Herpes Genitalis pada Kehamilan

Abstract

Herpes genitalis pada kehamilan merupakan infeksi pada genital disebabkan Herpes simplex virus (HSV) dengan gejala berupa vesikel berkelompok dengan dasar eritema dan bersifat rekurens pada perempuan hamil. HSV dibagi menjadi HSV-1 dan HSV-2. HSV-2 paling sering menyebabkan herpes genital sekitar 82% kasus ditularkan melalui kontak seksual, HSV-1 lebih sering menyebabkan herpes non-genital, tetapi terjadi peningkatan kasus herpes genitalis diakibatkan HSV-1 karena praktek seksual orogenital. Penelitian tahun 2000-2001 dilakukan pada sekitar 16.000 ibu hamil melaporkan 16% terinfeksi HSV-2 dan 66% terinfeksi HSV-1. Infeksi HSV dibagi menjadi infeksi primer, non-primer, rekurens, dan asimptomatis. Frekuensi infeksi HSV neonatus di Amerika Serikat adalah 1/12500 kelahiran hidup. Herpes genitalis pada kehamilan memungkinkan penularan ke janin pada masa intrauterin 5%, perinatal 85%, atau postnatal 10%. Metode pewarnaan Giemsa, kultur HSV, biologi molekular (PCR), pemeriksaan histopatologi, atau serologi membantu menegakan diagnosis HSV. Penularan pada janin dapat menyebabkan abortus, stillbirth, pertumbuhan terhambat, Kelainan kongenital, dan kematian. Penggunaan Asiklovir atau Valasiklovir pada ibu hamil sebagai terapi utama dan terapi supresif. Terapi supresif digunakan untuk mencegah, menurunkan frekuensi rekurensi, menurunkan penularan selama kehamilan, dan menurunkan angka pelaksanaan sectio caesaria. Infeksi herpes genitalis pada kehamilan diatas 34 minggu direncanakan sectio caesarea untuk mengurangi risiko transmisi virus ke bayi. Kontak lama neonatus dengan jalur persalinan pada saat melahirkan spontan akan meningkatkan risiko tertularnya neonatus oleh HSV.

Genital Herpes in Pregnancy

Abstract

Genital herpes in pregnancy is an genital infection caused by the Herpes simplex virus (HSV) with symptoms in the form of grouped vesicles on an erythematous basis and is recurrency cases in pregnant women. HSV has HSV-1 and HSV-2. HSV-2 often cause genital herpes about 82% of cases and transmitted by sexual contact, HSV-1 caused more often non-genital herpes more often, but cases of genital herpes caused by HSV-1 were increasing due to orogenital sexual practices. A study in 2000-2001 conducted on about 16,000 pregnant women reported that 16% of cases were infected with HSV-2 and 66% were infected with HSV-1. HSV infection is divided into primary infection, non-primary, recurrent, and asymptomatic. The frequency of HSV-infected neonates in the United States is 1/12500 live of births. Genital herpes in pregnancy allows transmission to the fetus  5% during intrauterine, 85% during perinatal, or 10% during postnatal. Giemsa staining methods, cell culture, molecular biology (PCR), histopathological examination, or serology would be helpful on establishing the diagnosis of HSV. Transmission to the fetus may cause abortion, stillbirth, growth-retardation, congenital disorders, and death. The use of Acyclovir or Valacyclovir for pregnant women may be considered as primary therapy and suppressive therapy. Suppressive therapy is applied to pregnant women to prevent and reduce the frequency of recurrence, transmissions during pregnancy, and the rate of sectio caesaria. Genital herpes infection after 34-weeks-pregnancy is planned for caesarean section to reduce the risk of transmitting the virus to the baby. Prolonged contact of neonates with canal birth at spontaneous delivery will increase the risk of HSV transmission to neonates.

Keywords : Genital Herpes, Pregnancy, HSV, Caesarean Section, Suppressive Therapy