Sunday, March 25, 2007

Genital Herpes in Pregnancy-A Health Hazard for the Baby

Question:

I got married a week ago and I have missed my period. I saw my doctor who did a pregnancy test and pelvic ultrasound and told me I was 6 weeks pregnant. Two weeks ago I started having painful urination and multiple blisters on my vulva. My doctor diagnosed me with genital herpes and started me on medications. I have finished the treatment but I am supposed to take the medication throughout the pregnancy. Is my baby going to be alright?

Answer:

Genital Herpes is a common sexually transmitted disease which is under diagnosed because sometimes patients with the disease don’t have any symptoms. In your case, your doctor did the right thing by treating you and giving you medication to prevent recurrent infections during your pregnancy and after delivery. Your husband has to have blood test to ensure that he does not have the disease. If he has it he should also be treated as he may have outbreaks and transmit the disease to you again. I will suggest that even if his test is negative you should use condoms for sexual intercourse.

The effect of the infection on the new born baby is severe. About 80% of the babies may be infected by the virus at birth if untreated. Hence if you are found to have the disease at the time of your delivery, you would be delivered by cesarean section to prevent the baby from being infected by the virus. Other prevention measures include giving you prophylactic antiviral medications to suppress the infection during the pregnancy. Three medications are available for treatment. Valacyclovir and Famciclovir would be more convenient as prophylaxis than Acyclovir because of convenience in their dosing.

Since many people with genital herpes don’t know they have the disease, it will seem to be reasonable to screen all pregnant women for genital herpes with blood test. This way, if their test is positive, they would receive prophylactic medication to prevent possible herpes infection in the pregnancy and the postpartum period.