Viruses – Intrauterine and Neonatal Herpes

Intrauterine and Neonatal Herpes is a skin condition that I rarely encounter in both my The Woodlands dermatology and Conroe dermatology clinics.  Intrauterine herpes infection is very serious and can be fatal to the fetus in many cases.  Severe fetal anomalies can also occur such as scarring of the skin, limb defects, neurological damage, encephalitis, and eye abnormalities.  The majority of intrauterine and neonatal herpes cases are caused by HSV-2, which is the most common cause of genital herpes.  85% of neonates are infected at the time of delivery and will not usually manifest signs of infection for 1 to 3 weeks due to the incubation time of the virus.  Although infection of a neonate can occur when a mother does not have any active genital lesions, the infection rate is much higher when herpes lesions are present.  If the outbreak is the mother’s first episode of herpes, there is a much higher chance of transmission to the neonate during vaginal delivery than if it is a recurrent herpes outbreak.  Currently,  a C-section is recommended if the mother has active genital herpes lesions at the time of delivery or is experiencing the prodrome of an oncoming herpes outbreak.  Treatment with antivirals is usually initiated for genital herpes outbreaks in pregnant women for the 2nd and 3rd trimesters.