Herpetic infection of
Herpes (herpes) for the first time was described in Ancient Greece, the Name of this virus is translated from Greek “creeping“, Since then prevalence of this disease did not become less - now this infection occurs more than at 90% of the population of the earth. Allegedly in the territory of Russia and the CIS various forms of a herpetic infection annually infect about 20 million people, and mortality among viral diseases takes the second place after flu.
the Disease is caused by a virus of simple herpes (VPG, herpes simplex). From 80 types of herpes can only 9 cause in the person of a disease, at the same time the disease of first (VPG1) and the second (VPG2) type most often is registered. The main distinction of these two viruses consists that infection with a virus of the first type is shown in the form of herpes of lips, an eye and oral cavities, and a virus of herpes of the second type causes genital, or sexual, herpes and herpes in newborns. However recently this statement is called in question. So, in 20 - 40% (on different sources) cases at genital herpes reveal the first type of the activator.
Practically in all cases of herpetic damage of a genital tract at women infection happens at sexual contacts, also infection at a kiss, use of the general ware, towels, linen is possible. A sick herpetic infection it is infectious, as a rule, only during an aggravation i.e. when rashes are shown or there are other signs about which it will be told below. At contact with the sick person in the period of an aggravation the probability of infection is very high. Perhaps also self-infection when the patient himself transfers a herpes virus from the infection center to not infected parts of a body: face, hands, eyes, oral cavity or genitals.
Through mucous membranes the virus gets to nervous system (okolopozvonochny nerve ganglions - at sexual herpes and knot of a trigeminal nerve - at front) where there can be a long time in the “dozing“ state. At emergence of conditions, favorable for it, for example when weakening protective forces of an organism at a stress or cold, it is activated, migrates from nervous cages to skin and mucous membranes.
Symptoms of developing of herpes
the Incubatory period - the period from infection before emergence of the first symptoms - at a herpetic infection makes 3 - 14 days.
Then there comes the period of harbingers of an illness. The general weakness, temperature increase of a body to 38 °C, painful increase in inguinal lymph nodes, increase of an urination, muscle pain is noted. In genitals the itch, pain, burning is felt. Sometimes there are nausea, vomiting, a nape sleep, a headache, however all these symptoms independently pass with the advent of rashes. On mucous membranes of genitals (small and big vulvar lips, a vulva, a clitoris, a vagina, a uterus neck) and adjacent sites of skin there are small bubbles, grouped, inclined to merge, filled with liquid to reddening around them. In 2 - 4 days contents of bubbles grow turbid, and they burst, forming the becoming wet yazvochka which then become covered by crusts. At the favorable course of a disease in 5 - 7 days the crust disappears, on its place there is a spot. Even in the absence of treatment disease symptoms usually pass independently in 2 - 3 weeks.Subsequently at many the disease recurs
, and time before the next recurrence can fluctuate from several weeks to several years. At infection with the first type of a virus recurrence within a year arises at 50%, the second - at 90% of patients. The exacerbation of a disease is promoted by various factors: ultra-violet radiation at long stay on the sun, pregnancy, periods, medical manipulations, including abortions and introduction of an intrauterine spiral, excessive cooling, stressful factors, etc.the Clinical picture of recurrence of a chronic genital herpetic infection is various
. Diagnostics of recurrence is often complicated as the period of harbingers is very short, and signs of discomfort can be absent. However some patients in 6 - 12 hours prior to emergence of rashes on the place of primary defeat note a pricking. As a rule, recurrence proceeds easily, duration of rashes does not exceed 3 - 5 days. In some cases at recurrence visible rashes are not found at all, and puffiness, an itch, feeling of discomfort in genitals appear. Patients with good immune system have a herpetic infection easier, at them it passes in the latent form more often. At patients with the lowered immunity crushing and long herpetic defeats are observed more often.
the Course of pregnancy
of VPG takes the second place after a rubella on a teratogennost (ability to formation of malformations at a fruit). It is established that pre-natal infection of VPG can happen:
- transplatsentarno - through placenta vessels;
- in the ascending way from the infected genital tract, especially at a premature rupture of fetal covers, the long waterless period;
- from a cavity of a small pelvis on uterine tubes.
sexual herpes during pregnancy, then the fruit can suffer. As a rule, at infection to 10 - y weeks of pregnancy there is a death of a fruit and an abortion. Defeats of the developing bodies of a fruit, emergence of congenital uglinesses are possible.
Infection in the second - the third trimester, and especially after 36 weeks of pregnancy, is fraught with defeat of nervous system of a fruit, skin, liver, spleen. Despite the treatment appointed after the delivery, to 80% of newborns at primary episode of genital herpes at mother perish or become deep disabled people.
Primary episode of genital herpes and the related loss of desired pregnancy - a severe psychological injury for both potential parents. But the following pregnancy will proceed already against recurrent genital herpes, and in blood of mother antibodies which will keep will circulate for life and will protect future child, getting through a placenta into his organism. During pregnancy from mother sick with recurrent genital herpes, the virus is transmitted to a fruit only to 0,02% of cases. Therefore recurrent genital herpes is not so dangerous during pregnancy, does not cause uglinesses and damages of internals. However at recurrent herpes the frequency of malfunction of a placenta, pre-natal growth inhibition of a fruit, pregnancy not incubation increases. These complications are most often connected with autoimmune processes in mother`s organism against a herpetic infection when the immune system “does not recognize“ own fabrics and cages and develops to them antibodies, as to alien proteins. Such processes influence, in particular, fibrillation process, at the same time the fruit suffers again as a result of damage of vessels of the developing placenta.
