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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 during pregnancy - consequences of lichen for pregnant women

Herpes viruses are many-sided and very dangerous for humans. Of particular concern is the infection in a woman expecting a baby.

Doctor's consultation

You can get the consultation of the necessary specialist online in the Doctis application

Laboratory

You can undergo a comprehensive examination of all major body systems nine0005

• Genital herpes in early pregnancy
• Genital herpes in late pregnancy
• Pregnancy herpes test
• Chicken pox and herpes zoster during pregnancy
• Prevention of infection of the newborn with chickenpox
• Treatment and prevention of exacerbations of herpes

There is an opinion that if a pregnant woman is infected with the herpes simplex virus, then the unborn danger! But everything is not so scary if the disease does not manifest itself (is in stable remission) or a pregnant woman with an active form of the disease is observed by an infectious disease specialist. Today approaches to maintaining patients with genital herpes changed

Why is herpes dangerous during pregnancy

I am pregnant, short term, and I have genital herpes. Does this mean that I need to terminate the pregnancy?

No way! Genital herpes is not an indication for abortion. Virus crosses the placenta extremely rarely. But for a child, herpes is dangerous if it first appeared a month before birth. or repeated a few days before the birth, since there is a risk of infection of the baby at the time of his passage through the infected birth canal. If infected, the infant will develop severe the disease is neonatal herpes, often occurring with damage to the central nervous system. nine0005

Although during pregnancy the risk of transmission of herpes virus from mother to fetus minimal, tolerate the manifestations of genital herpes and not take antiviral drugs, being afraid the consequences of treatment for the unborn child are not worth it.

After 14 weeks of pregnancy, if genital herpes occurs, treatment with an antiviral drug is possible acyclovir. After 22 weeks, therapy with valaciclovir is possible.

In the vast majority of cases, the herpes simplex virus is transmitted from the mother child during childbirth, so the closer to the end of pregnancy there is a recurrence of genital herpes, the higher the risk of infection of the child and the more relevant the treatment of the disease. nine0037

If primary genital herpes or recurrence occurs at or after 36 weeks of gestation, clinicians do not limit treatment to 5-10 days, but continue the entire period until the moment of delivery. As in the case very frequent recurrences of genital herpes during pregnancy (one outbreak in 1-2 months) - at week 36, proactive treatment with acyclovir or its analogues begins and continues until the moment childbirth. The goal of proactive treatment is to prevent recurrence shortly before delivery and to reduce the likelihood of asymptomatic carriage. nine0005

It must be remembered that it is the asymptomatic shedding of the virus from the urogenital tract that can often be cause of infection of the child during childbirth.

Even when there seems to be no cause for concern, since the manifestations genital herpes are absent in the last months of pregnancy, still at 32-34 weeks pregnancy, it is necessary to conduct a smear (scraping) examination from the cervical canal for the presence of DNA herpes simplex virus types 1 and 2 by PCR. nine0037

This analysis is necessary for primary genital herpes or its recurrence in the 1st and / or 2nd trimester, relapses genital herpes before pregnancy, relapses of genital herpes in a sexual partner, lesions urogenital tract of unknown cause, antibodies to herpes simplex virus type 1 and type 2 IgM class, detected during a routine examination during pregnancy.

For rashes or virus shedding on Wednesday within 7 days before delivery, especially in the presence of genital herpes by the beginning of childbirth, a caesarean section is performed to reduce the risk of transmission virus from mother to child. nine0037

I'm just planning a pregnancy. And I want to get rid of herpes recurrences that have been haunting me for a long time me. How do you feel about the treatment of genital herpes with interferon inducers and immunomodulators?

Widespread use of immunomodulators and interferon preparations in Russian medical centers (viferon, polyoxidonium, isoprinosine, etc.) for the treatment of herpesvirus infections is completely unreasonable. The so-called "ozone therapy" will not help the patient either. You will not find these methods in international protocols, recommendations for the treatment of viral infections in children and adults, including pregnant women women. Neither in Russia nor abroad have studies been conducted proving the effectiveness of these drugs in accordance with all international regulations. nine0005

An infectious disease specialist, a professional in his field, will never turn to immunomodulators and inducers interferon, but will look for the cause of the disease and prescribe therapy that acts on the pathogen itself - drugs acyclovir, valaciclovir or famaciclovir. With primary genital herpes for 10 days, with relapses diseases - in appropriate doses for 5 days.

Therapy should be started as early as possible at the very first signs of an exacerbation. Application possible antiherpetic drugs as a preventive treatment - 2-3 days before the expected relapse, if the patient is aware of the factors that provoke it, and for the entire period of the risk factor. If genital herpes disturbs a person more than 6 times a year and / or relapses reduce the quality of life of the patient and bring him not only physical, but also serious psychological discomfort, should be discussed with the patient long-term (at least 12 months) daily suppressive antiviral therapy (for example, valaciclovir). The effectiveness of such treatment tactics for the prevention of recurrence of herpes infection has been proven. all international rules. nine0005

Sequelae of chickenpox during pregnancy

How dangerous are chicken pox and shingles for a pregnant woman?

