Герпес при of pregnancy – на губах, генитальныйherpes how dangerous?

Update: December 2018

Content:

  • Ways of transmitting herpes
  • Symptoms of herpes infection
  • Shingles герпес
  • Diagnosis of herpes
  • Deciphering analysis for herpes simplex during
    of pregnancy
  • Опасность герпеса при of pregnancy
  • Чем лечить герпес при of pregnancy?
  • Herpes Prevention


Herpes infection is more common than we can imagine
imagine. However, herpes is particularly threatened by
of pregnancy. Herpes is a disease of viral etiology,
the main manifestations of which are rashes on the skin and
mucous membranes of the person. Infected with herpes infection
once, it is impossible to get rid of it throughout life.
The virus is able to stay in the body in a dormant
состоянии, а при ослаблении immunityа – проявляться негативной
symptomatology.

There are two types of herpes viruses: HSV-1 (labial, labial
herpes) and HSV-2 (genital herpes localized on the genital
bodies). For pregnant women, the danger is simple
genital herpes, it refers to TORCH infections, which are especially
опасны во время of pregnancy. This is due to the fact that they have
extremely negative effect on the fetus.

Ways of transmitting herpes

Infection with HSV-1 labial herpes is carried out
household contact or airborne (kisses to the sick
contact with infected skin areas through
personal belongings of a sick person – dishes, towels, washcloths, dental
brushes, cosmetics).

Pregnant woman can get infected with genital herpes (HSV-2)
during intercourse. In 50% of the infection occurs when the virus is located
in the asymptomatic active phase, the sick person has
minor unpleasant sensation – burning, pain, small
rash. With первичном заражении беременной женщины генитальным
herpes risk of infection of the fetus is about 50 – 60%.

The HSV-2 virus can also be transmitted vertically from
pregnant mother to the fetus through the placenta or during childbirth at
contact with mother’s birth canal infected with herpes.

Infection of the population with herpes simplex virus is very
high. Byэтому проблема влияния герпеса на беременность – это в
первую очередь проблема, напрямую зависящая от состояния immunityа
future mother

Symptoms of herpes infection

Labial and genital herpes have different localization, but
similar clinical manifestations and course, while they manifest
the presence of such symptoms:

  • local itching and burning sensation in the mucous membranes of the genital
    organs;
  • bubble eruptions;
  • deterioration of the general condition of the body (weakness, muscle and
    headaches, fever up to 38 – 39 º C.

Ofначально в месте проникновения вируса в организм (через
microcracks and sores on the surface of the skin and mucous membranes) to
the appearance of eruptions there is a burning sensation and itching that is
early harbingers of a rash. Then on this place appear
vesicles filled with clear serous
content.

HSV-1 herpes blisters are located in the lips and nose, and
при ВПГ-2 – на половых губах (больших и малых), шейке матки,
vagina, in the rectal area. A few days later the bubbles
burst, their contents flow out, and in their place appear
wounds – ulcers that do not heal for a long time, they are painful when
touching a sick person causes a lot of inconvenience. Have
women suffering from genital herpes may appear
watery discharge from the vagina (for 5-7 days),
которые тоже являются симптомом diseases.

Рецидивирующий генитальный герпес во время of pregnancy (ВПГ-2
type) mimics the symptoms of the primary genital, but has
more erased clinical picture. In most cases, relapses
herpes occur due to a natural decrease in immune
системы во время of pregnancy. In its course distinguish period
aggravations and remissions. During remission, the disease does not
manifests and flows unnoticed. And when relapse is exacerbated
the virus manifests itself acutely, similar to the primary herpes.

Shingles герпес

Herpes zoster is particularly dangerous when
of pregnancy (синоним: опоясывающий лишай – причины возникновения).
This is also a viral etiology disease, which is characterized by
unilateral skin rashes that mimic
herpetic By ходу высыпаний отмечается сильная боль,
due to the fact that the virus lives in the nerve cells. Shingles
herpes is caused by the varicella-zoster virus, it can last for a long time
live in the body without causing any manifestations, and then suddenly
активизироваться при ослаблении immunityа. (see signs of chickenpox
у взрослых, опоясывающий лишай – симптомы, лечение)

Shingles герпес может иметь разные формы:
ophthalmic, Ramsey-Hunt syndrome, motor. Also
there are atypical forms of the disease: cystic, abortive,
gangrenous, hemorrhagic.

