Herpes on the lip during early pregnancy, at 1, 2 and 3 trimesters
Last reviewed: 23.04.2024
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The most common virus infection in the human population, known to modern medicine, is herpes. Representatives of the virus family "Herpesviridae" know more than two hundred varieties, only eight of them are still considered dangerous for us. Lips are the most common and noticeable localization of herpetic eruptions. The appearance of fever, that is, the bubbles on the lips, causes mainly herpes of the first type, sometimes the second, the so-called herpes simplex viruses, which infected most of the adult population of the globe. Many doctors generally do not believe that someone could avoid it. Therefore, herpes on the lips during pregnancy is not a rare occurrence, in one of three women in this period necessarily appear pruritic vesicles.
To live to the fertile age and not to meet the herpes simplex virus, with its widespread prevalence in the human population is extremely rare. For most women, the onset of pregnancy after herpes on the lips should not cause any particular concern if such rashes do not appear the first time. This suggests that antibodies to the virus have already appeared in the body. In this case, the probability of its adverse effect is considered significantly lower than in the case of primary infection before conception itself. The organism of a woman in this case has not yet had time to respond with the production of antibodies to viral aggression, and before the formation of an immune response, which takes about one and a half months, there is the possibility of damage to any organs and tissues, including the embryo.
Epidemiology
Part of the world's population, infected with both types of herpes simplex, is estimated at 65-90% or more. The first type occurs much more often than the second, in the US, for example, 3.6 times.
Statistics state that only 10% of women of fertile age have never experienced herpes on their lips in their lives. Fever on the lip "pops up" at least once every nine months for every third pregnant woman, and more than 70% of cases of rashes occur in the first months of childbearing.
Based on the results of studies of the presence of characteristic antibodies in the body, it can be confidently said that most people contracted herpes of the first type in early childhood, the second - when they started to lead a sexual life.
Some people are immune to infection with herpes, others, the majority, on the contrary, have an inherited tendency to herpes infection, transmitted from generation to generation.
Causes of the herpes on the lip during pregnancy
The main reason for the appearance on the lips of herpes rashes is a physiological decrease in the immunity of a future mother after conception. Typically, this occurs with long-infected women who have experienced such rashes before pregnancy or in childhood. The virus could safely exist in their body, not behaving in any way. According to statistics, this happens quite often.
The lowest immune defense in a pregnant woman at the sixth to eighth and 20-28 weeks of gestation, when conditions favorable to the development of the "foreign body" are created, and then - his own organs are actively formed. It is during this period that it is most likely not only to pick up any infection from outside, but also to get news from safely dying in the body of infections, in particular, herpes bubbles on the lips.
Primary infection with the herpes simplex virus during pregnancy is rare, however, you can not rule out such a possibility. Therefore, if you do not remember that you were previously troubled by similar rashes, and, moreover, their appearance is accompanied by the appearance of symptoms inherent in the virus infection (fever, weakness, joint pain), perhaps your case is exactly this.
The most likely infection is contact with a sick person in the acute stage of the disease. Especially dangerous is the liquid that flows from the blisters on the lips of the infected. It just swarms with viruses. The saliva of the patient is also unsafe. Infection can occur with a kiss, through a towel, dishes, lipstick and other items. To get from a sick person to a healthy virus can also airborne way with microparticles of saliva or rhinobronchial secret during conversation, coughing, sneezing.
Carriers of the virus in the latent period can pose a threat only with direct contact of the mucous membranes and then under conditions of profuse invasion or disruption of the integrity of the mucous or skin of a healthy person.
Infection with simple herpes of any type can occur with oral-genital sex with an infected partner, and skin integrity disorders are not necessary. Sexual herpes in this respect is rather insidious, as in the majority of infected its active phase proceeds asymptomatically or the symptoms are so erased that the patient does not pay attention to them.
Another source of infection is self-infection (touching the site first to the site of the rash, and then to another part of the body). For example, it is possible to infect the sexual organs with a virus of the first type during active primary eruptions on the lips. However, the appearance of antibodies six weeks after infection, basically, neutralizes this possibility.
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Does herpes on the lips affect pregnancy?
A single answer is missing. At least, the recurrence of herpes on the lips of a pregnant woman is treated as a practically safe phenomenon, since the mother already has antibodies to it, and they will be transferred to the child through the general bloodstream and then the mother's milk, protecting him from infection for the first six months after birth.
According to statistics, the vast majority of women should be infected with herpes simplex virus almost from childhood, nevertheless, almost all of them, sometimes more than once, became mummies of quite safe and healthy children.
