Herpes during pregnancy. Types, symptoms, treatment

Today, herpes during pregnancy is a very hot topic due to more frequent infections and relapses. If you are wondering whether herpes is dangerous during pregnancy - yes, it is dangerous, but not always. Below we will talk about how herpes infection affects pregnancy, whether there can be a miscarriage if herpes was detected in the early stages of pregnancy, and what drugs are used in its treatment.

Herpes and pregnancy are quite serious phenomena that are scrupulously monitored by infectious disease doctors. The herpes simplex virus poses a huge danger to the proper maturation and formation of the fetus. For example: due to teratogenic initiative, of all viruses, only the rubella virus has the ability to cause deformity to the embryo.

As a result, the distinctive features of herpes, especially during pregnancy, have always been carefully examined. To date, scientific medicine has collected quite extensive material on this disease.

People encounter herpes infections much more often than one might imagine. Herpes in pregnant women poses a particular threat to both the woman and the fetus.

Localization and types

Herpes during pregnancy behaves as usual in relation to the pregnant woman herself; the most common strains are:

1. Herpes type 1. during pregnancy, it is also localized in the form of bubbles near the labial borders and on the lips. It is most often transmitted through close contact with a virus carrier.
2. Herpes type 2 during pregnancy causes the same herpetic rash in the groin and genital area, which brings much more discomfort during pregnancy. One of the varieties is that during pregnancy it can lead to infection of the fetus.
3. Type 3 virus – chickenpox and. Shingles during pregnancy forms rashes around the torso, less commonly around the legs or around the forearms and arms. In the case of primary viral infection, shingles is the well-known chickenpox.
4. Type 4 virus () – excites. The disease does not form a blistering rash.
5. Type 5 of herpes. proceeds without rashes. A characteristic manifestation is increased body temperature and symptoms of colds. Diagnostics – laboratory examination of a blood test.

Why does pregnant women have decreased immunity and how does herpes react to it?

A possible relapse or secondary reproductive activation of herpetic infection invariably occurs against the background of a significant decrease in immunity. During pregnancy, a decrease in the body's protective functions is called physiological and is considered a completely normal phenomenon.

As a rule, herpes often appears during pregnancy. This is due to a significant decrease in the woman’s immunity. This phenomenon occurs in the body for the purpose of bearing and preserving the fetus. If a pregnant woman’s immunity functioned at its maximum capacity, the fetus would simply be rejected.

Based on the foregoing, we conclude: a reduced immune system during pregnancy is necessary. But at this moment the body is very susceptible to infection, especially in the second trimester. The fact is that during the 2nd trimester of pregnancy, a woman’s health becomes better, and accordingly, sex returns. And genital herpes, as a rule, is most often transmitted sexually.

The deterioration of immunity in the second trimester of pregnancy occurs due to a lack of vitamin complex, which is energetically consumed in the body during the formation and maturation of the fetus. In the third trimester, immunity decreases for the same reasons.

Statistics on the danger of herpes for the fetus

Let's look at the dangers of herpes during pregnancy. There is no point in objecting to medical statistics on herpes during pregnancy. Regarding this disease, she provides the following information and figures:

• literally 90% of people on Earth are carriers of the herpes virus of the first type, as well as the second type;
• with primary infection, the risk of infection of the fetus in utero is thirty to fifty percent, for recurrent herpes three to seven percent;
• herpes in the early stages of pregnancy becomes the basis for spontaneous miscarriage in thirty percent of cases;
• herpes during pregnancy in the 3rd trimester will cause late miscarriage in fifty percent of cases;
• in forty percent of newborns, intrauterine infection actively leads to the formation of latent virus carriage with the possible development of dysfunctional disorders at a later age;
• Women who have had the disease asymptomatically or in atypical forms give birth to sick children in seventy percent of cases. Infant mortality in this group itself is approximately fifty to seventy percent of cases. About fifteen percent of babies are born healthy.

It is important to note that treatment of herpes during pregnancy can be carried out at any stage. The more timely the expectant mother contacts an obstetrician-gynecologist at the clinic, the more timely the diagnosis will be carried out and both therapeutic and preventive measures will be prescribed. Otherwise, numerous complications of various types may arise.

In case of extensive rashes on the lips, nose, face, possibly on the mucous membrane of the genital organs or in any other part of the body, the attending physician will refer the pregnant woman for additional studies, the purpose of which will be to identify the type of herpesvirus that has entered the body. Herpesvirus type 1 is not as dangerous as the genital one. In this case, it is clear how herpes affects the condition of a pregnant woman and that the virus can cause serious complications.

Treatment methods for herpes during pregnancy

Let's analyze what goals the treatment of herpetic infection during pregnancy has:

• significantly reduce symptoms;
• accelerate regeneration (restoration) processes;
• reduce the duration of the acute period;
• significantly reduce the severity of the release of infectious virus in affected areas;
• reduce the number of relapses.

No therapeutic measures lead to the absolutely complete and final disappearance of the virus from the body for one simple reason - it always lives in a person. Nevertheless, it is possible to eliminate symptoms as much as possible and reduce the number of secondary relapses.

