Patient Guidance

Facts

It is possible to have a genital herpes outbreak during pregnancy.

Medical Treatment

If it is your first outbreak, you should receive medical treatment. If you have recurrent genital herpes outbreaks, medical treatment is recommended only if there are severe symptoms or if outbreaks occur multiple times during pregnancy (twice or more). Regardless of whether it is a first outbreak or known recurrent herpes during pregnancy, you should be treated with preventive medication from week 36 of pregnancy until delivery.

If you have had a genital herpes outbreak in the past

During your first pregnancy check-up with your general practitioner or midwife, it is a good idea to inform them if you have previously had a genital herpes outbreak. If you experience a genital herpes outbreak during pregnancy, there is no need for medical treatment unless the outbreak is severe (you have severe symptoms) or frequently recurrent (twice or more during pregnancy). In this case, herpes is treated in the usual way with the medication Aciclovir. In the event of a genital herpes outbreak during pregnancy, preventive treatment with Aciclovir should begin from week 36 until delivery to minimize the risk of infecting the baby during birth. If you have previously had a herpes outbreak but have not had an outbreak during pregnancy, there is no need for preventive treatment in the last weeks of pregnancy.

Mode of Delivery
A pregnant woman with known recurrent genital herpes has a very low risk of transmitting the virus to her baby during birth and can therefore give birth vaginally. If you have had an outbreak of genital herpes before pregnancy or early in pregnancy, the risk of infecting your baby during birth is very low. Most women can therefore give birth vaginally.

If your partner has had genital herpes and you have not

It is relevant to inform your healthcare provider if your partner has previously had genital herpes, even if you have not. A blood test can determine if you have also had the virus (without symptoms). If the blood test shows that you have not had the virus, special precautions may be necessary as birth approaches. You can discuss this with your doctor.

If you have never had genital herpes before but experience an outbreak during pregnancy – a primary outbreak

A first-time outbreak of genital herpes carries a greater risk of transmitting the virus to the baby during birth. If you suspect this, you should contact your general practitioner or the maternity ward for diagnostics, including swabbing from sores and blood tests, and to initiate medical treatment. In the case of a primary herpes outbreak in the third trimester, the risk of transmitting the virus to the baby during a vaginal birth is 30-40%. If you experience your first outbreak of genital herpes during pregnancy, you should be treated with Aciclovir during the outbreak. Additionally, it is recommended to start preventive treatment with Aciclovir from week 36 of pregnancy until delivery to minimize the risk of a new outbreak and transmission to the baby during birth, regardless of when the first outbreak occurred during pregnancy.

Mode of Delivery

If the first outbreak of genital herpes occurs in the third trimester and is confirmed (via blood tests) to be a primary herpes outbreak, a cesarean delivery is recommended to minimize the risk of transmitting the virus to the baby during birth. A pregnant woman experiencing a first outbreak of genital herpes, especially in the latter part of pregnancy, has a high risk of transmitting the virus to her baby during delivery.