Genital herpes simplex (HSV type 2) during pregnancy

What is Genital Herpes Simplex?

Herpes refers to a blistering inflammation on the skin and mucous membrane. There are two forms of the herpes simplex virus (HSV): type 1 mainly causes cold sores, type 2 leads to genital herpes in most cases. Here one speaks of the so-called herpes simplex genitalis. HSV1 can also trigger infections in the genbital area and, conversely, type 2 viruses can cause cold sores.

How to get infected with genital herpes?

The infection rate with herpes viruses is very high because they are very common. Most people become infected when they are children. In adulthood, 70 to 90 percent of all people are already infected with type 1 HSV. Type 1 herpes viruses are usually spread via droplet infection. However, they can also be transmitted via genital secretions. This is particularly the case with Type 2. The virus enters the body through the smallest injuries to the skin or mucous membrane. The virus attaches itself to the nerve nodes and can survive there and later lead to symptoms again. In particular, if the immune system is disturbed, for example by stress, fever or injury, it can break out again. The best way for a woman to prevent infection is to practice safe sex. Unfortunately, there is no vaccine yet.

Symptoms of genital herpes

While type 1 herpes usually occurs in the form of cold sores and goes unnoticed most of the time, this is already much more noticeable with type 2. The so-called genital herpes (type 2) is noticeable by a painful rash and blisters on the inside and outside of the vagina. They usually appear in groups. They then burst open and then heal without leaving scars. Itching, tingling and burning in the external genitalia can indicate an infection. Along with the other signs, fever and body aches are also symptoms that can indicate infection with this virus.

complications in pregnancy

If a pregnant woman falls ill with this virus, the infection can be transmitted to the child during childbirth. This can also happen without the pregnant woman having previously shown any symptoms of an outbreak. Transmission usually takes place through the birth canal. Rarely also during subsequent contact with the mother. Such an infection occurs in one in 7,500 births. If the mother is infected for the first time, the risk of transmission to the child is even 30 to 50 percent. If the disease is reactivated, the risk of transmission to the child is significantly lower at 4 to 5 percent.

Infection during pregnancy via the placenta is rather rare, since herpes viruses are less likely to spread throughout the body. In such a rare case, however, a miscarriage can occur. If you are also already suffering from HSV type 1, which is noticeable by itchy blisters on the mouth, you are protected to a certain degree from infection with HSV type 2, which is dangerous for the child, due to the virus.

A herpes disease in the child can result in eye diseases up to blindness, intellectual deficits or a so-called hydrocephalus. If the child’s organs and brain are also affected in the event of an infection, the child’s chances of survival are unfortunately greatly reduced. In such cases, physicians speak of a chance of survival of around 50 percent. Unfortunately, the surviving children then bear an increased risk of permanent damage. But these cases have been observed extremely rarely in medicine!

Possibilities of prenatal diagnostics

• In diagnostics, an antibody test can be used to look for the presence of a herpes disease. Other diagnostic options are also available to the doctor.
• Prenatal diagnostics also offer further opportunities to detect a disease or complications at an early stage. This allows you to look for changes on the ultrasound .
• Especially if it is a first-time illness in the pregnant woman, the doctor can look for an illness with an amniocentesis , chorionic villi biopsy or umbilical cord puncture in the child.
• Antivirals in tablet form can prevent the virus from spreading. Recurring infections are therefore less common. If a pregnant woman has an initial infection, she is treated with antivirals from the 30th week and then again around the birth. If blisters or ulcers appear on the vagina at the time of delivery, doctors recommend a caesarean section to minimize the risk of infection. If this is not the case, the child can also be born naturally, and the mother then receives additional medication during the birth.

Measures after birth

Newborns are treated with prophylaxis with immunoglobulins and antivirals if their mothers show symptoms of an illness shortly before birth. Eye drops should be administered after birth. Affected women and their children will first isolate themselves from other mothers and children on the ward to prevent further infection. If it is not an initial disease but a reactive form, isolation can be dispensed with. Good hygiene measures are then sufficient.