Treatment with drugs

Of course, women need to know how to treat herpes during pregnancy, but not to use these drugs without consulting a specialist. The main medications for combating herpes during pregnancy are groups of specialized drugs to increase the efficiency of the immune system:

1. Interferon. Viferon – suppositories, gel, ointment. Immunomodulatory drug with antiviral effects. Pregnant women are allowed to use the drug for herpes in the second trimester;
2. Interferon. Genferon - candles. Immunomodulatory drug with antiviral effects. Used when absolutely necessary in the second and third trimesters.

Let's look at which medications are effective today, but with caution and only after appropriate recommendations from the attending physician:

1. Famciclovir-teva- pills. The antiviral drug is used to treat diseases caused by the Varicella zoster virus and the Herpes simplex virus.
2. Fenistil Pencivir– cream. An antimicrobial, antiviral drug is used in the treatment of recurrent herpes simplex - skin diseases for external use. Pregnant women should use only on the recommendation of their doctor;
3. Valaciclovir. Antiviral drugs in the form of tablets are prescribed by the attending physician for systemic use. Can be used during pregnancy only in cases where the expected benefit of therapy for the woman outweighs the potential risk to the fetus;
4. Acyclovir - lyophilisate, cream, ointment, tablets, powder. The antiviral drug is used in the treatment and prevention of exacerbations or primary and recurrent herpetic infections.

If before pregnancy the expectant mother already had genital herpes, then she needs to inform the gynecologist who is observing her about this. It is necessary to inform your doctor immediately when the first symptoms of an exacerbation appear. Herpes during early pregnancy can lead to miscarriage.

Timely treatment will be more effective. The maximum effectiveness of antiherpetic medications is observed before the appearance of the rash or within 24 hours after the appearance.

Prevention

In case of relapses, it is recommended to take sitz baths with herbal infusions of chamomile and chamomile flowers, followed by the application of drying ointments. Doctors also strongly recommend that you seriously think about a healthy lifestyle: walk in the fresh air more often, maintain a calm psychological environment, avoid stressful situations and depression.

It is necessary to include in your diet foods containing lysine (one of the amino acids that is part of proteins). Lysine slows down the massive reproduction of the virus. This amino acid is found in huge quantities in fresh fruits and fresh vegetables, as well as in chicken and fish. Sources of lysine include dairy products, legumes, some grain products, chicken and quail eggs.

Many of us have not only heard about such a disease as herpes, but even know it, as they say from personal experience. Indeed, today more than 90% of the entire population of the planet are carriers of the herpes virus. Constantly present in the human body for five, ten and even twenty years, the herpes virus may not manifest itself in any way. This happens, first of all, because the human immune system is able to “suppress” its manifestations and the virus itself, as if realizing that it cannot cope here yet, is slowly “dormant.” And all this lasts until the strong protective forces of the human body weaken for some reason. Then, in fact, we observe painful plaques on the face and other mucous membranes.

Today, there are many different methods of treating this disease. However, all of them are aimed, first of all, at sharply suppressing the manifestations of this disease, as well as at actually restoring the immune system. However, there is one unpleasant “but”: this disease cannot be cured completely; it can only be “put to sleep” for a while. Moreover, the disease goes away only until the human immune system weakens again. Unfortunately, pregnancy is one of those periods that depresses the immune system, when a disease living, as they say, in a state of suspended animation begins to progress quickly and painfully.

What do we know about herpes for sure?

• To begin with, we all clearly understand that every second person on earth is a carrier of this virus.
• Secondly, the herpes virus can usually lurk in the peripheral nervous system, somewhere in the spine area.
• Thirdly, herpes is different from herpes. Moreover, we present this statement in order to remind you that today medical science distinguishes between herpes of both the first and second types.
• Further, as you remember, herpes most often manifests itself as rashes in the form of small and painful blisters. And the most favorite place for such rashes is the lips or nose (if it is a type 1 virus) or the genitals (if it is a type 2 virus).
• The herpes virus can be transmitted in four ways. So among them: airborne droplets, both sexual and contact household (during kissing, shaking hands, sharing some common household objects in everyday life) and birth (directly from the mother to her child, possibly during pregnancy, and possibly during childbirth).
• In addition, the herpes simplex virus is usually present in its carrier both in saliva and in the blood, lymph, tears, urine, semen or cerebrospinal fluid.
• Typically, the herpes virus penetrates the DNA of a sick person, then introduces completely new information into it and actively multiplies.
• Sometimes the herpes virus can contribute to the sudden development of such a dangerous disease as cervical or uterine cancer.

How can the herpes virus be dangerous during pregnancy?

As previously mentioned, the herpes virus most often manifests itself during pregnancy, at a time when women experience a sharp decrease in immunity. And the latter, as you understand, is simply necessary for successful conception and gestation of the fetus, which to a certain extent can be a foreign object for the body of a pregnant woman. That is why mother nature arranged it so that for almost all nine months the woman’s body weakens somewhat and does not even try to get rid of such a “stranger” on her own. Or rather, from the perspective of pregnancy, the phenomenon of immunosuppression during pregnancy is simply necessary, but in the case of the herpes virus, everything is completely different.