Therefore if you have a recurrent herpetic infection, needs to observe with special care the schedule of all researches conducted during pregnancy in due time to eliminate possible complications.
If at the time of delivery at the woman is active rashes, newborn children not always manage to avoid infection when passing through the infected genital tract of mother. Frequency of an infection of newborns at whose mothers allocated a herpes virus at the end of pregnancy makes 40 - 60%. According to WHO experts, 0,03% of all newborns were infected with VPG at the time of delivery. Except the ways of a transmission of infection stated above, infection at direct contact is at the time of delivery possible during passing across the patrimonial canal, and also after the delivery from mother in the presence at it active rashes. At newborns at the same time rashes on skin come to light, in hard cases damage of a brain and other bodies are possible (a liver, lungs, adrenal glands). Mortality of newborns with primary herpetic infection makes about 50%, and a half of survivors has eye or neurologic complications.
Diagnosis of genital herpes is carried out by
in three directions now:
Signs of pre-natal infection on ultrasonography can be
- of Cultural method . Its essence is that from herpetic rashes or bubbles take away contents from the sick person and place him on the growing chicken embryo. Then determine existence of VPG by characteristic defeats. To advantages of a method its high sensitivity, belongs to shortcomings - research duration (the result prepares till 2 weeks). Thus it is possible to tell precisely that these rashes have the herpetic nature.
- of DNA - diagnostics which is carried out by means of the polimerazny chain reaction (PCR), i.e. allocation of the activator. PTsR can find a virus in the patient only at the time of recurrence. Material for PTsR is taken away a special brush from places of rashes. Reaction allows to eat or not in an organism with this or that type of a virus of herpes.
- of Serodiagnostik (detection of specific antibodies to a herpes virus in blood serum). Antibodies to a virus of herpes appear in blood serum to 4 - 7 - mu to day after primary infection, reach peak in 2 - 3 weeks and can remain all life. As the gain of antibodies is very important for establishment of the diagnosis, existence in the only sample of serum yet means nothing them. In blood of most of adults there are always antibodies. To distinguish primary episode of genital herpes from the first recurrence with visible symptoms, the patient needs to take a blood test from a vein on antibodies to the first and second types of a virus of herpes. If in blood there is IgG - protective antibodies - class G immunoglobulins, so herpes recidivous and there is practically no threat for a fruit or an embryo. If in blood there is no IgG, and there is IgM - that is primary episode of genital herpes.
a suspension in amniotic waters, the “thick“ placenta, is not enough - and abundance of water, fruit brain cysts.Conducting pregnancy and treatment of herpes
At coincidence of primary episode of a disease to the first trimester of pregnancy is expedient to interrupt with
At infection in the second or third trimester pregnancy is kept, carry out treatment, childbirth plans in natural patrimonial ways. For prevention of rashes in 2 weeks prior to childbirth the doctor can appoint inside antiviral preparations of ATSIKLOVIR, FAMTsIKPOVIR or VALATsIKLOVIR. It is possible to use candles of VIFERON, KIPFERON.In case the first in life episode of genital herpes happens to
in 30 days prior to childbirth, - the rodorazresheniye by operation of Cesarean section is recommended. If such woman had a rupture of fetal covers earlier, than in 4 - 6 hours prior to childbirth, then the woman gives birth in natural patrimonial ways which process YODONATOM or other antiseptics - it is a usual measure, it is applied to one and all women in labor. If at the woman herpes not on genitals is noted, then Cesarean section is not carried out.
At women with recurrent genital herpes conducting pregnancy has some features. During pregnancy in order to avoid an exacerbation of herpes it is desirable to avoid stresses, to happen more in the fresh air, to accept vitamins for pregnant women. But if the aggravation nevertheless happened, it is necessary to pass complex treatment. Outwardly at rashes it is possible to use ointment on the basis of the ACYCLOVIR. Ointments and creams do not affect a fruit since in blood they are not soaked up.carry out by
In two weeks prior to childbirth medicamentous prevention of an aggravation, take material for PTsR - diagnostics from the channel of a neck of a uterus, carefully survey patrimonial ways, a crotch and a vulva for identification of the possible herpetic centers of damage. If at the time of delivery find rashes on skin in mothers who had recurrence of genital herpes in the past and mucous or a herpes virus in dab, then carry out a rodorazresheniye by means of operation of Cesarean section or conduct childbirth in natural patrimonial ways with processing of patrimonial ways and the child`s skin antiseptics.
Prevention of herpes
having Once got to an organism, the virus periodically causes aggravations. It is impossible to achieve removal of a virus from an organism nowadays existing techniques therefore no treatment before pregnancy can be provided. Specific methods of prevention of transfer of genital herpes during pregnancy are also not developed. It is necessary to plan pregnancy approach (to be exact - in advance to be examined), to exclude addictions from the life, to complete a course of the all-strengthening treatment (vitamin therapy, a hardening etc. - everything that will allow to increase protective forces of an organism), to make the serologichesky analysis on VPG. If in blood there are immunoglobulins G or M (regardless of their quantity), so primary episode of a meeting with this virus already was and it is possible to become pregnant. When planning pregnancy at women with frequent recurrence preventive purpose of the ACYCLOVIR, immunomodulatory preparations, polyvitamins is recommended. The good effect before pregnancy renders the course of intra vascular laser radiation of blood conducted in specialized clinics. This treatment allows to get rid of a virus at least partially.by
If in blood did not find antibodies to VPG, then, on the one hand, this situation is optimum for a fruit. However such women need to observe special precautionary measures. In particular, it is necessary to be convinced that the partner has no genital herpes. If antibodies to VPG are found in the partner, it is necessary to avoid sexual contacts (even with use of a condom or oral sex).