Герпес и беременность

Depending on the form of the disease, its symptoms may be
different, but in all cases rashes appear that
are located along the major nerve trunks and nerves (intercostal
nerves, trigeminal nerve, etc.) and have one-sided
(asymmetrical) nature of the lesion. In the area of ​​the rash is marked
severe itching of the skin. Common symptoms also appear – malaise,
fever. Later pains of neuralgia appear
character in the localization of lesions. (see herpes on the body,
treatment, symptoms)

Initially, pink spots are visible on the skin, against which
erythematous papules and vesicles with
serous contents. As the nature of the rash increases
nearby lymph nodes and sharply increased pain along the nerves.
After about a week, the burst bubbles dry out, in their place
crusts are formed, which eventually disappear, forming after
self pigmented areas of skin. After being sick
rash and other manifestations of the disease have disappeared, it may remain
pain along the nerves (postherpetic neuralgia) that is hard
treatable.

Diagnosis of herpes

Reliable method for diagnosing herpes virus type 2 and 1
is an ELISA (ELISA). Using this method
protective antibodies are detected – class G and M immunoglobulins,
that circulate in the blood of a sick person. After
a pregnant woman got infected, Ig M appears in her blood, and
a few weeks later – Ig G (after relapses of the disease
or primary infection). The reaction of the ELISA can be of high quality
and quantitative. In this case, the qualitative reaction determines the presence of
to the herpes virus antibodies Ig G or Ig M, and quantitative – reveals
He has a titer of immunoglobulins (their number).

The qualitative response reliably establishes the type of virus (HSV 1
or 2), and also determines whether the patient is immune to
herpes infection. Using quantitative reaction
estimated the state of immunity of women to the herpes virus. If in
blood has a high antibody titer, this indicates a relapse
diseases.

There are other methods of diagnosis of herpes: virological
seeding (material – the contents of the bubble rashes), PCR�
(polymerase chain reaction) – detection of virus DNA. Shingles
herpes is diagnosed on the basis of symptoms and clinical
manifestations that, as a rule, do not cause doubts. Of
laboratory diagnostic methods exist: microscopy,
immunofluorescent method, culture and serological
diagnostics.

Deciphering analysis for herpes simplex during
of pregnancy

Modern studies have found that antibodies to the virus
herpes simplex type 1 is detected in 80% of women of childbearing
age, 2 types are found in 30%. Women planning
pregnancy and already pregnant women often experience
concern about the fact that the analysis by ELISA revealed herpes in
blood. Fears about this may be unfounded,
insofar as:

  • blood tests for herpes determine protective antibodies,
    produced by the body and not the virus itself
  • detection of antibodies in the blood Igg is not a serious threat to
    the fetus, on the contrary, significantly reduces the risk of transmission of herpes
    child and indicates the presence of immunity to the virus in the mother

As already mentioned, antibodies of class M (Igm) appear in
within 2-6 weeks of the onset of the primary infection, however, they may
indicate and about the reactivation of existing herpes. Igm persist in
only for 1-2 months, and Igg – for the entire
жизни (это называется  серопозитивность). At primary
herpes infections are a diagnostic value represent as Igm, so
and fourfold increase in titers of immunoglobulins Igg detected in
patient with an interval of 12 days.

Recurrent herpes is most often diagnosed by high
Igg indicators that indicate chronic antigenic
stimulation of the body, as well as the occurrence of Igm in these patients
is a signal of exacerbation of the disease. Issuance by the laboratory
Igm’s questionable results require re-testing through
10-12 days.

The table describes the interpretation of the results of analysis of herpes
in pregnant women by ELISA, for the determination of infection,
estimated time of infection, or the presence of recurrent herpetic
infections. A positive result in the table means that the titer
specified on the laboratory letterhead above the reference values,
negative result – the amount of protective antibodies is lower
norms.

Antibodies to the disease Igm  Igg  Расшифровка анализа крови методом ИФА  What to do
Herpes simplex Have женщины отсутствуют антитела к вирусу – она относится к
seronegative pregnant
В период of pregnancy женщине следует строго соблюдать меры
предосторожности – ограничить контакт с людьми, у которых
there are active manifestations of genital or labial
herpes zoster
+ High probability of infection that occurred for a period of 1-1.5
months
It is necessary to seek advice from an infectious disease specialist, gynecologist.
and conduct additional surveys
+ + Женщина инфицирован герпесом сроком 1.5 – 5 months или
reactivation occurred (exacerbation) of infection
It is necessary to seek advice from an infectious disease specialist, gynecologist.
and conduct additional surveys
+ A pregnant woman has protective antibodies to herpes simplex that
indicates latent chronic disease or non-sterile
immunity
These are not dangerous for the fetus and the flow
of pregnancy

Danger of herpes to the fetus

How does herpes affect pregnancy, is it dangerous? With
the primary episode of herpes with clinical manifestations risk of transmission
инфекции плоду очень высок – 60%, первичная инфекция без
symptoms -40% for recurrent infections or asymptomatic
within 0-4%. Primary Herpes Simplex Infection
can lead to:

  • Патологии развития плода – спонтанный аборт, внутриутробная
    infection, stillbirth
  • Нарушению течения of pregnancy: преждевременные роды,
    многоводие, прерывание of pregnancy
  • Pathology of the newborn: prematurity, congenital herpes,
    low body weight, malformations

