Herpes Risks During Pregnancy and Pre-Marital Health Checks

Type 2 Herpes, Pregnancy Risks, and Pre-Marital Health Checkups

Hello, Doctor: I am currently aware that I am pregnant, but I am very worried because the day after conception, I discovered what appeared to be a herpes infection in the area near my thigh, not on the vulva (the partner showed no symptoms, and this was my first time).
On the first day, I experienced a stinging sensation, and within three days, a small patch of white blisters appeared.
Due to work commitments, I only bought an ointment to apply until I could see a gynecologist during my time off.
However, the infected area has healed about 50-60% and is not painful, but there is scabbing.
Because of this, the doctor could not definitively diagnose it as herpes, suggesting it might also be due to friction during intercourse.
I would like to understand: 1.
If it is herpes, what impact could an undetected infection during conception have on the child? Can I safely carry the pregnancy to term? 2.
I have no previous history of herpes, and I am hesitant to ask my partner, but I was indeed feeling more fatigued during those days.
I have heard that a weakened immune system can trigger herpes; could this apply to type 2 herpes as well? 3.
I plan to undergo a premarital health check; can I still do this while pregnant? Are there any tests available to check for herpes? Thank you!

MIGO, 30~39 year old female. Ask Date: 2009/08/11

Dr. Huang Jianxun reply Obstetrics and Gynecology

Dear MIGO,
Hello, the characteristics of the general herpes you described differ from what is typical.

1.
Location: General herpes typically appears on the vulva or labia, not on the thigh.
2.
Number: General herpes usually presents with multiple lesions, rather than just one.
3.
Onset time: General herpes typically takes 3 to 7 days to manifest after exposure, while your description suggests it appeared the next day.
4.
Duration: General herpes usually takes 2 to 3 weeks to heal, whereas it seems yours resolved quickly.
Based on these differences, it does not appear to be general herpes.
Even if it were, research from international scholars indicates that if a pregnant woman contracts general herpes early in pregnancy, she typically develops antibodies quickly, providing protective effects.
The likelihood of fetal infection is extremely low, approximately one in 200,000, so there is no need for excessive concern.
To test for general herpes, a viral culture can be performed when there are active lesions or if a blister has just ruptured.
Since your lesions have already crusted over, a viral culture is not suitable.
You can instead have a blood test to check for the presence of new antibodies to general herpes.
Thank you for your letter.
Wishing you peace and happiness.
Sincerely,
Dr.
Li-Cheng Lu
Attending Physician, Department of Obstetrics and Gynecology
Taoyuan General Hospital, Department of Health

Reply Date: 2009/08/11

More Info

When it comes to herpes and pregnancy, it's essential to understand the potential risks and implications for both the mother and the baby. Herpes simplex virus (HSV) can be categorized into two types: HSV-1, which typically causes oral herpes, and HSV-2, which is primarily associated with genital herpes. Here’s a comprehensive overview addressing your concerns:
1. Impact of Herpes on Pregnancy: If you have contracted genital herpes during pregnancy, particularly in the third trimester, there is a risk of transmitting the virus to the baby during delivery. This can lead to neonatal herpes, a serious condition that can cause severe complications for the newborn. However, if you were infected before pregnancy and have no active lesions during delivery, the risk of transmission is significantly reduced. If you suspect you have herpes, it’s crucial to consult with your healthcare provider for appropriate testing and management.

2. Initial Infection and Immune Response: It’s important to note that initial infections of herpes can sometimes be asymptomatic or present with mild symptoms that may be mistaken for other conditions. Stress and fatigue can indeed lower your immune response, potentially triggering an outbreak. If you have never had herpes before, and if your partner is also unaware of any infection, it may be challenging to ascertain the source of the virus. However, if you suspect that you might have contracted HSV-2, it’s advisable to seek medical advice for testing and possible treatment options.

3. Prenatal Health Checks: You mentioned considering premarital health checks. It’s entirely possible to undergo such tests even after becoming pregnant. Many healthcare providers recommend comprehensive screenings during pregnancy, which can include tests for sexually transmitted infections (STIs) like herpes. Blood tests can determine if you have been exposed to HSV and whether you have antibodies, indicating a past infection. This information is vital for managing your health and the health of your baby.

4. Managing Herpes During Pregnancy: If you are diagnosed with herpes, your healthcare provider may recommend antiviral medications, such as acyclovir, especially in the later stages of pregnancy to reduce the risk of an outbreak during delivery. It’s crucial to communicate openly with your healthcare provider about your symptoms and any concerns you have regarding herpes and its implications for your pregnancy.

5. Emotional and Psychological Considerations: It’s understandable to feel anxious about the potential implications of herpes on your pregnancy. Many women with herpes have healthy pregnancies and deliver healthy babies. The key is to maintain open communication with your healthcare provider, adhere to any recommended treatments, and attend regular prenatal check-ups.

6. Preventive Measures: If you are diagnosed with herpes, it’s essential to take preventive measures to reduce the risk of transmission to your partner and to manage outbreaks effectively. This includes avoiding sexual contact during outbreaks, using condoms, and discussing your condition with your partner to ensure they are informed and can take precautions as well.

In summary, while the presence of herpes can raise concerns during pregnancy, with proper medical guidance and management, many women with herpes have successful pregnancies. It’s crucial to seek medical advice, get tested, and follow your healthcare provider’s recommendations to ensure the best outcomes for both you and your baby. If you have further questions or need clarification on any points, don’t hesitate to reach out to your healthcare provider.

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