According to the herpes figures, published by the World Health Organization in 2023, Herpes simplex virus type 2, or HSV-2, infection affects nearly 491 million people aged 15 to 49 worldwide. Frequent and often asymptomatic, genital herpes is a viral disease which progresses in outbreaks, the virus remaining in the body for life once the person is infected. In the event of genital herpes during pregnancy, there is a risk of contamination of the baby, particularly during childbirth. Pregnant women must benefit from preventive measures and specific care.
Definition and incidence of genital herpes during pregnancy
Herpes is a very common viral disease caused by two forms of the Herpes simplex virus: HSV-1 or Herpes simplex type 1 (often causing cold sores or cold sores), and HSV-2 or Herpes simplex type 2. In the second case, that is to say for 491 million people worldwide according to the World Health Organization, contamination occurs through sexual contact (sexually transmitted infection), and the person suffers from genital herpes. Once the virus enters the body, it stays there for life. People who suffer from it have flare-ups, the pace and intensity of which vary greatly from one individual to another. Pregnant women affected by genital herpes have often been infected beforehand, but in rare cases, they come into contact with the virus during their pregnancy. According to the study on herpes and pregnancy, published by the College of Infectious and Tropical Diseases Scholars in 2022, nearly 70% of pregnant women are affected by herpes, and in 2 thirds of cases, by genital herpes.
Risks of genital herpes for pregnant women and babies
In pregnant women suffering from genital herpes, contamination of the baby can occur:
- during pregnancy: in the event of primary infection during this period;
- at birth: via vaginal secretions during the descent of the baby through the genital tract.
The risks of transmission vary from one situation to another, and essentially depend on the date of contamination of the mother, the frequency of herpes attacks and the knowledge of the disease in the pregnant woman. In the event of infection with the virus long before pregnancy, the risks of contamination of the baby are low, with appropriate preventive measures being offered to the mother. If the mother is infected during pregnancy (rare case), the risks of transmission are particularly high, and doctors must take extra precautions. It should be noted that fetuses and newborns have an immature immune system, incapable of fighting the herpes virus.
Symptoms of genital herpes during pregnancy
Very often, genital herpes is asymptomatic. Many pregnant women do not know they have it, and transmission of the virus is noted during childbirth. But the disease can also progress in crises, with symptoms affecting the sexual organs, and possibly the buttocks and thighs. According to the practical guide on herpes and pregnancy, published by the Herpes Association, primary infection with herpes virus type 2 involves:
- itching, tingling, pain and burning sensations in infected areas;
- vesicular lesions: redness, blisters, open sores and scabs a few hours later;
- symptoms of infection: fever, body aches, swollen lymph nodes;
- healing after about ten days.
During flare-ups, the symptoms are generally less severe and disappear more quickly. In the event of infection of the fetus or newborn, serious clinical manifestations and complications may be observed: growth and development delays, miscarriage, cataracts, neurological disorders, myocarditis, necrotizing hepatitis, etc. There is also a risk of mortality.
Treatments for genital herpes during pregnancy
To reduce the risk of contamination of the baby, pregnant women affected by genital herpes benefit from special care. This is essentially based on taking antiviral medications. In some cases, doctors may favor cesarean delivery, particularly if the last herpes outbreak was recent. After delivery, doctors determine whether or not the virus has been transmitted, and treat the baby with antiviral drugs if necessary. Finally, preventive measures constitute an important part of care.
Sources
- Herpes and pregnancy: let’s talk about itHerpes Association
- Herpes and pregnancyCollege of Infectious and Tropical Diseases Scholars, July 1, 2022
- Herpes (Herpes simplex virus, HSV)World Health Organization, March 16, 2023
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