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Pregnancy

Special Considerations: Herpes, AIDS

Jessica Evert, MD

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Genital Herpes

Genital herpes is a sexually transmitted disease caused by the herpes simplex virus. Commonly herpes infection presents with painful ulcers in the genital region which first occur several weeks after infection (the primary outbreak), and then reoccur from time to time (secondary outbreaks). Some people, however, do not experience any noticeable symptoms of infection.

While genital herpes is an annoying and lifestyle-altering condition for adult women who get the disease, it can be a devastating condition for newborns. Mothers can pass their herpes infection to their children through the process of vaginal birth. The most common way herpes is transmitted to the fetus is when the baby comes into direct contact with vaginal secretions during labor. The virus is also capable of traveling up the vaginal canal into the uterus or infecting the baby via the blood, but these modes of infection are quite rare. The chances of passing the virus on to the infant are highest when the baby is exposed to lesions of a primary outbreak during vaginal birth. Although some babies who are exposed to herpes at birth suffer no permanent damage, neonatal herpes infection can also result in skin and eye lesions, neurological damage, retardation, pneumonia or overwhelming infection, and even death. Talk to your doctor if you have herpes and are pregnant. The use of antiviral drugs (such as Acyclovir or Valacyclovir), and cesarean section birth in place of vaginal birth can substantially reduce the likelihood that you will infect your new baby with the herpes virus.

HIV and AIDS

medication bottleAdvances in medicine have significantly reduced the rate of mother-to-child infection with HIV, the virus that causes AIDS. However, women who carry HIV must remain cautious during pregnancy. Most importantly, women with HIV need to consult with their HIV doctor, their gynecologist, and other important healthcare team members prior to getting pregnant, or as soon as possible after becoming pregnant so that all possible precautions can be taken to reduce the risk that the HIV virus will be transmitted from mother to newborn baby.

The HIV virus is spread via contact with infected body fluids. While developing in the uterus, the baby is largely (but not entirely) protected from infection by various mechanisms. However, the baby is likely to contact infected body fluids during birth. Doctors working with an HIV positive pregnant woman are likely to prescribe various antiretroviral drugs which decrease the amount of virus in the woman's body, and therefore lessen her chances of infecting her baby. Doctors may also recommend that the baby be delivered via cesarean section rather than vaginally.

Women who carry HIV/AIDS should not breastfeed because it is possible to transmit the virus to the newborn via breast milk.

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