The fact is that when infection is introduced in the lips area, the viruses multiply locally not too far from the site of implantation - while facial tissues and nerve endings of the facial nerves are affected. Peritoneums, and the more so the uterus with labial herpes viruses do not reach. Moreover, women, whose herpetic eruptions sometimes appear on the lips, after forming an immune response become immune to genital herpes caused by the same virus.
Yet the herpes simplex virus in the active phase is able, as doctors say, to infect the fetus in the womb and cause congenital anomalies, fetal death and miscarriage, however, all this is relevant for genital localization. Both the first and the second type, activated on the genitals, can infect the child in utero and during childbirth. The primary sexual genital herpes is considered the most dangerous for bearing a child, the probability of infection of the fetus in this case is estimated at 60%. This also applies to recurrent herpes, although in this case the risk of infection is reduced.
Primary infection of the mucous membrane of the woman's lips during pregnancy can hypothetically lead to the defeat of any tissues until an immune response has formed, although in reality this almost never happens.
But nevertheless, the appearing rashes on the lips during pregnancy should not be ignored. They must be treated, and not independently, but under the supervision of a doctor.
Risk factors
Herpes is more likely to be infected by people whose relatives are familiar with this fever. Heredity increases the likelihood of infection. Neglect of sanitary and hygienic standards also increases the risk of infection.
Immunodeficiency states caused by the use of immunosuppressors, stress, physical or mental overload, chronic diseases, and also - hypothermia and cold increase the activity of the virus in the body and the number of relapses.
During pregnancy in the first months, the activity of immune killer cells is physiologically suppressed in order to allow the fetal egg to unhinderedly enter the endometrium and begin its development. It is the deficit of natural killers and provokes a relapse of dozing in the body of herpes.
Pathogenesis
Herpes simplex virus of the first type, as a rule, affects the mucous membrane of the mouth and eyes, face and neck skin, facial, trigeminal nerves, cells of the spinal cord, the second - prefers mucous and skin of the genitals and anus. But both of these viruses are completely interchangeable and with oral-genital sexual caresses can become a source of infection of any localization.
Herpes simplex virus falls into the mucous membrane or skin of a healthy woman in any of the above described ways, moving with small breaks, bypassing the protective barriers, until it reaches the nerve cell. Merging with the cell membrane, it penetrates into the neuroplasm, where the viral deoxyribonuclease is released and, having advanced a little more, is built into the genetic apparatus of the sensory ganglion nerve cell. Here it settles forever, its replication occurs, as a consequence of which viral fragments are embedded in human DNA. The immune system responds by activating the immunocytes and producing antibodies, which causes the fragments of viral deoxyribonuclease to "be conserved" in the nervous node of the trigeminal nerve.
Once the human immunity decreases, the virus raises its head and begins to multiply actively. Bubble rashes appear on the lip near the nerve end of the trigeminal nerve. During the exacerbation a great many fragments of viral DNA are formed, migrating along the processes of the neuron into the epithelial layer of the skin and mucous, provoking the appearance of vesicles, causing degenerative changes and necrosis of the epithelium. The replication cycle of the herpes simplex virus is ten hours. Over time, the body develops immunity against a specific type of virus, the number and severity of exacerbations decreases.
A person is an active virus carrier, usually during the first year after infection. In immunodeficient conditions, this period is prolonged, for example, in HIV-infected individuals.
Immunity is produced only against a particular type of virus. Thus, those infected with labial herpes of the first type will not already be infected by it through the genitals, they will not have herpetic keratitis or panaritium caused by this type of virus.
Symptoms of the herpes on the lip during pregnancy
Whatever the name of this disease - fever, cold and even malaria, and the symptomatology of labial herpes is the same for all, without gender and age difference. Pregnant women are no exception. The stages of development of the acute period have a clear sequence.
The first signs are felt as a slight tingling and itching at the site of future rashes. This corresponds to the progress of the virus through the cells of nerve endings from the ganglion of the trigeminal nerve to the epithelial tissues of the lip. At this point, viral DNA replicates actively. Externally, the portion of the lip at this site is slightly hyperemic.
Then comes the inflammatory stage - the emergence of a group (sometimes one) of bubbles with liquid contents, the sizes of which increase. The process is accompanied by itching and pain.
At the next stage, the bubbles that reached their largest size burst and the contents filled with ready-to-be-inserted genomes of the virus are poured out. On the site of the bursting of bubbles there are ulcers. At this stage, the patient presents the greatest danger to others.
Dahl is regressed - over the jaundice formed a pancake under which healing occurs. At the site of the rashes, there is usually no trace of them.
