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Herpes simplex, caused by Herpesvirus hominis, is a viral infection of the skin manifested by erythema, vesicles, and crusting. Herpes neonatal es el herpes adquirido al nacer, es una infeccion por el virus del Herpes simple que el bebe adquiere al nacer. Una infeccion materna primaria durante la gestacion o la infeccion genital activa en el momento del parto pueden tener como consecuencia la infeccion intrauterina o intrapartum del feto, por el virus del herpes simple (VHS).
Aunque hay casos descritos de infeccion congenita del lactante, casi siempre en madres que adquirieron la infeccion primaria durante el embarazo, la posibilidad del contagio del feto intrautero es excepcional. Si en el momento del parto la madre tiene una infeccion activa con herpes genital sobre todo el Virus del Herpes Simple tipo 1 (VHS-1), el paso del feto por el canal del parto puede producir la transmision del VHS-1 a partir de una lesion activa o, con mayor frecuencia, estando la mujer asintomatica, por medio de las secresiones genitales infectadas.
De los casos publicados de herpes neonatal, el 70-80% es debido a Virus del Herpes Simple tipo 2 (VHS-2) y el 20-30% restante a VHS-1.
El herpes adquirido al nacimiento puede provocar enfermedad localizada o sistemica (en todo el cuerpo).
Un segundo tipo de infeccion con herpes adquirida (sistemica) produce encefalitis (una inflamacion del cerebro que puede provocar convulsiones y problemas neurologicos posteriores) que, si no se trata, puede conducir a la muerte.
El herpes adquirido en el periodo poco despues del nacimiento tiene sintomas parecidos a los del herpes adquirido al nacer. Un bebe muy enfermo puede presentar signos de shock, hemorragia, convulsiones u otros de los signos de la lista anterior. El diagnostico definitivo es por medio del cultivo, pero pueden emplearse como pruebas preventivas la busqueda de celulas de Tzanck en un frotis a partir de las lesiones, inmunofluorescencia directa y ELISA.
Son de bajo valor las determinaciones de anticuerpos sericos a menos que se logren obtener titulos significativos de IgM anti-VHS. El uso de practicas sexuales mas seguras, puede ayudar a la madre a prevenir el Herpes genital. Las madres que no estan infectadas con herpes no pueden transmitir el virus del herpes al feto durante el parto.
El estandar actual es el parto por cesarea de todas aquellas gestantes con herpes simple genital sintomatico o diagnosticado.
Estudio serologico tipoespecifico de VHS-1 y VHS-2 en toda mujer embarazada (mas si es de riesgo preconcepcional).
En aquellas que serologicamente son negativas se debe prevenir que la adquieran en el tercer trimestre del embarazo. En embarazadas con antecedentes claros de Herpes simple genital recidivante o primoinfeccion, puede ser util el tratamiento supresor con Aciclovir desde la semana 36 hasta el parto. En mujeres seropositivas para el VHS-2, evitar en el parto manipulaciones traumaticas como rotura artificial de las membranas o el uso de instrumentos que puedan lesionar el cuero cabelludo fetal (forceps, extrator al vacio, electrodos en espiral).
There are maternal infections (such as herpes simplex virus, or HSV and Group B Strep, or GBS) that are extremely dangerous when passed on from mother to child, that respectively cause encephalitis and meningitis. Herpes simplex virus (HSV) encephalitis is a viral infection in the brain that babies can get from their mothers during delivery. Most neonatal infections result from exposure to HSV in the genital tract during birth, although in utero and postnatal infections occasionally occur.
First-time infection of the mother is the most important factor for the transmission of genital herpes from mother to newborn. Symptoms of neonatal herpes encephalitis typically present between four and eleven days after the baby is delivered. All babies with suspected or diagnosed HSV must be treated with intravenous (IV) acyclovir. Although high dose IV acyclovir for a sufficient period has been proven to be effective, neonatal HSV infection is still associated with high residual lethality and morbidity because acyclovir may suppress but not eradicate the virus in infants. Localized HSV usually heals without negative outcomes, whereas the CNS form is lethal in about 6% of cases.


