on your breasts. Make sure that sores elsewhere on your body are covered and wash your hands frequently and carefully. If you are taking acyclovir, it will be excreted in your breastmilk but is not thought to be harmful.

What are the symptoms of a genital herpes infection?

Symptoms vary a lot from person to person. What most people do find is that symptoms are usually worse, and last longer, the first time they have a herpes outbreak. Symptoms of a primary or first infection may include:

painful sores over your genitals and buttocks

1. itching
   
2. stinging when passing urine
   
3. vaginal discharge
   
4. swollen glands in the groin area
   
5. flu-like symptoms including fever, headache and muscle aches

A primary episode can last two to three weeks.
With a second or later infection you may get no symptoms at all or just a small area of irritation. If it is not your first outbreak, it will probably be over within three to five days.
Whether or not you have symptoms, it is important to remember that you are still contagious during a herpes recurrence. In fact, most infections occur when the person passing it on has no noticeable symptoms. This is why it is important to tell your midwife if you or your partner suspect you may have had a herpes outbreak in the past.

How can I avoid catching the virus while I am pregnant?

If your partner has genital herpes you need to be particularly careful when you are pregnant. As the virus can be transmitted without your partner knowing that he is having an outbreak there are no foolproof methods to avoid catching herpes. In fact, the virus is most infectious when, or just before, symptoms appear. You can catch herpes from penetrative and non-penetrative sex (vaginal or anal), from oral sex, and by sharing sex toys. Condoms may help to reduce the risk of catching herpes from your partner, or you may want to avoid sex altogether. You should also be aware that you can catch genital herpes from your partner if he has oral herpes and performs oral sex.