Most often there is herpes on the lips in the early stages of pregnancy, it is quite normal for a recurring virus, which becomes active against the background of a natural decrease in immunity during this period. The mother's body is not able to control the "woken up" viruses that successfully migrate along the axons of the neurons to the periphery of the primary infection sites. Appeared in the context of exacerbation of the disease, herpes on the lip during pregnancy in the first trimester is considered not dangerous, as well as throughout the gestation period. In the second half of pregnancy, immunity usually normalizes and herpetic rashes appear much less frequently than in the early stages.
Primary infection often differs from the reactivation of the virus by the presence of symptoms of systemic indisposition - headache and joint pain, fever, weakness and nausea. Specific eruptions are abundant with severe pain. Although some of the symptoms are worn out, there may be no symptom, such as a rash, but there are signs similar to ARVI.
Frequent herpes on the lips during pregnancy can be a symptom of violations of the immune system of the future mother. You should pay attention to this condition by your doctor. This is just the rare case when, against a background of reduced immunity, the infection can spread to the fetus.
Herpes on the labia during pregnancy is an alarming symptom and the cause of major complications of pregnancy, childbirth and vertical infection.
Complications and consequences
Fetal death, spontaneous abortion, intrauterine infection with subsequent developmental disorders, neonatal infection and neonatal herpes - such consequences of herpes infection are possible, however, only if it is localized on the genitals of a pregnant woman.
Primary infection in the first trimester of pregnancy with labial herpes does not pose a serious danger, although there remains an insignificant risk of infection of far-away tissues. If the future mother does not have a serious immunodeficiency (physiological immunosuppression does not count), then there is a high probability of no negative consequences. There is danger only if the infection is transferred to the genitals.
Herpes on the lip during pregnancy in the 2nd trimester, neither primary, nor, especially, recurrent is not dangerous for the mother and child. Reactivation of the dormant virus during this period occurs much less often than in the initial stages. Danger, again, can only occur if the infection is transferred to the genitalia during primary infection.
Herpes on the lip during pregnancy in the third trimester is the most dangerous when first infected, literally in the last week before childbirth. In this case, the mother can infect the child, taking care of him and not guessing what is the source of infection, but the baby does not receive antibodies with the mother's milk. The probability of such infection is estimated from 30 to 60%. Even with recurrent immediately before childbirth, there is a probability of neonatal infection within 3%.
The recurrence of herpes on the lips during pregnancy is not considered dangerous, however, traumatic procedures during childbirth are nevertheless recommended to be avoided. In addition, the danger may represent self-treatment of herpetic eruptions. Oral antiviral agents may cause more harm to the developing fetus than her mother's labial herpes.
Diagnostics of the herpes on the lip during pregnancy
Clinical symptoms of herpetic lesions, doctors know well, however, chronic forms of infection often occur atypically or completely asymptomatic. Therefore, the final point in the diagnosis is usually set after laboratory tests. Classical and modern blood tests and scrapings from the affected surface of the skin (mucosa) give a fairly informative answer regarding the infection and the type of virus.
Diagnosis of malaria on the lips during pregnancy is carried out by different methods.
The most informative is the polymerase chain reaction. This is a modern method that allows to detect viral DNA in biological material (contents of vesicles, cell scraping, blood) even at the initial stages of infection, when there are no antibodies to the virus. Its main disadvantage is that the presence of repeatedly copied DNA does not allow us to judge the severity of the process occurring in the patient.
Of the methods for determining antibodies to antigens, an enzyme-linked immunoassay (serological) analysis is used, which is currently the most popular. It does not allow to detect infection in the initial stages of the disease (when there are no antibodies), in addition, the concentration of antibodies does not always correspond to the severity of the process. It is recommended to take it at least two times with an interval of seven to ten days to see the dynamics of antibody titers.
Immunofluorescence analysis allows one to determine the antigens of the herpes simplex virus in a biomaterial treated with a special composition that causes glow when they are present.
Cytomorphological allows using a light microscope to detect viruses in strokes stained with special means.
Virological studies are based on the isolation of the virus in the culture media of sensitized tissues. The method is characterized by high sensitivity (about 100%) and the same specificity. At the same time, its high cost, complexity and duration of execution (sometimes up to two weeks) makes it not applicable in wide medical practice.
To establish an accurate diagnosis it is desirable to use several methods of research. False positive results can be obtained due to insufficient sterilization of laboratory instruments after previous analyzes. On false-negative - the human factor also influences: wrong sampling of biomaterial, its storage, transportation. Substandard reagents can also cause a false result.
