Herpes Simplex in Pregnancy

Only about 1 in 5,500 babies gets neonatal herpes, even though the virus is widespread in the adult population. Neonatal herpes is not a reportable disease in most countries, so there are no hard statistics about the exact number of newborns affected. However, most researchers estimate there are between 1000 and 3000 cases a year in the United States, out of a total of four million births. To put this number in greater perspective, an estimated 20-25% of pregnant women have genital herpes, while less than 0.1% of babies contract an infection. Although remarkably rare in newborns, herpes outbreaks can cause severe and lasting damage to those who are infected with the virus.

Transmission rates to the baby are lowest for women who acquire herpes before pregnancy. One study (Randolph, JAMA 1993) places the risk at about 0.04% for such women, who then have no signs or symptoms of an outbreak at delivery. The chances of transmission are highest when a woman acquires genital herpes late in pregnancy. With monogamous partners, this is a very rare occurrence.

Medical practitioners are concerned about release of the membranes for longer than four hours when a woman has a herpes outbreak. Great care must be taken not to release the membranes. No one should be stripping the membranes of a pregnant woman who is a herpes carrier.  The speculum exam at the time of birth should be the only pelvic exam. Internal scalp monitors must not be inserted because insertion can infect the child through the scalp puncture.

Dangers to the baby who develops herpes include death (60% mortality rate), herpes encephalitis or aseptic meningitis (inflammation of the brain or spinal cord), which, in turn, leads to neurological damage. The first symptom of disease in the newborn may be a sore on the skin, which can be tested with a fluorescent stain to diagnose it as a herpes lesion.

Herpes sores on newborn

If left to develop into full-blown herpes, it can cause the baby’s death, brain damage, or blindness. Early treatment is imperative if there is a suspicion that a baby might have a herpes skin eruption. Premature or otherwise compromised babies are at greater risk when a woman has a recurrent outbreak of HSV II.

Preventing outbreaks

•             Avoid coffee, sugar, chocolate, and junk food.

•             Get plenty of sleep each night.

•             Reduce work- and relationship-related stress.

•             Take elderberry, zinc, vitamin C, garlic or alfalfa to help support the immune system.

•             Take olive oil extract.

•             Take 500 mg of lysine (an amino acid) daily.

•             Take colloidal silver orally after consultation with a naturopath (research colloidal silver; it is an important antiviral, antibacterial, and antifungal.  Don’t overdo, it can turn the skin permanently blue).

During an outbreak of herpes in pregnancy, have the pregnant woman take 1000 mg lysine three times a day along with vitamin C (500 mg, 3 times a day). If the woman is having recurrent outbreaks in pregnancy despite all the preventive measures taken, at 36 weeks the midwife may suggest she take Acyclovir 400 mg BID daily until the birth. Pharmaceuticals are thought to prevent outbreaks at term but they don’t always work and are hard on the baby’s liver.  If the pregnant woman has an allergic reaction to the antiviral drug, she should stop taking it immediately and report it to her provider.

After the birth, the mother and breastfeeding baby should be kept warm and skin-to-skin. Breastfeeding is of ultimate importance for the baby’s well being.  Rest for the mother is extra important. Nourishing fluids and extra vitamin C after the birth is recommended. Visitors should be kept to a minimum, told to wash hands carefully before entering the mother’s room, and barred from visiting if the visitor has any type herpes outbreak or infection.

— Gloria Lemay, “Herpes Simplex II,”  first published in  The Birthkit Issue 37 (Midwifery Today)

4 thoughts on “Herpes Simplex in Pregnancy

  1. Hi! my name is Leah and i am having a bit of a problem i would REALLY appreciate some help. I have no one else to ask besides my OB and would really appreciate another opinion. I was diagnosed with HSV type 1 in 2006 after i gave birth to my son. I have always have a some what weak immune system but i still only had maybe 4 outbreaks since then up untill I got pregnant again. I am now 29 weeks pregnant and ever since i hit 23 weeks it has been out of control. They gave my valtrex for the episode which use to work but it doesnt work as well as it use to now. Since then it has spread to my mouth, forehead my neck, my fingers hand and arm. it sems to pop up whereever it wants or whever i may have a cut.. i have been washing my hands so much they were dry and cracking and now it broke out with what i think it herpes. they are skin colored fliud filled bumps. i have a 4 yr old so i keep them covered up with bandages and just seem to be getting worse and worse because of the bandages. i am taking 1 gram of valtrex twice a day and it got rid of the horrible outbreak on my mouth but not my hands. they start out as one little bubble and if left alone go completely away. but when i covered them up with all these bandages they are just getting worse. i dont know what to do. will i be able to take care of my little girl when she is born??? I asked my dr if i should have a csection because my outbreaks arent going away and he said its up to me but it would be rare even having an outbreak that she would be infected because of it being hsv1 and a recurrent infection. i dont want to risk it but i am worried about my water breaking before the csection because me and my mom always have our water break when we go into labor. I am scared for my unborn daughter to be born im scared of all the meds i have to have been taking and im scared now i wont even be able to care for her once shes here because of the infection being on my hands. is there any hope for us? please help!

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  3. Hello…i am from Greece…forgive me for my poor English…I am 8 weeks pregnant to my first child…..i have a mild Herpes simplex infection on my upper lip since yesterday….can this infection harm my child????

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