Genital Herpes is a sexually transmitted disease caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). Most genital herpes is caused by HSV-2. Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters or vesicles break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.
During pregnancy perinatal transmission to the developing fetus can occur. Primary, or first time, outbreaks of the HSV virus carry the greatest risk for transmission during pregnancy and may also have the greatest effect on the developing fetus. Later transmission can occur, however, in anyone who is actively shedding the virus. During labor, or after your water breaks, your provider will inspect the vaginal area to ensure that no lesions are present. You should report any recent symptoms of outbreaks such as blisters, tingling or burning that have occurred within the past 2 weeks. If you have had any of these symptoms, or if your provider finds any lesions consistent with herpes, they will recommend you have a cesarean section. By bypassing the vagina, this reduces the chance of the baby being exposed to the virus, and contracting the infection in the post-natal period.
We recommend that anyone who has a history of HSV in the genital region, be placed on prophylactic medication to prevent outbreaks after 36 weeks gestation. These include medications like Acyclovir and Valtrex.