How to Handle Herpes and Pregnancy

Genital herpes is a sexually transmitted infection. This means that it can be passed along to another person by any type of sexual contact. This includes genital sex, oral sex, and anal sex. Pregnancy does not protect you from getting herpes.

Herpes Simplex Virus Type 1 (HSV-1) is the virus that is responsible for cold sores on the lips and about 50% of genital herpes. These are also known as fever blisters. Herpes Simplex Virus Type 2 (HSV-2) can cause you to get genital herpes (genital area, anus, thighs, etc.) and lesions in the mouth in the case of oral sex with an infected partner. Both forms of HSV will stay in your body forever, causing symptoms on an off.

The virus can be dormant, meaning that you are not contagious. When you are contagious, the virus is considered to be active. While most people will have some lesions while active, not everyone will. 

Symptoms vary widely and may go unnoticed because the person doesn't recognize the symptoms of herpes. 

• Itching or burning feeling in the genitals or anal area
• Pain in the genital area
• Discharge of fluid from the vagina
• You can have lesions on the cervix or in the vagina
• With the first outbreak, you may have flu-like symptoms as well.

Usually, once you've been exposed you will get sores within 2-10 days. These symptoms can last 2-3 weeks. After this initial outbreak, future outbreaks, which may come a couple of times a year, are less severe.

Currently, there is no cure for herpes. Once you have it, you will always have it. Though there are medications that can lower your risk of future outbreaks. These medications have not been shown to increase the risk of birth defects when taken in pregnancy:

• Acyclovir (Zovirax)
• Valacyclovir (Valtrex)

Herpes while pregnant takes some management. If you have your first outbreak of herpes in pregnancy, it is possible to transmit herpes to your baby. This means that your baby may be born prematurely or even die. However, if you have had outbreaks before and you are simply having a recurrence, this is generally not a risk for your baby.

During an active herpes episode, whether the first episode or a repeat one, you should follow a few simple steps to speed healing and avoid spreading the infection to other places on the body or to other people.

• Don't touch the sores
• Keep them clean and dry
• Do not have sexual contact with anyone until you are completely healed.
• Wash your hands

If you are symptoms free and you go into labor, this will not change your plans for labor. The only risk of being infected is if you have an outbreak and the baby can come into contact with the active sore during the birth. This would be a reason to do a c-section. You should talk to your doctor or midwife about watching for signs of an outbreak to prevent neonatal herpes.

_Sources

_{ACOG Committee on Practice Bulletins. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists. No. 82 June 2007. Management of herpes in pregnancy. Obstet Gynecol. 2007 Jun;109(6):1489-98.}

_{Pinninti SG, Kimberlin DW. Clin Perinatol. Preventing herpes simplex virus in the newborn. 2014 Dec;41(4):945-55. doi: 10.1016/j.clp.2014.08.012. Epub 2014 Sep 27.}

_{So-Hee Kang, RPh, Angela Chua-Gocheco, MD, Pina Bozzo, and Adrienne Einarson, RN. Safety of antiviral medication for the treatment of herpes during pregnancy. Can Fam Physician. 2011 Apr; 57(4): 427–428.}

_{Stephenson-Famy A, Gardella C. Obstet Gynecol Clin North Am. 2014 Dec;41(4):601-14. doi: 10.1016/j.ogc.2014.08.006. Epub 2014 Oct 5. Herpes simplex virus infection during pregnancy.}