Pregnancy and Autoinoculation risk

[healthybabygirlmom]

Hello Terri,

I am currently 34 weeks pregnant. On Thursday morning, I noticed a small amount of blood on my underwear, so I washed my hands and inserted my finger into my vagina to make sure it was not vaginal bleeding (which was not). Then I checked the same way a couple more times within several hours, each time I washed my hands before checking.

The same evening, I felt tingling on my lower lip and realized that I was developing a cold sore. I have had cold sores multiple times previously before pregnancy. I have not touched my genitals/vagina for a couple of hours before the tingling sensation started and have not touched it after it started.

The following morning I called my OBGYN and was put on Acyclovir 400mg TID x 5 days for the cold sore.

My question is: what is the chance that I could autoinoculate myself genitally by doing a vaginal exam couple of hours before cold sore symptoms occur if I touched my lip between washing hands and vaginal exam and didn’t realize it?

[healthybabygirlmom]

In case that autoinoculation occured, is the risk for the baby as high as in primary infection or lower like in recurrent infection?

[healthybabygirlmom]

Also, can autoinoculation happen asymptotically and affect baby in the womb or during delivery?

[healthybabygirlmom]

I have and additional question. After getting this cold sore, I’ve read lot (maybe too much) about hsv. Hopefully it is just pregnancy anxiety and overthinking.

I have been in monogamous relationships with my husband for 15 years. He is the only sexual partner that I ever had. He had one sexual partner before me. We have never been tested for HSV. Neither of us ever had any genital symptoms. But we both have cold sores infrequently since teenage years. (So I’m assuming we’re both positive for hsv 1)

Is there a possibility that he could have gotten hsv 2 from his previous partner, passed it to me and we both stay asymptomatic for 15 years?

Is there a risk of the outbreak during delivery? Do we both need to get tested now, when I’m 35 weeks pregnant?

Thank you from overly anxious future mom!

[Terri Warren]

Since you have a well established history of cold sores, I think it is extremely unlikely that you transferred the cold sore virus to your genitals. I also think it is highly unlikely that you have acquired HSV 2 from your husband but have never gotten symptoms, either of you.
If you do decide to test, and I’m not recommending that, do only the western blot as there is such a high rate of false positives with the IgG test

Terri

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