Using Acyclovir to Suppress Herpes During Pregnancy

Acyclovir medical text

If you're taking acyclovir for herpes and thinking about getting pregnant, you may be wondering if acyclovir and pregnancy can mix. How safe is this drug when you're pregnant?

Herpes and Pregnancy

Most women with herpes give birth to perfectly healthy babies. In the U.S., as many as 30% of pregnant women have herpes. But, less than one tenth of one percent of babies born here have neonatal herpes.

However, neonatal herpes is a very serious illness. The highest risk comes when the mother has an active outbreak of genital herpes when the baby is born. As the baby passes through the birth canal, he or she is exposed to the open sores.

Women with new-onset herpes are most likely to pass the infection to their babies. That's because the mother has not yet begun making antibodies to the infection. Women who have had herpes for a while can pass protective antibodies to their babies. The antibodies help prevent the baby from catching herpes, even if the mother has an outbreak at the time of birth. Still, doctors usually recommend that any woman with an active outbreak have a cesarean section instead of a vaginal birth.

About Acyclovir and Pregnancy

Acyclovir is an antiviral medication used to reduce the number of herpes outbreaks. It works by suppressing the virus, although it cannot eliminate the infection entirely.

There are no studies specifically looking at acyclovir and pregnancy in humans. The manufacturer does not recommend taking it during pregnancy. However, researchers have tracked women who did take the drug when they were pregnant, and as of early 2007 there do not seem to have been any problems.

Some doctors choose to prescribe acyclovir to pregnant women around the time the baby is due. The idea is that the medicine will decrease the chance of an outbreak, making vaginal delivery safer. The usual prescription is one dose per day during the month before the woman's due date.

Information for Partners

If a pregnant woman does not have herpes but her partner does, it's important to prevent transmission of the disease during the pregnancy. Partners can help by always using condoms and by abstaining from sex if there is any sign of an outbreak.

Since acyclovir helps prevent outbreaks and reduces the chance of transmission, the infected partner may want to consider taking the drug for the duration of the pregnancy.

Neonatal Herpes

What happens if a baby does catch herpes? Neonatal herpes can be a very serious disease. It can damage the nervous system, causing mental retardation or even death. Antiviral medications like acyclovir can help lessen the effects of infection, but even with medicine babies may become very ill.

Some babies only develop eye, skin, or mucous membrane infections. Signs usually begin to appear about 10 days after birth. The baby may have reddened, watery eyes or, occasionally, blisters inside the mouth. He or she may not appear to be sick in any other way, but it's important to get treatment because the initial symptoms can progress to very serious disease.

Neonatal herpes that affects the baby's whole body is called "disseminated" disease. Disseminated herpes can infect the nervous system, the digestive tract, the heart, the kidney, and other vital organs. Symptoms may begin as early as one day after birth. The baby may be irritable or lethargic, have trouble breathing, appear jaundiced, develop a rash, have seizures, or appear ill in other ways. The baby may or may not have typical herpes blisters.

Talking to Your Doctor

Talking about herpes can be difficult. Keeping your infection a secret from your doctor can put your baby at serious risk. If the infection affects your cervix (the entrance to your uterus), it's possible to have an outbreak without even realizing it. If you or your partner has herpes, talk to your doctor about how to keep your baby safe. You can talk over the pros and cons of acyclovir and pregnancy and decide together what's best for you and your baby.

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Using Acyclovir to Suppress Herpes During Pregnancy