It is incredibly dangerous if a woman manages to become initially infected with the herpes virus while already pregnant. It is in this case that there is a real possibility of this virus penetrating through the placenta directly into the body of her unborn baby. To tell the truth, infection may not occur after all. If a woman was infected in the first trimester of pregnancy, the risk of spontaneous miscarriage will increase significantly. However, if this does not happen, the herpes virus can “work” in a completely different area and, somewhat later, provoke a variety of diseases. These can be lesions of the entire central nervous system, and the most serious congenital defects of brain tissue, and visual and hearing impairments, and a variety of deviations in the general physical development of the child. Infection of a woman in the third trimester of pregnancy can even lead to stillbirth or the birth of a baby with brain damage.

Somewhat more comforting prognoses exist for those women who previously had herpes and were carriers of this virus at the time of pregnancy. In this category of women, children are under reliable protection of existing maternal antibodies.

One of the most commonly used methods of delivery, in cases where shortly before birth could occur, is this. And this is due, first of all, to the fact that there is an incredibly high risk of infection of the child directly when he passes through a previously infected birth canal. However, despite this, some specialists still practice childbirth in the usual natural way. But to do this, they try to neutralize the virus with the help of special medications. Actually, one of these drugs is, for example, acyclovir ointment.

Treatment of herpes virus during pregnancy

Let us immediately note that in the case when a woman observed any manifestations of herpes before pregnancy, she should tell her obstetrician-gynecologist about it. But in cases of exacerbation of the disease directly during pregnancy, you definitely should not postpone your next visit to the doctor: since the earlier the appropriate measures are taken, the greater your chances of success.

And as we have previously noted, medications that destroy this virus and ensure complete recovery simply do not exist, at least for today. The measures taken by doctors usually affect either the virus itself, somewhat inhibiting it, or, on the contrary, supporting the woman’s immunity. The situation is usually aggravated by the fact that during all nine months of pregnancy it is possible to use not all of the known drugs.

The most important and main ally of a pregnant woman in the fight against the herpes virus is such a well-known drug as Panavir. Moreover, this is exactly the drug that can be used both internally and externally during pregnancy. In addition, but with greater caution, an antiherpetic ointment such as acyclovir is used. Usually, only the foci of rashes are lubricated with it, about five times a day and for one week. In addition, oxolinic, alpizarin, and less commonly tebrofen, tetracycline or erythromycin ointments are sometimes used.

Also, sometimes doctors recommend that their patients lubricate herpetic rashes with a simple solution of interferon, or, which in turn promotes slightly faster healing of existing wounds. If a woman has been diagnosed with severe immune deficiency, immunoglobulin therapy may be prescribed.

Among folk remedies, lubrication of foci of infection with fir oil is usually used; sometimes the crusts of rashes are softened under the influence of chamomile cream or ointment from calendula flowers. Doctors also strongly recommend drinking plenty of warm drinks, for example, tea with honey or viburnum.

It should also be noted that all instructions for drugs used to treat herpes indicate that they can under no circumstances be used during pregnancy. However, any woman, first of all, will have to trust her attending physician, who actually prescribed one of these drugs. In addition, a woman should know and clearly understand that an infection that is not treated in a timely manner can be much more dangerous than taking some “unapproved” medications.

Pregnancy is a difficult period, because while pregnant, a woman cannot get sick with anything, since all this immediately affects the course of pregnancy and the development of the fetus in the most negative way. Herpes is considered a particularly dangerous disease during pregnancy. It increases the risk of miscarriage, premature birth, and can also cause malformations of the child, depending on the period of gestation during which the mother fell ill.

Almost every person living on earth is considered a carrier of the herpes virus. Only five percent, for still unclear reasons, remain “indifferent” to the effects of this viral disease; their body has developed a strong immunity to it. Exacerbations of this disease in carriers occur when the body’s defenses decrease due to colds, bacterial infections, chemotherapy, and pregnancy.

What is herpes?
Herpes is an infection of viral origin, which manifests itself in the form of blistering lesions of the mucous membranes and skin in various areas. After a couple of days, these rashes break out and give way to ulcers. Most often, the labial form of the disease occurs. In everyday life it is also called “cold on the lips.” In addition to the lips, the infection can spread to the mouth, eyes, face, neck, and central nervous system. Another equally common form of infection is genital herpes, which is localized mainly in the genital area. This virus may have other varieties, but we are interested in its genital form, which during pregnancy is a strong argument in favor of its termination.

While pregnant, a woman is exposed to many viruses, including herpes. Most often, this infection affects the skin of the face and the external organs of the woman’s genital area. You should know that herpes simplex does not have any effect on the intrauterine development of the baby, which cannot be said about its genital form.

The danger of genital herpes during pregnancy.
In recent years, such a pathology has occurred in pregnant women much more often than any other. Moreover, it must be said that it contributes to the occurrence of many complications of pregnancy, including causing deviations and disturbances in the development of the fetus. Primary infection with this virus can provoke premature birth. The severity of complications from herpes directly depends on the period (term) of pregnancy during which the infection occurred. At earlier stages of infection, the most severe and dangerous complications of pregnancy are observed.

If the virus was present in a woman’s body before pregnancy, her body has produced the necessary antibodies, so the disease does not threaten the fetus during pregnancy; it is protected by the mother’s immune system. If the infection is diagnosed in the first trimester, the virus enters the baby’s body through the placenta, which usually results in a miscarriage. In addition, exposure of the fetus to the virus during this period causes severe pathologies in the development of the central nervous system, physical health, brain, visual and hearing organs. If the primary infection was recorded at the end of the second and beginning of the third trimester, then the babies born are highly likely to have this viral disease. It should be noted that there is also a risk of the baby being stillborn.

