Herpes and Pregnancy

Herpes outbreaks during pregnancy can be an especially tense and scary period for the expectant mum. She needs to decide on the course of treatment and whether to deliver by caesarian section or have natural birth. We cover the various aspects here and invite you read this and other literature and then discuss this with your midwife or obstetrician so that you make an informed decision.

The greatest concern is that of the baby contracting herpes. Neonatal herpes can be very serious. Whilst half of infants will recover with intervention, the other half can be presented with serious illness or even death. We therefore need to understand the various risks and put this virus into perspective.

The incidence of neonatal herpes is extremely rare when we consider that a quarter of pregnant women have a history of genital herpes outbreak. From the available statistics of births, only 0,00025% to 0,00075% of all infants born contract neonatal herpes. Of these neonates that contract herpes some 5 to 10 % of them contract it after birth. The incidence is therefore extremely low.

Neonatal herpes in mothers with long standing outbreaks (herpes outbreaks for at least 1-2 years before pregnancy) is very rare. This is explained by the fact the mother confers natural protection to the unborn child by passing her antibodies via the placenta to the child. Maternal antibodies pass onto the foetus by the first few weeks of the third trimester. Premature babies are at a slightly higher risk as they may not have got the complete “dose” of maternal antibodies by that time. There may also be asymptomatic shedding by the mother, that is the virus is shed without there being active disease. The fact that there is a lower transmission of antibodies and the asymptomatic shedding, the premature child is more susceptible to infection.

Neonatal transmission is highest in mothers who contract herpes in the last trimester. Although this is not common, it accounts for half of all neonatal herpes. The reason for this high level of transmission is because the mother has not developed sufficient antibodies to confer protection to the baby.

If there is a known history of infection or if you suspect infection, consult your doctor or midwife immediately.

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