Valtrex for prevention of herpes outbreak at birth

[#2ontheway]

reposted from "I'm Pregnant" discussions....maybe this is a better place for this question...please help

Hi I'm new to these discussion boards, I hope I posted in the right place...

I got genital herpes 13/14 years ago. I had a few outbreaks in the first year and then maybe there have been 3 small-outbreaks (not requiring meds) since then. The last small-outbreak I had was about a week AFTER giving birth to my first child (now 4 years old).

When I was preggo the 1st time (living in Canada) my Dr told me that if I had a breakout at the time of delivery then I had to have a c-section. I did not have an outbreak at delivery and I had a good no-meds vaginal birth.

I am pregnant with #2 now; 4 months pregnant (living in US). My new midwife has recommended that I take Valtrex (herpes meds - which I've never used before) from 36 weeks until the delivery. I've never heard of Valtrex before. I did some quick searches but most of the information is not regarding using it as a "preventative" measure in pregnancy/birth.

So....has anyone done this? Decided not to take the drugs and what was the outcome? I'm very unsure of using any meds while pregnant, especially this drug when I haven't had an outbreak for nearly 4 years. BUT, I also want to trust my midwife and I don't particularly want a c-section. Can taking this drug actually give me an outbreak? Links with more information on this topic would be useful too.

Thanks in advance.

[zofranland]

i dont have any links for you right now but i can work on it... i am an NP and educate my pts on the use of herpes suppression from 36 weeks on. i have not seen any bad outcomes. in my opinion i am not a big advocate of drugs during pregnancy but there seems to be more risks involved with baby getting HSV than with taking the drug... i would not be willing to risk passing it to baby... but that is just my opinion... i am intersted to see what others think

[pamamidwife]

I would definitely use the Valtrex than risk a cesarean because of a small outbreak.

[MsBlack]

Ok, not to sound too flakey here since I can't provide a link...but--

some years back I read that some hbmws were using superglue to cover herpes sores during labor--and that it was effective in preventing HSV transmission. anyone else remember this? maybe it was Anne Frye who put this word out?

Something to consider. I would not want to take the meds either.

By the way--another thing is to be proactive in protecting yourself from an outbreak. The way I understand it, viruses love phenylalanine and hate l-lysine. So, since phenylalanine is found in chocolate and peanuts, avoid these (and any other foods you can find are high in phenyla). Take an l-lysine supplement, and additionally, be sure you are taking plenty of b-complex, c, and zinc (a 'stress formula'). I have some experience with this--yrs ago, I got a herpes 'cousin' with my then 2 &3 yr olds. Herpatic gingiva stomatitis--awful, just plain awful with terrible sores all over inside of mouth/gums/tongue, high fevers, ague. A naturapath told me about phenyla, l lysine and the 'stress formula' --it helped clear this thing pretty fast. And we would resume that stuff whenever we started to get a recurrence--the merest hint of mouth tenderness, mind you, over the next 2 yrs, always nipped it in the bud. None of us ever had a recurrence--and it's been more than 20yrs now since then.

[pamamidwife]

MsBlack, yep, I've heard of midwives using superglue and clear nail polish. Not sure if I'd want either in my vagina - or that any OB would go for that (because there could be lesions on the cervix that are not seen), but it's something that has been recommended and done in the past.

[intorainbowz]

Different area and issue, but next time I have a baby I will be taking preventative Valtrex. I got a cold sore and was unable to see DD while she was in the NICU for several days. I researched and the exposure to HSV can be very seroius to the baby, and I don't want that risk.

[Defenestrator]

One gentler solution than nail polish is bio-occlusive dressing. I consider proceeding with a homebirth in the presence of lesions to be a possibility given good informed choice. If a client has had a history of having lesions only on her labia or sacrum, then we talk about the possibility that they might be somewhere else and what the risks of transmission are, but if the client wants to proceed at home, I would cover the lesions with bio-occlusive dressing (one brand is suresite -- it is the stuff that is used to cover iv sites in the hospitals -- the adhesive is pretty gentle and can usually be removed from hair without pain). It is waterproof and would probably last the whole labor.