The infection of the expectant mother itself can occur through sexual (most often) or simple contact with a sick person. The danger also lies in the fact that this infectious disease during pregnancy often occurs in combination with other infectious diseases, in particular gonorrhea, syphilis, mycoplasmosis, trichomoniasis, chlamydia and others.

It should be noted that once an infection has occurred, it is not yet possible to completely recover from it. This virus can be present in the body, both in active and latent form. The body's defenses can only fight the open form of the disease. While carrying a baby, a woman may experience primary and recurrent herpes. By the way, with the last form of infection, the risk of a child being born with this viral infection is only five to seven percent.

If, during the period of bearing a child, a pregnant woman experiences an exacerbation of the disease, specialists will definitely perform a caesarean section. This is due to the extremely high risk of infection of the child during its movement through the birth canal of a sick mother. As a result, three weeks before the expected due date, the woman is hospitalized to set a date for cesarean section.

Signs of genital herpes during pregnancy.
The incubation period of this pathology can be three to seven days. A constant symptom that accompanies herpes is slight vaginal discharge with a watery structure. It often happens that only this symptom is a sign of the presence of this pathology. The discharge can last up to seven days. Another distinctive sign of infection is blistering rashes on the surface of the labia minora and majora, the lining of the uterus and vulva. After two or three days, these blisters burst, and ulcers form in their place. In addition, a pregnant woman may experience itching, burning, headaches, muscle pain, fever, malaise and general weakening of the body. All this can last for ten days.

The signs of recurrent herpes during pregnancy are very similar to those of its acute form.

Treatment of herpes in pregnant women.
As mentioned earlier, if the infection was diagnosed in the early stages of pregnancy, the woman is advised to terminate it. Preservation of pregnancy is only possible if infection occurs after the second trimester of fetal development. Treatment of this infectious disease is aimed at suppressing the activity of the virus and its ability to reproduce. For this purpose, antiviral drugs are used, taking into account the possibility of their use during gestation. These can be tablets, ointments, creams. Ointments and creams are applied directly to the surface of the affected tissue. If the threat of infection of the fetus is minimal, then medications are prescribed in minimal doses.

Often, specialists for the treatment of herpes prescribe the drug Panavir, Acyclovir (not suitable for long-term treatment), Alizarin and Oxolinic, Tetracycline or Erythromycin ointments (long-term use is allowed).

To speed up the healing processes, folk and traditional medicine recommends using sea buckthorn oil and rosehip oil. Lubricate the affected areas of the vulva with oil several times a day for three weeks. For these purposes, it is effective to use vitamin E. To strengthen the body's defenses, you can take B vitamins, brew ginseng and echinacea. In rare cases, experts allow treating the affected areas with an interferon solution. If after these measures the immunity still remains weakened, treatment with immunoglobulins is prescribed.

During lactation, treatment of herpes with Zovirax and Acyclovir is allowed.

Prevention of herpes during pregnancy.
Preventive measures during pregnancy are aimed at strengthening the immune defense. This includes regular use of vitamins, physical exercise, hardening, etc. When planning to conceive a child, you should definitely be examined for the presence of the virus in the body. It should be noted that giving up any bad habits is also a prevention of this infectious pathology.

Frozen pregnancy with herpes.
A frozen pregnancy is understood as the cessation of fetal development during the first three months of pregnancy. It is believed that the main culprit in the occurrence of this condition is the presence of the herpes virus in the mother's body. Most often, frozen pregnancy is observed in women with genital herpes. Other triggers include drug use, alcohol abuse, chlamydia and toxoplasmosis. Implantation of the embryo is successful, but no further development of the fetus follows. The mechanisms of occurrence of this condition are still not fully understood.

It is not possible to immediately identify the occurrence of this condition, and besides, the woman in this position feels great. It must be said that when such a condition occurs, the female body does not reject the embryo; as a result, severe intoxication of the woman’s body is often observed. As a result, inflammation of the uterus occurs, leading to the development of endometritis and infertility. In addition, thrombosis and bleeding are observed.

In such situations, timely diagnosis is vital. It is necessary to identify this pathological condition during the first two months of pregnancy (usually an ultrasound scan). The fetus must be removed from the uterine cavity using vacuum extraction. This surgery is performed using anesthesia. After this, treatment for the genital form of herpes is prescribed, usually lasting for six months. As a rule, after a course of effective treatment, a woman can give birth to a healthy baby.

Herpes in newborns.
The herpes virus in newborns is observed due to infection of the mother during pregnancy. The infection is transmitted from mother to baby through the placenta, birth canal, after childbirth due to contact with a sick mother, or with breast milk. The first symptoms of the pathology appear in the baby already two weeks after birth in the form of a blistering rash on the skin and mucous membranes (conjunctiva of the eyes). The situation is different with premature babies; in such cases, brain damage is often observed. In medical practice, this condition is called herpetic encephalitis. Its main symptoms are: convulsions, high fever, drowsiness, difficulty breathing. Only in twenty percent of cases do children with such an infection survive.

