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Sexual health and LGBT population
Living with HIV
Post-exposure prophylaxis (PEP)
Once again, genital herpes is common, approximately 25 % of the adult population is infected (known or not) by genital herpes. This follows through that outbreaks of genital herpes during pregnancy can occur. In the event of recurrent outbreaks (you contracted herpes prior to pregnancy), the risk of contaminating the baby are during delivery and vaginal passage. The risk of infection to the newborn is very low if there are no active lesions detected in the week to days prior to delivery. In the event of lesions, your doctor may recommend a caesarean-section to be sure to avoid transmission of herpes which can lead to a severe lung infection (pneumonia) in the newborn. This is an infrequent occurrence and most women are able to deliver their children by spontaneous vaginal birth. If infection is suspected, there are effective anti-viral medications useful in treating and decreasing the rate of complications in the newborn.
The risk of flare-up at the time of delivery also depends on the natural history of your herpes…if you have had no or very few recurrences in the months to years prior to pregnancy and delivery then the chance of reactivation at delivery is likely quite slim. The chances of perinatal transmission are highest when genital herpes is acquired late in pregnancy.
At times your doctor may prescribe anti-viral medications to be taken during pregnancy. This is infrequent during the first two trimesters of pregnancy. Your obstetrician may encourage the use of anti-virals in the eighth or ninth month of pregnancy so as to prevent outbreaks and decrease the risk of asymptomatic transmission at birth.
To put neonatal herpes infections into perspective, an estimated 20-25% of pregnant women are sero-positive for genital herpes, while less than 0.1% of babies contract an infection. Protective antibodies against herpes are passed from the mother to the fetus and are in large part responsible for low transmission rates. These protective antibodies are transferred via the placenta at approximately 28 weeks gestation – this means premature babies may be at greater risk for infection at birth.
It is important that you inform your gynecologist-obstetrician or midwife of your genital herpes status such that an appropriate management plan may be decided upon.
The first outbreak can be more dangerous: If the first episode of genital herpes occurs while pregnant, the virus can be passed on through the placenta to the unborn child with serious consequences. About half of babies infected this way are either stillborn or suffer damage to the brain, nerves, eyes or skin.
The important question is whether this is truly a first episode during pregnancy or a reactivation..If performed promptly, a Western blot blood serology can tell you whether the outbreak is a true primary (a new infection in a person with no previous antibodies to either HSV-1 or HSV-2), a non-primary first episode (an infection of HSV-2 in a person with previous antibodies to (HSV-1), or a recurrence. Speak with your doctor – timing is of the essence in determining your situation.
Prevention is key!!