Is Genital Herpes Common in Pregnant Women?

Genital herpes is a sexually transmitted infection caused by the Herpes Simplex Virus (HSV). Many cases of genital herpes are caused the by the HSV-2 serotype of the virus. However, an increasing number of genital herpes are caused by HSV-1, the serotype known to cause causes herpes lesions on the lips and oral mucosa.

Approximately 22% of pregnant women are carrying Herpes Simplex Virus type 2 (HSV-2), though they are not necessarily experiencing symptoms of genital herpes. Almost 90% of these pregnant women are undiagnosed.

Of women who are unaffected prior to becoming pregnant, 2% will become infected during their pregnancy. However, approximately 70% of new infections are asymptomatic or simply not recognized as a herpes infection by the pregnant woman.

These numbers suggest that genital herpes during pregnancy is a surprisingly prevalent problem, and unfortunately the actual prevalence of genital herpes is underestimated by the above statistics. The HSV-1 type of herpes virus normally causes herpes lesions on the lips and oral mucosa, known as "orolabial herpes", but now HSV-1 comprises an increasing number of genital herpes cases.

In fact, in college age populations, up to 80% of new cases of genital herpes are due to HSV-1 with an overall prevalence estimated at 30-50% of college age men and women. The HSV-1 prevalence in pregnant women is even higher at 63%.

Many genital herpes infections are asymptomatic. 75-90% of women are unaware of having infection. Additionally, women may confuse their symptoms with other situations. For example, in women symptoms are often attributed to:

- Recurrent yeast infections, urinary tract infections (UTIs), bacterial vaginosis

- Allergies to condoms, semen, spermicides, pantyhose

- Irritation from sex

- Heat rash

- Hemorrhoids

Some of the common symptoms of genital herpes infection include:

- Vesicular and/or ulcerative lesions on external genitalia, perianal region, buttocks

- Vulvar or perianal fissures

- Mild discomfort, itching, severe local pain

- Dysuria (discomfort with urination)

- Vaginal or urethral discharge

- Sacral parasthesia

- Tender regional lymphadenopathy (swollen lymph nodes)

- Fever, malaise, myalgias, headache

- Aseptic meningitis, disseminated disease occurs rarely

Why is it so important to recognize which pregnant women are carriers of the herpes simplex virus? Certainly, this STD may cause the mother distressing symptoms. But the real concern is for the child she is carrying. Infants who are born to women who currently have or who have ever had genital herpes are at risk of developing neonatal herpes, a potentially lethal condition.