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Affect on Baby and Safe Treatments

If you’ve ever had cold sores — those annoying, painful, tiny, fluid-filled blisters that usually form around your mouth and on your lips — you know how inconvenient they can be.

But also if you’ve ever had cold sores (and therefore already have the virus that causes them), did you know they can recur, especially when you’re under stress or are undergoing hormonal fluctuations?

Stress and hormonal changes. That sounds an awful lot like pregnancy.

Cold sores in pregnancy aren’t unheard of, and they don’t usually have any impact on your growing baby. So first, let out a deep sigh of relief. Next, read on — because there are still important things to know about cold sores if you’re expecting.

Cold sores are caused by a virus — the herpes simplex virus (HSV). Of the two types of HSV, cold sores are generally caused by HSV-1, whereas genital herpes is usually a result of exposure to HSV-2. There have been a few instances where HSV-1 sores have been found in the genitals and vice versa.

Once you’ve had a cold sore (oral herpes), the virus remains in your system for life — it’s just not active unless you have a current outbreak.

But when we say that stress and hormones can cause the virus to reactivate, it’s important to know that stress and hormones don’t cause the virus in the first place.

If you’ve never had HSV, you can only get it through contact with someone who has. When it comes to a first-time cold sore infection, this can happen via activities like:

• kissing
• sharing food or utensils
• using someone else’s ChapStick or lip gloss
• oral sex

Here’s the really good news: If you already have the virus that causes cold sores, and you have an outbreak of oral herpes during pregnancy, it’s most likely not going to have any impact on your growing baby.

Cold sores are a localized infection, usually around the mouth area. They don’t typically cross the placenta and reach your baby.

The highest risk scenario is if you get HSV for the first time during your third trimester of pregnancy.

When you get the virus for the first time, your body hasn’t developed any protective antibodies to it yet. And while HSV-1 is usually associated with oral herpes, it can cause a genital herpes outbreak, which can be dangerous to your baby — especially as they pass through the birth canal.

Birth-acquired herpes is serious. However, it’s a concern with genital rather than oral herpes. That being said, because the same virus can cause both, it’s important to talk to your OB about any cold sores during pregnancy.

The most common treatment for cold sores is docosanol (Abreva), an over-the-counter topical cream. But the Food and Drug Administration hasn’t evaluated it for safety in pregnancy.

While some research has determined that it’s “likely safe” during pregnancy, at least one pharmaceutical company that manufactures the drug warns against using it unless it’s definitely needed — which really means you need to check with your doctor. There may be other treatments you should try first.

If you’ve had herpes in the past, your doctor may recommend antivirals — like acyclovir or valacyclovir — starting at week 36 and continuing until delivery of your baby, even if you don’t have a current outbreak of lesions around the genital area. This helps prevent reactivation and spread of the virus to the genital area.

This precaution is because you shouldn’t expose your baby to herpes in the vaginal area during delivery.

Alternatively, your doctor may suggest a cesarean delivery, which avoids the birth canal altogether — something that’s especially important if you have a current outbreak of genital herpes.

Cold sores are highly contagious, despite the fact that they won’t affect your baby in the womb. If you have them after your baby is born, avoid kissing those adorable little cheeks or touching any sores and then touching your newborn without first washing your hands with soap.

In the extremely rare event that you have cold sores on either breast, avoid breastfeeding from that breast while you’re still contagious.

Your cold sores are contagious until they crust over, at which point they’ll start to heal.

If you do pass a cold sore infection on to your newborn, it’s known as neonatal herpes. While not as serious as the birth-acquired version, it can still cause serious complications in a baby who hasn’t yet developed a robust immune system.

The cold sore on your mouth is likely to be more of an annoyance to you than a serious risk to your developing baby, particularly in your first two trimesters of pregnancy and especially if you’ve had one before. But you should still let your OB know about it.

The virus that causes cold sores — usually HSV-1 — can also cause genital herpes, which is more of a risk to your pregnancy and growing little one.

If you have an outbreak in your third trimester — or if you acquire the virus for the first time in your third trimester — your doctor may want you to follow certain treatment or precautionary guidelines, like antivirals or a cesarean delivery.

Herpes, cytomegalovirus, Epstein-Barr virus in pregnancy

Expecting a baby is always stressful for the female body, which has to work hard for nine months. And during pregnancy, the expectant mother has a lot of reasons for unrest. Infection with any infectious disease causes serious consequences that negatively affect both the condition of the pregnant woman and the child. Let's consider these diseases in more detail.