Instrumental diagnosis (ultrasound) is used to monitor the condition of the fetus of an infected woman, in order to respond in time to the appearance of unfavorable symptoms.
Differential diagnosis
Differential diagnosis is carried out with allergic or aphthous stomatitis, impetigo, bacterial lesions, mycoses.
Treatment of the herpes on the lip during pregnancy
Herpes therapy in pregnant women involves the use of mainly external antiviral agents with the active substance acyclovir - the first substance with antiviral activity, the effect of which during the gestation period is well studied.
Ointments from herpes on the lips during pregnancy are sold in pharmacies without a prescription, however, and they should not be used without the knowledge of the doctor. Although they do not have a significant systemic effect, however, side effects can cause.
For example, antiviral activity has cream Acyclovir. It is used to infect the lips and face. The active ingredient of the cream is well absorbed into the surface covered by the bubbles and penetrates into cells infected with the virus. The viral enzyme thymidine kinase catalyzes the reaction of phosphorylation of acyclovir to triphosphate, which has an affinity for the viral enzyme, a catalyst for the synthesis of its DNA. This property helps acyclovir-triphosphate to inhibit the enzymatic activity of the viral enzyme and, with its help, be integrated into the DNA strand of the virus, stopping its multiplication and causing the virus to go into a "sleep mode". The cream is applied with a cotton bud on the affected lip once every four hours. Usually, healing takes place fairly quickly. According to the instructions they do not use more than five days.
Cream Fenistil Penzivir can also be used from herpes on the lips during pregnancy. Its active ingredient, penciclovir, exhibits antiviral activity, directed mainly against the reproduction of the herpes simplex virus. When applied to the skin with vesicles, it is not found in the systemic blood stream, but rather quickly replicates the reproduction of the virus and the exacerbation ceases. The cream is applied every two hours for no more than four days in a row. Precautions and application features are similar to the previous product.
Can be used on a natural basis (the active ingredient - purified extract from potato shoots) - Panavir gel from herpes on the lips during pregnancy. Bioactive substances contained in the extract have the ability to block the synthesis of DNA virus, thereby preventing its reproduction. The gel can be applied to the skin and mucous membranes at the site of rashes. Five-fold treatment is performed daily for four or five days.
Any external drug can cause local allergic reactions. When applying it, it is recommended to put a glove on your hand, and after the procedure - it is good to wash your hands.
The effectiveness of treatment is increased if it is started in the prodromal stage, when the symptoms only begin to develop.
As soon as the bubbles dry up and the last "stalk-forming" stage comes, you can apply softening and regenerating agents, for example, an oil solution of vitamins A and E (Aevit) or sea buckthorn oil.
Pain is stopped with Lidocaine gel or Benzocaine ointment.
During pregnancy, in most cases, oral and parenteral antiviral drugs are not prescribed. In exceptional cases, when there is a risk of complications, they can be prescribed by a doctor.
In addition to antiviral drugs, anti-herpes activity has hygienic lipsticks: Hygiene-herpes, lip balm against herpes and others that have a natural composition (according to producers) and are reasonably effective.
In addition to treatment, any pregnant woman, and infected with the herpes virus, in particular, should take care of their immunity. First of all - to ensure a full-fledged diet, including all the necessary products containing vitamins and trace elements, and also - to take vitamin complexes intended for expectant mothers.
Physiotherapeutic treatment can complement and even replace medication. Procedures should appoint a doctor, since a pregnant woman, in addition to her position, there may be other contraindications to certain procedures. In the acute stage with herpes on the lips, ultraviolet irradiation of the site with eruptions and infrared laser therapy can be prescribed.
Folk treatment
Recipes of traditional healers are certainly the safest for pregnant women. True, most physicians are skeptical. Official medicine does not recognize the treatment of herpes folk methods, they are allowed to combine them with antiviral drugs as additional softening and regenerating agents. And by themselves, folk remedies are considered ineffective. However, the pharmaceutical industry can not offer a single agent that destroys the herpes virus in the body. Therefore, you can try some of the znacharian recommendations, not forgetting about the possible intolerance of any of their ingredients.
Folk remedies will also be more effective if you start treatment at the first signs of exacerbation. Lips are often greased with such improvised means:
- whipped egg whites;
- toothpaste;
- Pharmaceutical tincture of propolis;
- cut slices of garlic or onion, rubbing the juice into the skin;
- sea buckthorn oil;
- juice from leaves of alder or aspen, aboveground part of wormwood;
- ointment of yogurt and coffee (stir in ½ cup of yogurt, spoon of instant coffee, two slices of garlic pressed through garlic, a tablespoon of honey and flour).