A history of HSV infection in all pregnant women and their partners should be obtained at the first prenatal visit. Infants delivered vaginally by mothers with active genital herpes must be closely observed and treated with acyclovir.
In pregnant women with genital herpes, supressive acyclovir should be initiated at 36 weeks’ gestation and maintained up to and during delivery, regardless of delivery mode. Failure to properly deliver the baby of an infected mother in order to avoid risks of infection in the baby, which includes failure to perform a C-section when indicated, as well as utilization of delivery instruments and other invasive tools, such as a fetal-scalp electrode. Failure of the physician to obtain adequate informed consent, which includes advising the mother of the risks and alternatives of delivery methods, such as vaginal birth versus C-section delivery.
It is crucial that the physician take a thorough history of the pregnant woman, and this includes asking about HSV infection and risk factors.  If any of the risk factors for HSV are present, the physician should test the mother for HSV. To determine if you are eligible for compensation, contact our Detroit attorneys handling neonatal encephalitis cases in Michigan, Ohio, Washington, D.C.
Jesse Reiter, the firm’s president, has been focusing on birth injury cases his entire 29+ year career. Birth injury is a difficult area of law to pursue due to the complex nature of the medical records. National Women’s Health Week: A Focus on Prenatal CareMay 9, 2016National Women’s Health Week is this week! La infeccion intrauterina , ya sea transmitida por via transplacentaria o por infeccion ascendente en relacion a la rotura prematura y prolongada de las membranas fetales, resulta mucho menos frecuente que la infeccion intrapartum debida al contacto directo del feto con las secresiones vaginales infectadas durante el parto.
La mayoria de los herpes neonatales por VHS-2 se originan por contacto de secresiones genitales infectadas de la madre en el parto, en ausencia de lesiones clinicas.
Los bebes pueden desarrollar solo una infeccion de piel localizada, las lesiones cutaneomucosas ocurren en mas del 50% de los casos y consisten en vesiculas, ampollas, pustulas o erosiones mas o menos extensas, que aparecen en las zonas sometidas a traumatismos durante el parto como son el cuero cabelludo, la cara o areas proximas a la region cervical. En este tipo, el virus del herpes puede afectar muchos organos internos diferentes que incluyen el higado, pulmones, rinones y cerebro. Si la persona con herpes labial es una ninera, debe utilizar una mascara de cirugia y lavarse minuciosamente las manos antes del contacto con el bebe para prevenir la transmision posparto del virus. Las madres deben consultar con su medico la mejor manera de minimizar el riesgo de transmitir el herpes al bebe.
Epidemiologicamente, esta actitud solo evita un pequeno numero de herpes neonatal, ya que la mayor parte de las lesiones sintomaticas en el momento del parto dependen de la infeccion recidivante por VHS-2 y el herpes neonatal es consecuencia sobre todo de primoinfeccion en el ultimo trimestre del embarazo o secresiones asintomaticas con VHS. Para ello hay que valorar posibles cambios de actitudes sexuales e incluso la abstinencia sexual. Signs present themselves 1-20+ days after birth, and clinical tests can confirm the presence of HSV. When HSV is transmitted to a baby from the mother, it is known as neonatal herpes encephalitis, or encephalitis for short. HSV manifests itself in three forms:  skin, eyes and mouth herpes (SEM), disseminated herpes (DIS), and central nervous system herpes (CNS), which leads to encephalitis. Mothers with primary infections at delivery are 10-30 times more likely than women with a recurrent infection to transmit the virus to their babies.