Treatment and prevention of herpes in newborns.
In this case, antiviral drugs are also indicated. Most often, Acyclovir is prescribed at a dose of 50 mg per kilogram of the baby’s weight per day. The treatment course is three weeks. The course of treatment is three weeks. Eye damage in infants caused by this virus is treated with the drug Idoxiridine.

After childbirth, mothers infected with the herpes simplex virus must follow all preventive measures so as not to “give” the infection to the child. To do this, every time before picking him up, the mother must wash her hands thoroughly with soap. If the rash affects the lips, use a medical bandage every time you have contact with the baby.

Today it is impossible to completely get rid of the virus; it is only possible to suppress its reproduction and alleviate the symptoms. Therefore, remember that there is always a possibility of reactivation of the infection, especially with immunodeficiency (HIV, tumors). Relapses after several years may be asymptomatic, but the carrier continues to pose a danger to others.

One of the leading problems in practical obstetrics and gynecology is genital herpes during pregnancy. The infection rate in men is lower compared to women. This form is widespread among the adult population, due to the presence of a high percentage of undiagnosed and asymptomatic forms of the disease. In addition to problems with preventing possible complications of the infection itself, significant difficulties arise in the question of how to treat genital herpes during pregnancy in such a way that medications do not negatively affect its development and do not harm the fetus.

Cause and mechanism of development of pathology

The source of infection is a sick person during an acute period or during an exacerbation, from which a partner becomes infected through sexual contact. The highest incidence was observed among people 20-29 years of age. Those at highest risk are those with a large number of sexual partners, as well as those who become sexually active at an early age.

The causative agent of the disease is herpes virus type 2. It is a clinical variant of herpes simplex. The incubation period is from 2 to 11 days. The entrance gate for the pathogen is the skin of the external genital organs and the mucous membranes of the genitourinary system, then it enters the circulatory and lymphatic systems. But at an early stage, viruses penetrate into the endings of nerves, from there through the cytoplasm of the processes of sensitive nerve cells - to the peripheral, segmental and regional nerve nodes of the central nervous system.

In these nerve cells, herpes remains in a latent (hidden) form. The nerve ganglia of the lumbosacral spinal cord serve as a repository for the virus and a source for sexual transmission during periods of exacerbation, which occur on average in 40% of infected people.

Recurrent genital herpes is one of the most common sexually transmitted infections. Its pathogen differs from others in that it is present in a latent (hidden) form in the human body for life and is difficult to respond to specific therapy.

It is aimed at damaging not only nerve and epithelial cells, but also blood immunocompetent cells, which is manifested by multiple forms of clinical course and secondary immunodeficiency, which is associated with frequent colds, long-term and “unexplained” low-grade fever (37.0-37.2 o) body temperature, mental instability, swollen lymph nodes.

Recurrence of genital herpes during pregnancy can be caused mainly by factors such as:

• pregnancy itself;
• hypothermia;
• excessive exposure to sunlight;
• mental trauma;
• nervous fatigue and sleep disorders;
• hormonal changes in the body;
• chronic diseases of internal organs.

The degree of infection, exacerbation, its frequency and intensity of manifestations depend on the number and activity of microorganisms, the duration of their exposure, on the barrier state of the placenta and membranes, as well as on the degree of resistance of the organisms of the mother and fetus.

Clinical manifestations

In accordance with the international classification and depending on the clinical manifestations, primary and recurrent genital herpes are distinguished. The latter, in turn, is divided into clinical forms:

1. Typical, which is accompanied by the presence of characteristic lesions on the skin and mucous membranes of the external genitalia.
2. Atypical, or latent, presenting significant difficulties in terms of diagnosis. It is characterized by the presence of chronic inflammation of the mucous membrane of the internal genital organs in the form of vulvovaginitis, endocervicitis, (inflammation of the ovaries and fallopian tubes) with laboratory (bacteriological and microbiological) confirmation of the herpetic nature of these inflammatory processes, which is not always possible.
3. Asymptomatic with virus isolation - as a result of a virological examination of material (smears) from the genitourinary tract, the herpes simplex virus is sown, but there are no clinical symptoms of damage to the skin of the genitals and the mucous membrane of the genitourinary tract.

It is very important to be examined and identify genital herpes when planning pregnancy. Most often, a primary genital tract infection does not cause any symptoms, especially among people who have previously had a disease caused by the herpes simplex virus type 1. In these cases, infection with the second type of virus occurs in the form of a recurrent form or latent carriage.

At the same time, the acute phase of the disease or relapse of genital herpes during pregnancy is not always detected using standard laboratory microbiological and bacteriological methods. As a result, the woman does not receive the necessary specific treatment. She becomes a virus carrier and a source of infection of the fetus.

Typical symptoms of primary genital herpes

They, as a rule, are local in nature and manifest themselves:

1. Rashes on the labia minora and majora, on the skin in the area of ​​the anus. Rashes in the form of vesicles (vesicles) or papules (nodules), erosions or ulcers can be single or grouped, followed by the formation of crusts.
2. Itching and burning.
3. Redness and swelling of tissues.
4. Pain in the perineum and groin areas.
5. Discharge from the vagina and urethra.
6. Pain and burning during urination, dysuric phenomena.

Resolution of the rash elements occurs within 6-12 days, followed by epithelization of the affected areas. As a rule, there are no traces left on the skin and mucous membranes after the crusts are rejected. In some cases, redness and swelling may persist in the area where the blisters appear.