You can put on a vesicle grated apple, garlic or potatoes. Herbal treatment of herpes rashes is persistent, it is recommended to apply the drugs on the affected areas as often as possible and before skin cleansing.
Used ointment based on Vaseline with the addition of a teaspoon of freshly squeezed juice of marigold petals or sage infusion in the proportions: a tablespoon of grass is brewed for 20 minutes 200ml of boiling water, filter. Infusion can not only lubricate the rash, but also rinse your mouth with herpetic stomatitis.
In order to strengthen immunity and prevent the appearance of rashes, it is recommended to take a mixture of walnuts and honey three times a day. She is insisted for a month before the reception in a sheltered from light and cool place.
Homeopathy
An alternative direction of medicine that uses negligibly small doses of drugs that almost never have side effects can also be very helpful in herpes on the lips of pregnant women. Treatment with homeopathic medicines aims to activate the defenses of the body and make it overcome the disease. Treatment schedules are always assigned individually.
Herpes simplex uses Rhus toxicodendron, Acidum nitricum, Graphit, Apis mellifica, Atropa Belladonna, Mercurius solubilis. To prescribe homeopathic preparations should be a specialist, then the effect will be obvious.
In pharmacies you can buy a special anti -herpetic drug Herpes simplex-Nosod-Inel. This drug is made from herpes simplex virus in homeopathic dilutions. The so-called heteronous preparations, psoriatic, syphilitic, gonorrheal, have long and successfully been used in homeopathy. They are made from tissues or secretions of a sick person or animal, which are sterilized during the manufacturing process and no longer contain pathogens. These funds are not vaccines.
Herpes Simplex-Nosod-Inel has a strengthening immune system, cleansing and detoxification action. It is designed and used to treat herpesvirus infection of any kind and localization. There are no contraindications to it.
It is a solution in ampoules. You can use it in the form of injections or drinking solution.
Injections are done intramuscularly, intradermally or subcutaneously. The contents of the ampoule can be drunk without dilution or dissolved in pure water (volume -100 ml) by drinking small sips during the day at regular intervals.
Combines with any drugs.
It should be noted that as a result of taking this medication, the disease often exacerbates. This is treated as a favorable signal that the immune system was activated and responded to treatment. More effective will be the use of Herpes simplex-Nosod-Inel after a course of drainage of the body during previous two or three weeks of Galim-Heel and / or Lymphomyosot.
In the treatment regimen of patients infected with herpes, various preparations of the Heel series can be used: Aflubin, Anaferon, Arbidol, Immunal, Engistol and others.
Prevention
Planning a pregnancy, it is good for both future parents to pass tests for the presence of antibodies to the herpes virus, even if they do not remember the exacerbations with rashes. At least if a pregnant woman has herpes on the lip, she will know about her status.
Seropositive pregnant women should try to avoid possible exacerbations of the disease whenever possible, maintaining their immune system normally, not being overcooled, being less nervous and not overdoing with antiviral medications without medical advice. Since antibodies in the body are formed only to the type of virus that the patient is infected with, and the article is about herpes on the lips, which is considered the safest, then the infected persons should also not forget about precautions.
Uninfected pregnant women should follow even more carefully the rules of safety - personal hygiene, as well as to accustom their partner to this thought. Herpes on his lips during your pregnancy can become a cause of infection, and with oral sex - even more dangerous genital form. Especially risky is considered oral-genital contact with an infected partner during the last period of pregnancy.
Pregnant women should avoid kissing and other physical contact with friends, friends and even relatives, especially if they have any slight damage on their lips. Always wash your hands, going home, and after touching things common. Do not share lipstick, a cigarette, a handkerchief and other such things with anyone. Do not drink from other people's cups and glasses.
For information, the herpes virus lives on the plastics for up to four hours, on wet tissues - until dry, on metal objects - up to two hours. At room temperature and normal air humidity, the herpes simplex virus can survive all day long, in the cold up to -70 ℃ - five days. For his death, half an hour at a temperature of 50 ℃.
If the infection does happen, in principle, under normal immunity, this does not represent a great danger.
Do not transfer the infection from the lips to the genitals and eyes. Control your actions, do not comb the rashes, do not touch them with dirty hands, do not pierce the vesicles and do not tear off the scrapers. In addition to the danger of self-infection, there is the possibility of entering a secondary infection.
If you are infected in the last weeks of pregnancy, you should not kiss the child until the symptoms disappear. Breastfeed it in a sterile protective dressing. It should be noted that the appearance of antibodies in your blood and, therefore, in breast milk is a month and a half.