These diseases are caused by the varicella-zoster virus (VZV), which also belongs to the herpesvirus family. infect women are most often children who easily tolerate the disease. At the same time, chickenpox in an adult can be severe and dangerous to his health.

Infection is transmitted by airborne droplets from person to person already 48 hours before the onset of the rash, during the entire period of the rash and for a week after appearance of the last bubbles. nine0037

Expectant mothers who catch chickenpox may develop severe herpes pneumonia. Therefore, when sick chickenpox during pregnancy should be observed by an infectious disease specialist and in most cases of antiviral therapy.

In maternal varicella at 8 to 20 weeks of gestation infection fetus with the varicella-zoster virus can lead to fetal chickenpox with the development of a "syndrome congenital chicken pox" with severe malformations - damage to the brain, eyes, skeletal defects. Therefore, if a woman falls ill with chicken pox in the 1-3rd month of pregnancy, the doctor the woman should be informed about all possible risks of the disease for the fetus and discussed with her the question of a possible termination of pregnancy. nine0005

Second and third trimesters infectious disease doctor monitors the state of the future mothers. If the infection is severe or the infection occurred in the last month of pregnancy, prescribe antiviral treatment with acyclovir or its analogues. If ultrasound does not detect fetal pathology, pregnancy is not interrupted.

Within 96 hours (preferably within the first 48 hours) after contact a pregnant woman with chickenpox in the absence of IgG class antibodies to VVZ it is possible to introduce a specific VVZ-immunoglobulin as a measure to prevent the development of the disease. Immunity persists for 3-4 weeks, may be re-introduced after 21 days. nine0037

If the mother-to-be becomes ill with chicken pox in the last month of pregnancy , then the child may be born with skin rashes. If a woman falls ill in the last few days of pregnancy or in the first days after childbirth in a newborn infected during childbirth, the symptoms of chickenpox appear in the first 11 days of life. Chickenpox is most severe in infants whose mothers fell ill 5 days before or 2-3 days after delivery. In case of chickenpox in mothers, newborn children are given a specific immunoglobulin to prevent the development of the disease. In case of its severe course - appoint acyclovir for intravenous administration. nine0005

Infection of a child with VVV a few days after birth may manifest as postnatal varicella in the period of 12-28 day of his life. This form of the disease is less severe, it is possible to introduce a specific immunoglobulin with the risk of the disease and the appointment of intravenous acyclovir for destructive skin lesions.

Vaccination against the varicella-zoster virus is not given to pregnant women because this is a live vaccine. Therefore, if a young woman does not have IgG antibodies to VVZ before planning pregnancy, it is advisable to vaccinate against chicken pox. nine0037

Herpes zoster ("secondary" VVZ infection) in a pregnant woman is not dangerous for a child. Contact seronegative pregnant woman with herpes zoster is not desirable, although the threat of her infection There is practically no VVZ.

I'm just planning a pregnancy. And I want to get rid of herpes recurrences that have been haunting me for a long time me. How do you feel about the treatment of genital herpes with interferon inducers and immunomodulators?

nine0002 Widespread use of immunomodulators and interferon preparations in Russian medical centers (viferon, polyoxidonium, isoprinosine, etc.) for the treatment of herpesvirus infections is completely unreasonable. The so-called "ozone therapy" will not help the patient either. You will not find these methods in international protocols, recommendations for the treatment of viral infections in children and adults, including pregnant women women. Neither in Russia nor abroad have studies been conducted proving the effectiveness of these drugs in accordance with all international regulations. nine0005

Infectionist, a professional in his field will never turn to immunomodulators and interferon inducers, but will look for the cause of the disease and prescribe an effective pathogen therapy - drugs acyclovir, valaciclovir or famaciclovir. With primary genital herpes for 10 days, with relapses of the disease - in appropriate doses for 5 days.

Therapy should be started as early as possible at the very first signs of an exacerbation. Application possible antiherpetic drugs as a preventive treatment - 2-3 days before the expected relapse, if the patient is aware of the factors that provoke it, and for the entire period of the risk factor. If genital herpes disturbs a person more than 6 times a year and / or relapses reduce the quality of life of the patient and bring him not only physical, but also serious psychological discomfort, should be discussed with the patient long-term (at least 12 months) daily suppressive antiviral therapy (for example, valaciclovir). The effectiveness of such treatment tactics for the prevention of recurrence of herpes infection has been proven. all international rules. nine0005

If you have any questions, you can ask your doctor obstetrician-gynecologist or infectious disease specialist online at Doctis app.

The author of the article: Vasily Iosifovich Shakhgildyan

Herpes, cytomegalovirus, Epstein-Barr virus in pregnant women

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. nine0005

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. nine0005

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. nine0005

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. nine0005

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.

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