The general well-being of a pregnant woman often suffers, which is manifested by headache, malaise, sleep disturbances, and a slight increase in body temperature. The maximum severity of general symptoms is observed the day before and the first 2 days after the appearance of the rash. Subsequently, it gradually decreases and disappears within 1 week.

With the atypical course of genital herpes, which is about 60%, the only symptom may be vaginal discharge or unexplained pain in the lower abdomen.

Isolation of the pathogen from the urethra and cervical canals appears along with the first rash and lasts on average about 5 days, but can last a long time even in the absence of lesions.

Clinic for recurrent genital herpes

It is characterized by a persistent and long-term course, in which periods of exacerbation, alternating with remission of varying durations, can be repeated monthly or once every 3 years. The processes can be localized in the area of ​​the external and internal genital organs and urinary organs, causing colpitis, cervicitis, endometritis, adnexitis, urethritis, cystitis. They are accompanied by the same symptoms as with normal inflammation of the relevant organs. Often, inflammation as a result of herpes infection is combined with a non-viral inflammatory process.

The remaining symptoms are approximately the same as with acute herpes, but the inflammatory phenomena are less pronounced, and the healing processes last longer. With a long-term course of the disease, persistent excessive pigmentation of the mucous membranes and skin in the area of ​​the rash may occur. Often, as a result of frequent relapses, accompanied by burning, itching, pain and a feeling of heaviness in the lower abdomen, in the sacral region and in the perineum, mental instability and neuroses occur.

Generalization of infection is inherently a complication of a primary or activated recurrent disease and develops gradually 1-2 days (sometimes up to a week or more) after their onset. In pregnant women, the recurrent form most often occurs in the third trimester.

Initially, this process involves the entrance gates of infection - the external genitalia, vagina, and cervix. After this, severe general symptoms associated with intoxication appear: high body temperature, chills, muscle pain, general malaise and weakness. In almost 90% of cases, hepatitis develops, less often - glomerulonephritis, pancreatitis, encephalitis, myocarditis.

Is genital herpes dangerous during pregnancy?

Herpes virus type 2 is in second place in terms of the degree of danger to the fetus after the causative agent of rubella. Its presence in the body of a pregnant woman can lead to infection of the embryo, fetus and newborn child in various ways:

• through the fallopian tubes from the pelvic cavity and ovaries (transovarian);
• ascending infection from the external genitalia or birth canal;
• transplacentally, that is, through the placenta (with a significant concentration of the pathogen in the blood);
• through the cervical canal (transcervical);
• during childbirth;
• after childbirth during contact between the child and the mother, which can lead to generalization of the process in his body with damage to various parts of the nervous system and internal organs.

The effect of infection on pregnancy and the fetus is due to the following mechanisms:

1. Possibility of infection of the placenta, membranes, amniotic fluid and the fetus itself. This can cause damage to the placenta and membranes, disruption of the intrauterine development of the embryo or fetus, the development of generalized or limited damage, as well as latent infection of the fetus with subsequent manifestation of the disease in the child after birth.
2. The possibility of hormonal imbalance, as well as the development of a septic condition in a pregnant woman with impaired function of the placenta and the body’s self-regulation system.

This leads to early or late spontaneous miscarriage or delayed fetal development, its hypoxia (oxygen starvation) and developmental abnormalities, premature birth, etc.

A particularly high risk for the fetus is infection of expectant mothers who have never had herpes before pregnancy and are getting it for the first time. As a result of studying the effect of this infection on pregnancy, on the development of the fetus and on the newborn child, it was found that for all stages of pregnancy, the maximum danger is posed by generalized forms of this pathology, as well as primary infection. In the latter option, the woman secretes the virus for 8-10 days, and often up to 3.5 months.

The fetus or newborn child becomes infected in both primary and recurrent forms. However, infection with herpes infection in the first case ranges from 40 to 50%, while in recurrent forms it is only 5%.

When comparing data from clinical observations and laboratory studies of women with genital herpes, for example, at the 5th week of pregnancy and at the 19th week of pregnancy, it was found that with increasing period there is an increase in both the frequency of recurrence of the disease and the frequency and duration of virus shedding in asymptomatic cases.

These rates reach their peak in late pregnancy. By the beginning of labor, among pregnant women with seropositive reactions, from 2 to 5% develop an exacerbation of the disease, and in 20%, asymptomatic isolation of the pathogen is detected by polymerase chain reaction.

This is explained by the fact that during relapses of the disease, the body produces specific antibodies against the virus (found in 25% of women). Their presence, although not fully, still largely suppresses its activity. Therefore, in recurrent forms of genital herpes, the intensity of virus release is much less and the duration is shorter.

However, as the duration of pregnancy increases, the degree of immune suppression (decreased activity of the immune system) also increases, reaching its maximum at the onset of labor, which leads to an increase in the amount of virus released and the number of exacerbations.

Such data are the reason for recommending a woman to have a cesarean section for primary and generalized forms of genital herpes. This completely eliminates the possibility of infection of the child. In cases of recurrent genital herpes in the absence of its exacerbation and the absence of the virus in repeated smears from the genitourinary tract taken on the eve of the upcoming birth, it is possible to carry out the latter naturally.

