› Forums › Herpes Questions › Pregnancy related questions
- This topic has 9 replies, 2 voices, and was last updated 1 year, 4 months ago by Terri Warren.
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December 13, 2020 at 12:29 pm #72054Worried1234Participant
Hi Terri
For women who are asymptomatic for 10+ years with hsv2 do you recommend suppressive therapy towards the end of pregnancy?
Also, if a person has been asymptomatic for many years ( even with stress, illness, surgeries) would you expect pregnancy would trigger an out break?
If a person with asymptomatic hsv had there first outbreak say 2-3 days after vaginal birth would the baby be at risk for contracting hsv?
Lastly, I’ve read that 75% of women with hsv2 can expect one outbreak during pregnancy is this true and if so from your experience in treating many people over the years how many can they expect during pregnancy ?Thank you!
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December 22, 2020 at 8:40 am #72099Terri WarrenKeymaster
Yes, even without outbreaks, the recommendation would be suppression in the last month. And yes, because pregnancy suppresses the immune response, it is possible that being pregnant could trigger an outbreak. Women with established herpes infections are far less likely to infect their babies than those with new herpes during the pregnancy. But the question you ask is complicated – it is the first recognized outbreak or the first infection – very different questions.
I’ve not read that statistic about pregnant women with herpes. And since 80% of women with herpes don’t know they have it, I’m not sure how someone could come up with that statistic, honestly.Terri
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December 22, 2020 at 9:06 am #72100Worried1234Participant
Sorry, didn’t mean to be confusing! I meant the first recognized outbreak for an individual who is seropositive on tests but no outbreaks, last known sexual contact more than 10 years ago, what percentage would they be at risk for transmitting to their baby through shedding and IF they had their first recognized outbreak during delivery
And how many outbreaks are average during pregnancy for someone on no medication.
Thanks
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December 22, 2020 at 3:54 pm #72113Terri WarrenKeymaster
There is less than a 1% chance that someone with a well established herpes infection would infect their child at birth. An outbreak at delivery would not be good and a c-section would likely be done. Suppression would help prevent that.
I don’t know the average number of outbreaks in a pregnancy, I suspect it varies widely
Terri
- This reply was modified 1 year, 4 months ago by Terri Warren.
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December 23, 2020 at 7:21 am #72122Worried1234Participant
Ok and the 1% is with the virus shedding? Or with the active virus?
If there is active virus and an outbreak what is the percentage of passing on the infection with a well established infection?
In infants who do get hsv2 from their mothers despite the antibodies is it considered oral or genital?
Thank you!
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December 30, 2020 at 10:36 am #72162Terri WarrenKeymaster
Viral shedding IS active virus.
I seriously doubt that anyone would do a vaginal delivery on a woman having a herpes outbreak at the time of delivery. Never.
Infants who acquire HSV 2 are not defined as oral or genital, specifically. but an interesting question for their future.Terri
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January 4, 2021 at 2:06 pm #72213Worried1234Participant
Thank you for your response. I have a few more questions. Reading the guidelines on recurrent herpes in pregnancy it says women will be asked if they have any prodrome symptoms
1. can you describe what prodrome symptoms are? A lot of the websites says burning which worries me because I have had episodes of 5-7 days of burning ( more like the area is red and hot) maybe twice in the last year or so, both times I went to my Gyn and they prescribed me a triamcinoline nystatin cream saying it was a little red no blisters, sores and it was more outside of the urethra not around or in the vagina
2. How long does a prodrome last? Some websites say a few hours some say a few days
3. Can you have burning as a prodrome and no outbreak?
4. If you have prodrome during labor without lesions is the risk still 1% of spreading to the infantI guess I’m just still really nervous about delivery even if I do take antivirals and am asymptomatic to my knowledge ( I pay close attention probably too close). A lot these studies say babies are Born to women with no symptoms at delivery, not very reassuring.
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January 7, 2021 at 1:01 pm #72248Terri WarrenKeymaster
1. can you describe what prodrome symptoms are? A lot of the websites says burning which worries me because I have had episodes of 5-7 days of burning ( more like the area is red and hot) maybe twice in the last year or so, both times I went to my Gyn and they prescribed me a triamcinoline nystatin cream saying it was a little red no blisters, sores and it was more outside of the urethra not around or in the vagina
Prodrome can involving burning, yes, but more often, a crawling under the skin feeling is common.
2. How long does a prodrome last? Some websites say a few hours some say a few days
Yes, a few hours to a few days is accurate.3. Can you have burning as a prodrome and no outbreak?
Yes, but so many things can cause burning so I wouldn’t rely upon that as the only indication of viral activity.4. If you have prodrome during labor without lesions is the risk still 1% of spreading to the infant
Yes, I suppose there is some risk, but antiviral therapy should be very helpful. I’ll tell you that in labor, you aren’t going to be able to sort out prodromal burning from anything else. If you are very concerned about the burning, you could have a swab test done prior to labor and see if virus is identified. So that later, closer to labor you might have a more accurate idea about if prodrome is happening.Terri
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February 9, 2021 at 3:21 pm #72671Worried1234Participant
Hi Terri,
After 13 years of having hsv2, no outbreaks, or transmission to husband of 8 years, how many days out of the year would you suspect I would shed the virus I don’t take any medications and we don’t use condoms -
February 13, 2021 at 1:13 pm #72710Terri WarrenKeymaster
I honestly couldn’t say – well less than 10%. Has your husband actually been tested to know if he is infected? If, after 10 years of having sex without condoms or suppression, he isn’t infected, it seems unlikely he will now contract this from you but I can’t say there is zero chance.
Tell me again exactly how you were diagnosed with HSV 2?
Terri
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