Herpes

The concept of "herpes during pregnancy" is too broad and often becomes a cause for unreasonable panic among pregnant women who do not know what and in what cases a threat to their unborn child may appear. It is important for a pregnant woman to have information about all the features of this disease at different stages of pregnancy in order to contact a gynecologist in time and understand when there is really a danger to the fetus when a cold appears on the lips. nine0003

If a woman in an interesting position has a recurrent form of the virus, that is, she has already encountered it before pregnancy, almost any manifestation of herpes is not dangerous for the mother and child. A simple herpes virus can only be a threat during pregnancy if it is a primary infection, especially in the early stages, when all the internal organs of the baby are laid and, most dangerously, the neural tube. Only in the case of primary infection in the early stages of pregnancy, up to the second trimester, the virus poses a threat, as it can lead to missed pregnancy, miscarriage, and developmental abnormalities. However, this clinical situation is more likely to be an exception to the rule, because most women repeatedly experience herpes before pregnancy. nine0003

Cytomegalovirus

For a pregnant woman, the virus is dangerous during the primary infection during the expectation of a child. Infection from a sick person with an acute cytomegalovirus infection is the worst option for a pregnant woman, because due to the lack of antibodies in the blood, the virus easily crosses the placenta and has a negative effect on the fetus. According to statistics, infection of the fetus occurs in 40-50% of cases. The degree of adverse effect of the virus on the fetus depends on the duration of pregnancy. If the fetus is infected in early pregnancy, there is a high probability of spontaneous miscarriage or anomalies in the development of the child. If the infection happened at a later date, no fetal malformations are observed, but quite often polyhydramnios occurs during pregnancy, premature birth and the so-called "congenital cytomegaly" of the newborn are noted. Such children may have jaundice, enlarged liver and spleen, and anemia. nine0003

Eppstein-Barr virus

The Epstein-Barr virus predisposes to premature termination of pregnancy, fetal malnutrition, in newborn children causes damage to the nervous system, organs of vision, recurrent chroniosepsis, hepatopathy and respiratory distress syndrome. However, this virus provokes the listed pathologies only under certain conditions, in the presence of which during pregnancy it becomes dangerous. It is very bad if a pregnant woman has not previously encountered the Eppstein-Barr virus, which is why she does not have antibodies to this virus in her body. If there was still contact, and antibodies were found after treatment, then this is a good sign, because in this case there is nothing to be afraid of. This serves as evidence that if a woman's body is re-infected, it will cope with this dangerous disease on its own. This means that a pregnant woman will not have to take heavy and rather dangerous drugs for the development of the fetus. nine0003

THERE ARE CONTRAINDICATIONS. YOU NEED TO CONSULT WITH A SPECIALIST

The materials posted on this page are for informational purposes and are intended for educational purposes. Site visitors should not use them as medical advice. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your doctor!

Genital herpes and pregnancy - Omega-Kyiv reference book

Genital herpes is a viral disease that is associated with damage to the mucous membranes of the genital organs. The disease has an incubation period of two to ten days, after which the first symptoms of genital herpes may appear. nine0003

The clinical picture of the course of the disease is characterized by a slight tingling in the area of ​​the rash, redness. Soon bubbles filled with liquid appear. In this case, there is severe itching, burning, swelling. In rare cases, there may be fever, headaches.

After a few days, the blisters begin to burst, leading to the formation of small sores on the genitals. In this case, there may be increased pain during urination. Within 14 days, the sores heal, all symptoms of primary herpes disappear. nine0003

Further relapses of this disease are called secondary herpes and occur in a milder form. It should be remembered that treatment is only a set of measures aimed at eliminating the clinical manifestations of the virus. In this case, once it enters the body, the virus cannot be completely cured.

Particular attention should be paid to women who are planning a pregnancy or who are in a delicate situation. Indeed, in addition to sexual contact, the most likely way of contracting herpes is the transmission of the virus from mother to child during pregnancy or childbirth. nine0003

Genital herpes during pregnancy can cause miscarriage, fetal death, congenital malformations. Therefore, any manifestations of this disease should serve as a reason for a pregnant woman to visit the attending physician.

Primary genital herpes is especially dangerous. When infected with the primary form of the disease, the mother does not have antibodies - immunoglobulins G and M. This means that the virus can freely affect the fetus, leading to such consequences as:

1. miscarriage;
2. congenital malformations;
3. child's brain damage;
4. liver damage;
5. miscarriage.

The probability of damage and pathology of the fetus in the primary form of the course of genital herpes is 75%. Therefore, if there are symptoms and signs of this disease in a pregnant woman, an additional ultrasound of the small pelvis can be performed, antiherpetic drugs can be taken, as well as delivery by caesarean section. nine0003

If a pregnant woman has a secondary form of genital herpes, that is, its recurrence, then the likelihood of serious complications is much lower. So, with a relapse in the fetus, congenital deformities or damage to internal organs are rarely observed, since antibodies are present in the mother's body, which protect the fetus from exposure to the virus.

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