Reply To: Pass on genital hsv 1 first trimester, risk of birth defects-neonatal herpes

[factual_basis]

Hi Terri,

I am glad I got to interact with you. The doctor I initially consulted told me HSV1 or 2 did not make a difference and that genital spread would be same for both. That sent me on a spiral and that doctor visit became a PTSD inducing event, that I am going to therapy for.

I have done a risk assessment here in terms of neonatal herpes simplex, please see if it makes sense to you.

Conditions – 1
– partner never acquires ghsv1 0% risk of neonatal herpes simplex
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Conditions – 2
no sex with pregnant partner beyond 16 weeks conception, i.e. no primary infection beyond 26 weeks gestation i.e. seroconversion after possible infection prior to third semester (I assume 10 weeks is ample time to seroconvert).
– acquires ghsv1 well before ~13 weeks to term – maximum risk of transmission for recurrent episode in published literature – 5%
worst case scenario 2 years post infection based on shedding data from Christine Johnston (assume all shedding is infectious -I know it is a stretch) -1.3 %/ year.

I am assuming that after 2 years the 1.3% stabilizes and remains the same and I am not accounting for the effect of anti-viral.

Takes 3 years to get first child (neonatal herpes risk) ~ 0.20 %
Takes 7 years for second child (neonatal herpes risk) ~ 0.44 % (with 1.3 % transmission 7 years of relationship means more likelihood of transmission occurring)

I think these odds of risk are something I can live with, there are higher odds I will die in a car crash (0.88%).

Also, can PCR of amniotic fluid from amniocentesis at 21 weeks gestation reliably pick up an in-utero HSV invasion that could infect a fetus?