I haven't used it for this purpose before, but I have used it for other reasons at birth and I find that it stays where I want it to for as long as I want it to and then is pretty easy to get off. Also I would assume it is less toxic than something applied as a liquid.

To answer the op's question -- I have had several moms choose to take Valtrex at the end of their pregnancies and so far there have been no outbreaks among them.

[#2ontheway]

Thanks

Thanks for the replies. Lots to think about; I'm leaning towards taking the meds I think. Midwife said the dose would be 500mg, so that would be suppressive treatment. It just seems weird to take them when I haven't had an outbreak for 4 years, but I guess I can't really determine when I'll get them again. That said, I will definitely discuss the possibility of using some type of cover/ointment as an alternative - see what the midwife says.

[Jane]

Another potential benefit, as Wendy mentioned, is avoiding sores post-partum. Even if you immune system is very effective in pregnancy, sometimes post-partum can be stressful enough (NICU) to bring out an outbreak, or the body may not be running at full potential when healing + changing hormones from pregnancy to breastfeeding.
I've known women that chose to use Valtrex and some that didn't.
As my personal choice, I wouldn't attend if the woman had active lesions, even covered ones. It's beyond my comfort zone. But part of informed consent, I think.
I know of three babies that had neonatal HSV - that's probably a stastistical anomaly in life. But it influences me, still.

[zofranland]

Originally Posted by MsBlack

Ok, not to sound too flakey here since I can't provide a link...but--

By the way--another thing is to be proactive in protecting yourself from an outbreak. The way I understand it, viruses love phenylalanine and hate l-lysine. So, since phenylalanine is found in chocolate and peanuts, avoid these (and any other foods you can find are high in phenyla). Take an l-lysine supplement, and additionally, be sure you are taking plenty of b-complex, c, and zinc (a 'stress formula'). I have some experience with this--yrs ago, I got a herpes 'cousin' with my then 2 &3 yr olds. Herpatic gingiva stomatitis--awful, just plain awful with terrible sores all over inside of mouth/gums/tongue, high fevers, ague. A naturapath told me about phenyla, l lysine and the 'stress formula' --it helped clear this thing pretty fast. And we would resume that stuff whenever we started to get a recurrence--the merest hint of mouth tenderness, mind you, over the next 2 yrs, always nipped it in the bud. None of us ever had a recurrence--and it's been more than 20yrs now since then.

high lysine and low arginine as well... if you google high lysine a bunch of diets pop up that help guide you to eating a healthier diet to avoid an outbreak!

[Eskimo Dane]

Down to the wire and can't decide if I should take Valtrex!!

So this is my first post and I hope I'm putting it in the correct place to get some feedback...
I found out that I have herpes about 2 years ago when my first child was 6 months old and I had my first outbreak. I know I had it before getting pregnant with him because I know the culprit...the last man I was with (only once) before I met and married my husband (who didn't have the virus). Oh, regretful night of youthful abandon! My first childbirth experience was long, but terrific and healthy! No outbreaks to worry about. Now I'm 37 weeks into my 2nd and my midwives want me to take Valtrex. I have not had an outbreak since the one (the 1st) 2 years ago. I am not comfortable taking drugs at all, especially if there are no outbreaks. However, reading all the info about what herpes can do to a baby is just alarming and super worrisome. I am trying to keep my stress-level down, since I know this virus can feed on anxiety, but man it's hard when I have to make this decision!
Can a midwife always tell if you're having an outbreak during delivery or is it sometimes undetectable? Is there any good information about what Valtrex does to a baby in the last few weeks? How long before Valtrex takes effect? Could I start taking it maybe next week...to have my baby exposed to it for less time, and have it still work on fighting an outbreak?
aaahhhh! I have so many concerns about this.
Any suggestions or feedback would be comforting!

Thank you, Natasha
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