Pregnancy with genital herpes

　　生殖器疱疹是单纯疱疹病毒引起的性传播疾病。单纯疱疹病毒I型、II型均可致人类感染。I型称口型或上半身型，占10％，引起上半身皮肤、粘膜或器官疱疹，如唇疱疹、疱疹性脑炎等，但极少感染。II型称生殖器型，占90％，引起生殖器(阴唇、阴蒂、宫颈等)、肛门及腰以下的皮肤疱疹，主要由性接触传播感染，以青年女性居多。

　　妊娠合并生殖器疱疹的并发症主要有以下几种：

　　1、如果孕妇于妊娠20周前患生殖器疱疹，可以感染胎儿，流产率高达34％。

　　2、妊娠20周后患本病感染胎儿，以低体重儿多见，也可以发生早产。

　　3、由于新生儿细胞免疫功能低下，病变常常扩散，死亡率高达70％以上。患儿多于生后4-7天发病，表现为发热、出血倾向、吮吸能力差、黄疸、水疱疹、痉挛、肝肿大等。患儿多在10-14日因为全身衰竭恶化而死亡。幸存者多留有神经系统后遗症。

　　生殖器疱疹初感染的急性型主要通过性交传播。经2-7日潜伏期，突然发病，自觉外阴剧痛，甚至影响排尿和走路。检查见外阴多发性、左右对称的表浅溃疡，周围表皮形成疱疹。经10日进入恢复期，病灶干燥、结痂。痊愈后不留疤痕或硬结。孕妇于妊娠前经常出现外阴复发性疱疹，于妊娠初期出现疱疹，属于已感染单纯疱疹病毒并潜伏于体内，因妊娠再活化而诱发。常见外阴有2-3个溃疡或水疱。病程短，一周左右自然痊愈。

　　妊娠合并生殖器疱疹在预防时应注意预防感染。夏天气温高，出汗较多，加上局部的搔抓，很容易出现局部感染。每天用清水清洗生殖器部位。当出现局部感染后，要及时用消毒水清洗局部。常用3％硼酸水200mL外洗患部，也可用黄连素1片研末加入200mL沸开水中，待凉后清洗患部。其次，避免局部的搔抓，不可用刺激性太强的药品。患病后需注意预防感冒和着凉，以减少复发。治疗期间禁房事。

　　The main examination methods for pregnancy with genital herpes are as follows.

　　1. Immunological Detection: Culturing vesicle fluid and saliva on human embryonic fibroblasts or rabbit renal cells can make a judgment after 48 hours of culture, and immunofluorescence technology can be used to confirm.

　　2. Histopathological Examination: After scraping and staining the base of the vesicle, under the light microscope, the papillae are relaxed, and multinucleated balloon-shaped cells and eosinophilic nuclear inclusions can be seen.

　　3. Serum Enzyme Detection: Specific IgM positive in umbilical cord blood indicates intrauterine infection.

　　For pregnant women with genital herpes, attention should be paid to eating more vegetables, especially vegetables rich in vitamins, such as radishes and broccoli. Poultry, fish, milk, beans, and bean products are rich in protein and can enhance the body's immunity, so they can be eaten more. Seafood, mutton, deer meat, donkey meat, etc., should be reduced.

　　The treatment principle for pregnancy with genital herpes is to inhibit the proliferation of herpes simplex virus and control local infection. Specifically, as follows.

　　1. General Treatment

　　1. Mainly to keep the skin of the affected area clean, dry, and the integrity of the vesicle wall. Patients can clean the affected area with physiological saline every day.

　　2. For pregnant women with concurrent bacterial infection, antibiotic ointments (such as gentamicin ointment, etc.) can be applied to the affected area under the guidance of a doctor; for pregnant women with obvious local pain, 5% lidocaine hydrochloride ointment can be applied to relieve pain.

　　Second, Antiviral Treatment

　　Pregnant women with genital herpes who use acyclovir for treatment during pregnancy have a small impact on the fetus and newborn. Generally, pregnant women with the disease take 200 mg of acyclovir orally, 4-5 times a day, for 7-10 days. For patients with severe illness, intravenous administration can be given, with a dose of 5 mg per kilogram of body weight, once every 8 hours, for 5-7 days. For pregnant women infected in the late stage of pregnancy, in addition to using antiviral drugs (acyclovir), cesarean section should be adopted during delivery to reduce the chance of virus infection during vaginal delivery.