Does Herpes Pose Threat to Unborn Child?

Dear Dr. Tom:

My husband and I have recently been diagnosed with herpes. Prior to this occurance, we were anxious to start a family. Can he and I "reinfect" each other since we’ve both been exposed? What threat does this disease pose to an unborn child? What are the long term effects of the virus? Does it cause infertility? Any information provided would be greatly appreciated.

Dr. Tom’s Response:

Dear Curious:

Your short question poses some very important issues for would-be new parents. Hopefully, some of these answers will be of some value to you. The herpes virus can be spread to other parts of the body within and between persons who are already infected. Two risks are at issue for HSV infection during pregnancy: an increased risk of spontaneous abortion or premature birth plus transmission risk to the neonate during birth. However, uninfected children are regularly born to infected mothers. Congenital transmission is rare. Skin lesions, sometimes mis-diagnosed as impetigo or inflammation of a follicle, occur in about half of infected neonates. Invasion of the eye is also seen. About 3/4 of infected neonates show disease distributed throughout the body with general symptoms such as fever or sub-normal body temperature, vomiting, irritability, lethargy and poor feeding. The outlook for infected neonates is not good. In one study, about 60% of neonates died, and 18% survived with some residual nervous system or ocular disease. The remaining 22% survived with no harmful after effects. I am unable to answer specifically about influence on fertility. The best advice on childbearing for an infected mother should come from someone who deals with that professionally. Herpetic pregnancy and neonatal sequelae should be discussed with a pediatrician or a neo natologist and/or a family planning counselor. What seems to be important is that the mother keep her ob/gyn doctor informed of her status, re: outbreaks and recurrence cycles if known. Frequent virus cultures of the mother during her last few weeks of pregnancy to monitor the likelihood of possible viral presence at birth are inconvenient but quite helpful to guide delivery planning. I wish you well.


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