Herpes genitalis in pregnancy

Fortunately, relatively few women suffer from genital herpes in Germany.Nevertheless, such an infection during pregnancy can sometimes have dramatic consequences for the child. Unfortunately, there is often great uncertainty and helplessness among affected women: At what point is there danger for the newborn child? How can the child be protected?

Does a caesarean section have to be performed if genital herpes is present? When pregnant women contract genital herpes for the first time, i.e. suffer from the so-called “primary infection”, there is acute danger for the unborn child. Depending on when it occurs, the disease leads to an abortion or miscarriage in up to 50% of cases.

However, if pregnant women suffer from recurrent (recurrent) genital herpes infections, the risks for the child are significantly lower. The closer an initial illness comes to the end of pregnancy or the date of birth, the more likely it is that a caesarean section will have to be performed, as otherwise the newborn baby could become infected through the birth canal. To avoid unnecessary Caesarean sections, the gynaecologist uses vaginal swabs to check whether the viruses causing the disease can be detected.

In order to protect the child and alleviate the mother’s symptoms, antiviral drugs such as acyclovir can be administered during pregnancy after careful examination and explanation by the attending gynaecologist. Studies have also shown that only local ointments promise no improvement. If the virus is nevertheless transmitted to the newborn, one speaks of “Herpes neonatorum”, also called newborn herpes.

A total of three different forms of the disease can be distinguished: In summary, genital herpes must be taken seriously during pregnancy and discussed with the gynecologist in charge. However, many risks can be minimized by taking the right measures before and during birth!

About 45% show rather mild symptoms, with the typical blister rash on the skin and lips, as well as inflammation around the eyes.
If a drug therapy is started quickly, the symptoms usually subside without significant late effects. If a suitable therapy with e.g. Aciclovir is not initiated, the virus can spread in the central nervous system and cause e.g. life-threatening meningitis.
In about 30% of children, infection with the genital herpes virus occurs with significant involvement of the central nervous system. Affected newborns unfortunately often suffer, despite therapy, from permanent, severe neurological disorders and failures.
If the mother suffers from severe genital herpes at birth, her infant may suffer from a highly life-threatening “blood poisoning” (lat. Sepsis) that affects various organ systems.