Pregnancy with genital herpes
Introduction
Introduction to pregnancy with genital herpes Genital herpes is a sexually transmitted disease caused by herpes simplex virus (HSV). Herpes simplex virus type I and type II can cause human infection. Type I is called mouth type or upper body type, accounting for 10%, mainly causing skin, mucous membrane or organ herpes in the upper body, such as cold sore, herpetic encephalitis, etc., but rarely infected with the fetus, although it has also been reported to isolate type I from herpes simplex. The virus is still rare. Type II is called genital type, accounting for 90%. It mainly causes genital (labia, clitoris, cervix, etc.), skin herpes under the anus and lower back. It is directly distributed by sexual contact, and most of them are young women. Pregnant women with herpes simplex virus type II infection can be transmitted vertically to the fetus. basic knowledge The proportion of sickness: 0.1%, more common in patients with multiple sexual partners Susceptible people: mostly young women Mode of transmission: sexual transmission, vertical transmission Complications: abortion
Cause
Pregnancy with genital herpes
HSV and CMV, vesicular-zoster virus and EB virus belong to the herpesvirus family and have typical herpesvirus morphological characteristics. The complete virus particles are round, 150-200 nm in diameter and consist of a four-layer structure. The innermost layer is the core of the viral double-stranded linear DNA. It consists of two segments, long-chain and short-chain. The outer core is a icosahedral stereo-symmetric shell composed of 162 shell particles, and the outer layer is draped. The outermost layer is a two-layer lipid envelope. Depending on the biochemical composition, biological characteristics and antigen of the virus strain, HSV has two serotypes, HSV-I and HSV-II. The nucleotide sequences of the two types are about 50% identical, so there are intertype-specific antigens.
Prevention
Pregnancy with genital herpes prevention
First of all, to prevent its infection, especially in the summer, high temperatures, sweating, and local scratching, it is easy to have local infections, it is necessary to clean the genital area with water every day. When a local infection occurs, clean the area with disinfectant water in a timely manner. Commonly used 3% boric acid water 200mL to wash the affected part, you can also add berberine 1 piece into the 200mL boiling water, and then clean the affected part after cooling. Secondly, avoid local scratching, and do not use drugs that are too irritating. After the illness, you should take care to prevent colds, cold, and fatigue to reduce recurrence. During the treatment period, the house was banned.
Recurrence is related to the following factors:
Drinking, smoking, fatigue, cold, sexual life too frequent, spicy food, eating more seafood, too long foreskin, sexual partners are not treated at the same time, other factors leading to low immunity exist.
Complication
Pregnancy with genital herpes complications Complications, abortion, jaundice
1, if pregnant women with genital herpes before 20 weeks of gestation, can infect the fetus, the abortion rate is as high as 34%.
2, 20 weeks after pregnancy, suffering from the infection of the fetus, more common in low birth weight children, can also occur premature delivery.
3, through the birth canal infection is the most common, accounting for more than 80%. Due to the low immune function of neonatal cells, the lesions often spread, the mortality rate is as high as 70% or more; more than 4 to 7 days after birth, manifested as fever, bleeding tendency, poor sucking ability, jaundice, herpes, sputum, hepatomegaly Wait, more than 10 to 14 days of death due to worsening of systemic failure, survivors often have neurological sequelae.
Symptom
Pregnancy with genital herpes symptoms Common symptoms Vulvar burning when urinating... Vulvar pain vulva burning and irritating
1. Acute type of initial infection: mainly through sexual intercourse. After 2-7 days of incubation, sudden onset, conscious genital pain, and even affect urination and walking. Examine the genital multiple, bilaterally symmetric superficial ulcers, the formation of herpes on the pericarp, after 10 days into the recovery period, the lesions are dry, crusted, no scars or induration after healing, the body produces specific IgM, this type of disease 4 weeks or longer may be related to lymphopenia, immunosuppression, and decreased cellular immune function in pregnant women.
2. Induced type of reactivation: pregnant women often have recurrent herpes vagina before pregnancy, and cases of herpes in early pregnancy are all infected with herpes simplex virus and lurking in the body, induced by pregnancy reactivation. There are 2~3 ulcers or blisters in common vulva, the course of disease is short, and it will heal naturally in a week or so.
Examine
Pregnancy with genital herpes
In addition to the typical medical history and clinical manifestations, the basis for the diagnosis of herpes simplex virus infection is:
(1) Herpes simplex virus is isolated from blister fluid.
(2) Inoculation of blister fluid and saliva in human embryonic fibroblasts or rabbit kidney cells can be judged by culturing for 48 hours and confirmed by immunofluorescence technique.
(3) After the Giemsa staining of the blister at the bottom of the blister, the spinous process is seen under the light microscope, and there are several nuclear balloon-shaped cells and eosinophilic nuclear inclusion bodies.
(4) Amplification of herpes simplex virus DNA by PCR technology is reliable.
(5) Enzyme-free detection of specific IgG and IgM in pregnant women's serum and neonatal umbilical serum. If the specific IgM in cord blood is positive, it indicates intrauterine infection.
Diagnosis
Diagnosis and diagnosis of genital herpes in pregnancy
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Mainly with hard squat, soft squat identification:
Hard chancre is a single hard ulcer, no pain, no history of recurrence, experimental examination of USR (+) or RPR (+), syphilis spirochete visible.
Soft chancre is a soft ulcer, although there is pain in the local but no history of recurrence, the test is positive for streptococcus.
Other genital skin diseases such as contact herpes zoster and Behcet's disease. Impetigo is sometimes similar to genital herpes and can be distinguished from medical history and examination.