Genital herpes in the early stages of pregnancy most often leads to spontaneous abortion or missed abortion. According to statistics, up to 30% of spontaneous abortions in the early stages and half of miscarriages in later stages are provoked by the genital herpes virus.

In addition, infection of the fetus in the first trimester, when the laying and beginning of organ development occurs, may cause the formation of encephalitis, combined with microcephaly (underdevelopment of the brain) and hydrocephalus (dropsy of the brain), the development of anomalies of the digestive organs, malformations of the heart and vessels, etc.

The 2nd and third trimesters are also dangerous due to spontaneous abortion, intrauterine death, malnutrition, anemia and sepsis in the fetus, the development of hemorrhagic syndrome with bleeding and thrombosis, meningoencephalitis, epilepsy, cerebral necrosis, pneumonia, damage to the eyes, hearing aid, skin, mucous membrane oral cavity, liver damage with the development of jaundice, etc.

The primary disease also poses a threat to the pregnant woman herself, since dissemination of the virus (spread throughout the body) can occur with the subsequent development of acute hepatitis, meningitis or encephalitis (inflammation of the membranes of the brain). In the case of generalization of the infection and in the absence of effective specific therapy, this form ( in 70-80%) ends in death.

Treatment of genital herpes during pregnancy

Modern methods of therapy do not allow the genital herpes virus to be completely eliminated from the body. Therefore, treatment is aimed at achieving less frequent exacerbations and eliminating or correcting the disorders caused by the disease.

Its main principles are the use of antiviral drugs in combination, if necessary, with specific and nonspecific immunotherapy. For clinical manifestations of the disease (in cases of the primary form and in case of relapses), Acyclovir is prescribed 0.2 grams 5 times a day or 0.4 grams 3 times a day for a week. It is possible to use analogues of Acyclovir (Zovirax, Acyclovir-acri, Gerpevir, Gerperax, Valtrex, Famvir, Valacyclovir, etc.) in appropriate dosages.

Another approach is long-term (several years) suppressive treatment at lower dosages in the absence of exacerbation.

Immunotherapy is carried out using human interferon, natural leukinferon, interlock, viferon in suppositories. Local treatment is carried out by applying drugs to the affected area. What should I apply to the affected area? To do this, it is best to use Acyclovir cream 8 times a day or ointment containing Viferon (for a less pronounced process).

Thus, herpetic infection is a high risk factor for the development of pregnancy itself and the birth of a child with various pathologies, and sometimes for the life of the woman herself. On average, 42% of pregnant women with genital herpes had a threat of miscarriage, almost 29% had developmental delay, and 30% had a chronic form of fetal hypoxia (according to studies in 2000 and 2005). Careful examination and treatment during planning and during pregnancy in many cases allows you to avoid possible complications.

A disease called herpes is present in the blood of almost ninety percent of the planet's inhabitants. It is in a passive state, but under certain factors associated with a decrease in immunity, it is sharply activated. Pregnancy is precisely one of the most vulnerable conditions for such a disease.

What consequences?

There are two types of exacerbation of the disease during pregnancy:

1. Primary, is the penetration of the virus for the first time. Before this, the person had never encountered this problem and, as a result, certain antibodies of classes M and G were not produced in the blood.

For a woman expecting a baby, this type of infection poses a real threat, since the body does not know how to resist it and does not have the ability to instantly adapt. At first, you should immediately consult a doctor.

Signs include:

• redness associated with painful sensations in a small area of ​​skin or mucous membrane;
• severe burning sensation;
• increase in body temperature, etc.

2. Repeated or relapse- the peculiarity of this condition is that before pregnancy the lady already had herpes and her body had produced the necessary antibodies. In this case, the disease does not pose as great a threat as in the first option, however, it cannot be left without due attention.

To prevent negative consequences for herself and her unborn child, the herpes virus requires careful monitoring and complex drug therapy.

2. How dangerous is it for a pregnant woman?

Consequence: the baby became infected.

The danger during pregnancy depends on the following factors:

1. what kind of infection – primary or recurrent;
2. the presence or absence of antibodies in the blood;
3. trimester in which the infection occurred;
4. from the immune system.

During pregnancy, the virus easily passes through the placenta to the baby. If the expectant mother has encountered it before, then the baby in the womb is in virtually no danger; scientific research has revealed only five percent of cases of adverse consequences.

With the other option, there are no guarantees that everything will proceed easily and nothing will happen to the baby.

Consequence for the fetus

The worst thing is to become infected in the first three months, when the fundamental laying of all the organs and tissues of the future human being takes place. It is worth noting that it will not necessarily affect the child; if the mother’s immune system is strong enough, the outcome may be favorable.

In the first trimester, upon penetration into the blood, the following are possible:

• miscarriage;
• severe developmental defects;
• fetal freezing (regression).

The virus has also posed an equally great threat in the last three months:

• gross pathologies, often in the brain;
• premature birth;
• dropsy;
• stillbirth of a baby.

The possibility of transmitting the herpes virus to a baby is very high; only a timely examination of the woman and the prescription of the correct therapy will avoid many risks. In some cases, termination of pregnancy or cesarean section is recommended.