In fact, a pregnant woman who acquires genital herpes as a primary infection in the latter half of pregnancy, rather than prior to pregnancy, is at greatest risk of transmitting HSV to the baby. Women with a negative personal history of HSV, and especially those with a positive history in the male partner, should be strongly advised to have no oral and sexual intercourse at the time of recurrence in order to avoid infection (in particular, during the third trimester of gestation). The award winning lawyers at Reiter & Walsh have decades of experience with neonatal encephalopathy, hypoxic ischemic encephalopathy and cerebral palsy cases. Asymptomatic maternal shedding of herpes simplex virus at the onset of labor: relationship to preterm labor. Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant.


Neonatal herpes simplex virus infection in relation to asymptomatic maternal infection at the time of labor.
Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Los producidos por VHS-1 ocurren por la primoinfeccion genital de la madre por VHS-1 en las ultimas fases del embarazo.
La busqueda rutinaria de VHS en las secresiones genitales mujeres embarazadas asintomaticas mediante cultivos virales, preconizada por algunos autores, no parece tener valor en la prevencion, ya que no predicen cuales recien nacidos adquieren el herpes.
Siempre que sea posible, realizar estudio en la pareja para identificar aquellos que son seropositivos para VHS. There often is overlap of two or more of these types of herpes, and both DIS and SEM can progress to CNS herpes and encephalitis if left untreated. SEM HSV infections are treated for 14 days, whereas CNS or DIS infections require 21 days of therapy.
The DIS infection is lethal in 31% of cases and approximately 17% of babies are left with permanent disabilities.
Furthermore, use of condoms throughout pregnancy should be recommended to minimize the risk of viral acquisition, although the male partner has no active lesions.
All pregnant women who have a suspected active genital HSV infection or prodromal symptoms of HSV infection should undergo C-section, although membranes are intact. En ocasiones es recomendable que la pareja realice tratamiento profilactico durante el embarazo pra evitar el contagio. Other complications that can occur with maternal HSV infection during pregnancy include premature rupture of the membranes and preterm birth. On the other hand, when genital herpes lesions are not present, C-section is not required but lesions near the genitals should be covered with an occlusive dressing before vaginal delivery. We understand the complex legal issues involved in neonatal encephalopathy cases and will help you to obtain the compensation to which you are entitled.
Localized infections can heal fairly well, but untreated or untimely treated infections of the central nervous system are lethal in some cases and leave most survivors with permanent disabilities. Neonatal HSV infection, defined as infection in a newborn within 28 days after birth, is a devastating consequence of untreated or unmonitored genital herpes.
Thus, prophylactic administration of acyclovir or valacyclovir in the third trimester of pregnancy should be provided to all pregnant women with genital herpes during pregnancy. It is important to remember that fetal scalp electrodes monitoring during labor and vacuum or forceps delivery should be used only if necessary, since these practices increase the risk of HSV transmission. To prevent this from happening, physicians screen at-risk mothers and provide recommendations for preventing infections during the last parts of the pregnancy.
Whether caused by HSV  type 1 or type 2, neonatal HSV infection has severe consequences if untreated. It is also imperative that all pregnant patients be given informed consent so they can make important decisions regarding their pregnancies. Doctors should also administer a preventative treatment of acyclovir or valacyclovir in the third trimester to all women with genital herpes (another name for HSV infections), or antibiotics in the case of bacterial infections (such as group B strep). Thus it is imperative that it be monitored and managed appropriately as the infection can be passed from the mother to the baby during delivery. To prevent the infection, infants should be delivered via C-Section to prevent exposure, or else be immediately treated with IV acyclovir or antibiotics as soon as they are born.



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Comments
  1. AnTiSpAm 03.08.2015 at 22:10:39
    Sooner (within 5-10 days with out antiviral remedy) than over the years now.
  2. Reksane 03.08.2015 at 15:15:44
    The immune system and treating the sores themselves spread quickly.
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    Perceive why however I have slight burning sensation on your lips.
  4. ANAR_Icewolf 03.08.2015 at 16:57:45
    With antiviral medicine, although in severe taking medicine to suppress.