Герпес на губах при of pregnancy серьезной опасности для плода
не представляет, к нему вырабатывается immunity, который защищает
future baby from infection, however, it requires timely
local treatment. If there was a primary infection of the pregnant
women, the consequences depend on the trimester in which the
инфицирование (см. калькулятор расчета срока of pregnancy по
weeks):

  • Герпес на ранних сроках of pregnancy (первый триместр) чаще
    всего приводит к выкидышу или замершей of pregnancy (плод при этом
    dies).
  • In the second trimester, herpes in the fetus causes developmental abnormalities,
    not compatible with life.
  • На поздних сроках of pregnancy, в третьем триместре, герпес
    poses a threat to both the fetus and the mother. For a child, this
    severe hearing impairment and reduced vision, formation defects
    brain, heart defects, pneumonia, severe damage to the central nervous system,
    impaired physical development. And for the mother – heavy
    inflammatory processes.

Less dangerous is the recurrence of genital herpes,
however, it is unfavorable during childbirth, as it represents
child threat of infection. Recurrent genital herpes before
childbirth need to be treated. Если лечение герпеса во время of pregnancy
does not give positive results, a woman with genital herpes
Cesarean delivery is indicated (to avoid
contamination of the child at birth). For child entrance gate for
virus infection during childbirth are the eyes and nasopharynx.
The primary symptoms of herpes in a newborn are usually non-specific, and
often only a few days later the diagnosis is confirmed and
adequate therapy is carried out baby.

Чем лечить герпес при of pregnancy?

Pregnancy is a special condition of a woman’s body,
the time of which any medications, including anesthetics,
used during dentistry and even folk remedies
medicine must be applied with caution. That is why for
limited treatment of herpes in pregnant women
range of medical drugs. (see how to quickly cure herpes
lips)

For example, external and internal use is allowed.
Panavir drug. For the treatment of cold sores, you can also
apply Acyclovir (Atsigerpin, Vivoraks, Zovirax, etc.), it
lubricate the rash on the mucous membranes and skin for
weeks (up to five times a day). According to the testimony of the doctor may be appointed
other ointments: alizarin, oxolinic, tebrofen,
erythromycin, tetracycline. (see list of herpes ointments)

How else can herpes be treated if it is active during
of pregnancy? Lubrication of the lesions is allowed.
interferon and even vitamin e that speeds healing
sores Pregnant women suffering from extremely low
immunityом, рекомендовано употребление препаратов: женьшеня,
элеутерококка, эхинацеи, витаминов группы В. With необходимости
may prescribe immunoglobulin therapy.

Of народных средств рекомендуется смазывание ранок (на губах и
genitals) fir, sea buckthorn or rosehip oil, and
also chamomile or calendula based ointment – these remedies
perfectly soften the skin and accelerate its healing processes.

To reduce the chance of delivery by cesarean
cross-section in the 3rd trimester, pregnant is recommended to be treated with Acyclovir
2-3 weeks before the expected delivery at a dosage of 200 mg 4 p / day, this
The dose is safe enough for the fetus. Similar therapy is justified.
in that it significantly reduces the number of operational
delivery and the fact that the diagnosis of herpes on the eve of childbirth is not
can be implemented fairly quickly, and often results
Research doctor receives after a successful birth.

In addition to therapy with acyclovir on the eve of childbirth, women with genital
herpes during labor is recommended antiviral treatment
preparations of the genital tract (solution Poludana). In order to exclude
герпес на позднем сроке of pregnancy перед childbirth, рожениц
be sure to check for the presence of characteristic genitals
rash, when fresh herpes rash is detected
cesarean section. Also indications for cesarean section at
genital herpes are:

  • Herpes detection by PCR from the cervical canal in front of
    childbirth
  • Наличие высыпаний герпеса на половых органах перед childbirth
  • Primary infection of the pregnant in the last month
    of pregnancy, когда нет защитных антител в крови
  • Severe herpes infection with resistance to
    acyclovir

Herpes Prevention

Preventive measures can reduce the incidence of infection
herpes virus in pregnant women and even prevent
возникновение diseases. Among the main preventive measures
allocate:

  • укрепление immunityа (здоровый образ жизни, занятия
    physical culture, proper nutrition, hardening of the body)
  • avoiding bad habits (smoking, drinking alcohol)
  • timely analysis of the herpes virus during the planning phase
    of pregnancy (до зачатия).

If inы страдаете рецидивирующим герпесом, перед зачатием нужно
undergo treatment with immunomodulators and multivitamins, undergo a course
laser therapy that reduces the activity of the herpes virus. By
opportunities, refuse contact with people suffering from frequent
обострениями herpes infection.

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