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Hi Terri, one more thought that is just occurring to me:
I have a toddler son (almost 2) who has been attending daycare. I know I was seronegative for CMV at the start of this pregnancy, and I have been taking aggressive hand washing precautions to avoid contracting CMV, which is prevalent in his sub 2 age group. Last week my son was sick with a very high fever, and I’ve since gotten his cold (sore throat, lot of nasal congestions). If this were CMV, could that be causing some of the nerve symptoms I’m having and not HSV1?
What concerns should I have or precautions should I take if this were a primary CMV infection? This is obviously a term pregnancy.
Many thanks for your help.
I think you and I were in similar situations on an old thread. (Really similar. I’ll be delivering in April after contracting a primary HSV1 infection from my husband last April.)
I’m feeling nervous too, but just thought I’d see how things went for you? Did you deliver vaginally? Hoping everything went well. I know it is scary. Just wanted to say, you’re not alone!! Perhaps your experience will reassure me. There are so few GHSV1 birth stories online!
AJune 4, 2017 at 8:54 pm in reply to: Newly acquired genital HSV1 and trying to conceive #19179
And one more:
3) I respect Dr. Wald’s suggestion of waiting 6 months to conceive. It took me a while to conceive my first child though, and I am cognizant of losing time. I understand that the virus sheds more in the first year, which would presumably increase the risk of asymptomatic shedding at delivery. It sounds like with HSV1, this is particularly problematic with regards to neonatal herpes. I’ve seen 3-5% as the asymptomatic shedding figure for genital hsv-1. How much higher is it in year 1?
So essentially, if we began trying to have a baby after say 3 months, with the idea of likely conceiving one at 6+ months, since these things can take time, what relative risks are we dealing with on the high off chance that we conceive early? Do things drop off rapidly at a year or is it a gradual decrease in shedding?
Thank you for your time. I am so scared and depressed at the thought of giving my baby herpes. Is there anything else I can do to mitigate the risk? I had a long induction with my first son (36+ hours) and fear a similar labor the second time with a long period of time with ruptured membranes, internal monitoring, etc. I had essentially all the risk factors the first time, but of course didn’t have herpes yet.
My provider also seems to think that as long as I do suppressive therapy for the last month, everything should be fine. Am I overreacting? What kind of risks am I actually looking at here? This feels terrifying.June 4, 2017 at 8:41 pm in reply to: Newly acquired genital HSV1 and trying to conceive #19178
Thanks very much for your expertise. I sincerely appreciate your time. (I’m the original poster here.)
I find myself consumed with fear about neonatal herpes, in particular the higher transmission rates of HSV1 vs HSV2. I came across another study, which was not comforting:
“In a large prospective cohort study of women who had herpes cultures taken in labour, HSV was isolated in 202 women and, overall, neonatal transmission occurred in 10 (5%).47 Caesarean delivery significantly reduced the HSV transmission rate in women from whom HSV was isolated (1 of 85 [1.2%] caesarean vs 9 of 117 [7.7%] vaginal). Risk factors for neonatal HSV infection included first-episode infection, HSV-1 vs HSV-2 isolation at the time of labour, the use of invasive monitoring, premature delivery and young maternal age. None of the 140 women with viral shedding due to HSV-2 reactivation infected their babies, compared to 2/11 women with HSV-1 reactivation.”
1) Can you please help me understand the information here: When they say HSV1 reactivation do they mean active legions at the time of delivery or asymptomatic shedding? Nearly 20% transmission rate seems SO high.
2) This paper, which cites a study by Dr. Wald, also says this, “While it has been shown that the chances of acquisition of HSV-1 are decreased in women seropositive for HSV-2, trans-mission of HSV-1 to the neonate has been documented to be high irrespective of primary or recurrent infection.”
Can you shed some light on what that means practically speaking? What kind of odds am I looking at with a vaginal delivery with no legions? Would you suggest a C-section even if I had a vaginal delivery the first time? I am terrified.May 9, 2017 at 6:23 pm in reply to: Newly acquired genital HSV1 and trying to conceive #18803
Thanks very much for your help and expertise (as well as the expertise of Dr. Wald.) I’m sincerely appreciative.May 9, 2017 at 1:24 pm in reply to: Newly acquired genital HSV1 and trying to conceive #18784
Thanks for your insight, Terri. Whenever I get pregnant, my OB did discuss starting suppressive therapy at 36 weeks so I can attempt a vaginal delivery, as you mentioned.
On the note of more shedding earlier in the course of the virus, you just mean as far as transmission during a vaginal delivery is concerned right? (So IE. the sooner I deliver, given a new infection, the more asymptomatic shedding I risk.) Noted. My question is actually more about antibodies, as it seems that even if one is shedding asymptomatically at the time of delivery, the mother’s antibodies that she transfers to the baby around 28 weeks can provide a good deal of protection. I was infected on April 21st. Do I have these antibodies now? Do I make more after future outbreaks? How does that part of this work. Will I have more antibodies for the baby if I wait longer to conceive? I don’t know how long it takes to make them.
My OB does not seem like a herpes expert by any means but made me feel as thought outbreaks during a potential pregnancy were more or less local events I shouldn’t be too worried about. For a genital HSV1 infection that doesn’t occur during pregnancy but happens somewhat before, what are the rates of transmission to the neonate assuming no outbreak at the time of delivery? I am also worried that having had only one outbreak, when the time comes I won’t be familiar enough with prodrome with advise my medical team.
Thanks for your advice. I appreciate it.