3. Recurrent

Again, in the same place

In the case when a woman is already a carrier of the infection, then it poses the most minimal threat to the fetus. Signs of recurrent herpes are:

• the appearance of a sore with clear liquid on the mucous membrane or skin for a second or more time, provided that the first time the infection occurred before pregnancy;
• the presence of positive IgG antibodies in the blood.

Often during pregnancy, the expectant mother repeatedly encounters this disease; this is no coincidence, since immunity is significantly reduced and is much more susceptible to various viruses.

In cases where the disease is observed in the last trimester, doctors often strongly recommend a cesarean section. This outcome reduces the likelihood of infection of the child directly during childbirth, however, consent or refusal of surgical intervention always remains with the woman herself.

In case of illness during pregnancy, if it is repeated, you need to:

• draw the attention of doctors to this;
• pass the necessary tests;
• if detected before childbirth, undergo treatment and.

Research by scientists has concluded that it has a direct effect on blood clotting parameters, so in case of a recurrent disease, great importance should be given to this. In addition, in the overwhelming majority, along with herpes, other infections, often hidden, such as ureaplasma, become aggravated; in this situation, everything needs to be treated well.

4. Possible treatment for the woman

The main rule that every woman should remember while expecting a baby is that you cannot diagnose yourself, much less prescribe treatment. Such actions can lead to the most tragic outcome, including the death of the baby.

After examining the results of the analysis, as well as taking into account individual characteristics and the course of the pregnancy itself, the doctor can talk about specific treatment. As a rule, the following groups of drugs are prescribed:

• antiviral;
• to maintain immunity.

The most common ointments and gels that help in treatment are the following:

• acyclovir;
• Zovirax;
• Panavir;
• vitamin E;
• zinc ointment and so on.

They are used strictly according to the instructions and taking into account all the doctor’s recommendations. Of course, pregnant women are prescribed the most gentle medications (more details in the article:). You need to know for sure that the harm from medications is much lower than the effect of herpes on the body, and even more so on the fetus.

To strengthen the immune system, a woman needs to make it a rule to walk as much as possible every day, relax, not be nervous and eat a balanced diet. Perhaps, after agreement with the attending physician, also. In some cases, the following will be effective:

• herbal lotions (infusion of calendula, celandine, chamomile, etc.). To prepare it, take a certain herb in an amount of about ten grams and pour boiling water over it. After one hour, you can apply lotions to the affected area with a clean napkin;
• baths with the addition of essential oil (approximate ratio of two drops per ten liters of warm water);
• brewing birch buds and more;

Today, there is no single medicine that would defeat the virus once and for all. However, if you follow all the specialist’s recommendations, you can reduce the number of relapses, have a good pregnancy and give birth to healthy offspring.

5. Consequences

Approximate development diagram (click to enlarge)

The consequences of herpes for women who do not have certain antibodies in their blood during pregnancy are as follows:

• sudden termination of pregnancy, especially in the first weeks after conception. Moreover, frozen pregnancy is more often observed;
• severe pathologies in the fetus, at any stage of development;
• the birth of a premature or stillborn child.

Of course, if a primary infection has occurred, this does not mean that there is no chance of giving birth to healthy offspring and it will be recommended to terminate the pregnancy. In any case, specialists will evaluate the situation as a whole and draw conclusions based on everything studied.

Consequences of herpes during pregnancy if re-infected, they are not so dangerous, but can also lead to a number of serious problems associated with pregnancy and childbirth:

• miscarriage - typical for up to twelve weeks;
• changes in the functioning of the circulatory system and, as a result, insufficient supply of necessary nutrients;
• disturbance in the formation or inflammation of organs in the fetus, especially in the first and last trimester;
• infection of a child during natural childbirth. In this case, there may be changes in the baby’s mucous membrane or skin, which will not be easy to heal in the future.

Consequences: The virus was transferred from mother to fetus

It should be noted that it is wiser to perform a caesarean section.

6. After childbirth

Diagnostics

The ideal conditions for the penetration and recurrence of the virus are a weakened immune system, which includes the postpartum period. So, for nine months, the woman’s body worked hard, all the resources of nutrients and minerals were directed only to the development of the baby. In addition, a young mother, especially at first, cannot afford to rest properly and eat heavily.

When a virus appears, the risk of infecting a child is quite high. It is transmitted through kisses and dirty hands. It is a mistaken belief that breastfeeding is becoming impossible. On the contrary, it has been proven that herpes is not present in a woman's milk.

To protect a child from illness you need:

• wash your hands regularly with soap, especially before handling your newborn;
• during the period of illness, do not kiss or hug the child;
• wear a special bandage, which is sold in any pharmacy.

Drawing a conclusion, it should be noted that herpes during pregnancy poses a great threat, especially with the primary disease. If you undergo the examination on time, take all the necessary tests and strictly follow the specialist’s instructions, then the consequences can be avoided.

Who said that curing herpes is difficult?

• Do you suffer from itching and burning in the areas of the rash?
• The sight of blisters does not at all add to your self-confidence...
• And it’s somehow embarrassing, especially if you suffer from genital herpes...
• And for some reason, ointments and medications recommended by doctors are not effective in your case...
• In addition, constant relapses have already become a part of your life...
• And now you are ready to take advantage of any opportunity that will help you get rid of herpes!

There is an effective remedy for herpes. and find out how Elena Makarenko cured herself of genital herpes in 3 days!