Pregnancy is a precarious time for both the expecting mother and baby. A mother must be careful about her health in all aspects – emotional, physical and spiritual. A common problem a pregnant woman may encounter is cold sores on the face or around the mouth. These may be troublesome for the mother and may occur repeatedly.

What are cold sores?

Cold sores are essentially ulcers that develop around the mouth and lips. They are caused by a virus called Herpes simplex type 1 (HSV-1), and so a cold sore infection is also called oral herpes. Anybody may be infected by cold sores, but persons with low immunity such as pregnant women, infants or persons on steroid treatment are more susceptible.

Cold Sores During Pregnancy

What are the signs of cold sores?

A cold sore ulcer has characteristic features so a pregnant mother must look out for these common signs and symptoms on and around the mouth and lips:

1. Tingling or burning sensation

The first sign of a cold sore is usually tingling or burning, which occur before the sores appear. These signs signal the onset of the ulcer or cold sore.

2. Itching

Cold sores are typically nasty and very itchy.

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3. Fluid- filled blisters or eruptions

The cold sore ulcer contains fluid at the start, may ooze and then burst to form a scab.

4. Ulcer formation

5. Crust or scab formation

This occurs after 2 days, as the ulcer moves into the healing phase.

6. Self healing

The cold sores/ ulcers usually heal on their own within 7 -10 days.

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7. Reoccurrence

A cold sore virus never leaves the body. It remains dormant in the body and may be triggered off again under certain circumstances. Some of the common triggers which may cause reactivation of cold sores include sunlight, cold air, fatigue or stress.

Warning – cold sores are infectious!

Cold sores are due to a viral infection and are contagious. This may be transmitted from one person to anther through touch, sharing of utensils or cosmetics, kissing or sexual contact.

Cold sores during pregnancy

Pregnancy takes a toll on the body and a pregnant woman is in an immune-compromised state. Thus, a pregnant woman may develop cold sores on the lips or around the mouth. However, the same virus which causes cold sores (HSV-1) or its variant (HSV-2) may cause Herpes infection of the genital area as well. It is also possible to develop genital Herpes infection through transmission from a partner who has cold sores, through oral sexual contact.

Are cold sores dangerous for a pregnant woman?

Herpes infection of the genital area is a problematic situation for a pregnant woman. This is because of the risk of transmission of this virus to the baby at the time of birth. As a baby moves through the infected birth canal of the mother, he/she may contract the herpes infection during delivery. This leads to a potentially dangerous situation called neonatal Herpes. The risk of a mother transmitting Herpes infection to her child is high. Thus, the infection must be treated as soon as possible to allow safe child birth.

What are the signs of neonatal Herpes infection in a baby?

There may be multiple signs of Herpes infection in a newborn baby such as –

1. Blisters or sores

Herpes sores or fluid filled blisters appear on the skin of eyes, mouth or body. These may be present at birth or develop within a few weeks after birth. These sores are fluid filled, may ooze and then crust to form a scab.

2. Encephalitis

This is an inflammation of the brain seen in neonatal Herpes. This is a dangerous condition and requires immediate attention. This may be accompanied by fever, irritability and seizures.

3. Respiratory or airway problems

A baby may experience difficulty breathing.

4. Lethargy

Fatigue, tiredness and lethargy are also common signs.

5. Feeding problems

6. Liver and kidney problems

7. Delay in milestones

Long term complications in neurodevelopment may also occur, such as delay in motor or cognitive brain functioning.

Treatment of cold sores during pregnancy

Initially, laboratory tests on fluid from the sores or blood is used to confirm the diagnosis of Herpes infection or cold sores. The treatment of cold sores involves antiviral therapy or medication during pregnancy itself. If there is risk of transmission of Herpes infection to the baby, a caesarean section is generally preferred over vaginal delivery.

TORCH syndrome

Neonatal Herpes infection may also be a part of the TORCH Syndrome. The TORCH syndrome is caused by microbial agents that cross the placenta during pregnancy. These infectious or microbial agents are the ones that cause Toxoplasmosis, as well as rubella virus; cytomegalovirus; and herpes simplex viruses. TORCH syndrome may affect a developing fetus or newborn and may result in miscarriage, delay in fetal growth and development, or early delivery.

Finally..stay safe always!

Untreated cold sores are detrimental to the health and well being of a pregnant mother as well as her baby. Transmission of Herpes infection from mother to newborn is possible and can lead to unfortunate sequelae in the baby. If you are pregnant, it is good to be aware of the signs of a herpes infection or cold sores. If you do develop a Herpes infection, seek immediate treatment to avoid future complications in your baby.

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