HSV1 genital outbreak at 32 wks pregnant

[lovtonurse]

10 years ago I was dx with HSV 1 by a culture perfromed on an open area on my perineum. I was treated and never had another outbreak or prodromol symptoms that I am aware of. I am 32 wks pregnant and am experiencing an outbreak on my perineum. I quickly contacted my OB and am taking Valtrex BID and using topical cream. My question and concern is delivery of my baby. I delivered my last baby vaginally at 37 wks without complications. My worry is being that I have HSV 1 infection in my genital area and only having 2 outbreaks ever, exposing my baby. I feel that my baby is more at risk because I have HSV1 in the genital area and only two outbreaks, that hasen't allowed antibioties to be build up to protect my baby (am I correct for thinking this?) I am an L & D/NICU nurse so I am aware of the devestating effects of neonatal herpes. Should I continue with the plan of having a vaginal delivery once my outbreak is healed? What is a safe amount of time to wait prior to having a vaginal delivery (say I go into labor in the next 4 weeks should I request a c/s? Should I have my OB culture me now to make sure this isn't a new HSV 2 outbreak (I've had the same partner for the past 8 years). Should I have my OB swab at 36 wks for viral shedding? Advise please for someone who knows a little too much to not know enough. :)

[LisaM2627]

Hello Grace, I read this and it reminded me of another post I saw. A woman had written that she was currently having an outbreak and her delivery date was less than a month away. She was unsure if she would need a C-section or not. Her outbreak had just started. Let's assume her outbreak cleared up within a week parentheses which of course, is not always the case, can take 10 days or more). The infected cells could still be shedding for how long afterward? A week or two or more? My first question is, how long do the cells shed? In essence, what is the absolute minimum safe amount of time between the end of an outbreak and vaginal delivery? I would assume at least 2 weeks?

My other and greater concern is that some women are clearly unaware of how devastating a newborn herpes infection can be. I see people on here writing that they will take the 1 in 100 chance of the baby getting infected during a vaginal delivery...I don't think some mothers realize it can cause horrific outcomes - blindness, mental retardation, horrific infection and suffering, deformities, etc. When I see a mother-to-be writing things like, "I know there's a chance of infection....but I want to go ahead and take that risk," it is heart-breaking and alarming.

[world78]

Hi Grace
"you developed protective antibodies for hsv1 from the moment you were infected years ago and you passed those on to your baby around 28 weeks of pregnancy already."
If a woman psoitive for herpes, when she is pregnancy so the antibody develops for baby also even the baby in her? If yes then baby's blood test gives positive result for herpes?

I cant understand! or I misunderstood.

[gracefromHHP]

having a recurrence now isn't an issue unless you go into labor now.  you developed protective antibodies for hsv1 from the moment you were infected years ago and you passed those on to your baby around 28 weeks of pregnancy already. It has nothing to do with how many ob's you've had or anything of that sort.  

have you and your provider discussed you going on daily suppressive therapy for the rest of your pregnancy in the pregnancy doses?

grace