HPV, Genital Warts, and Pregnancy

Pregnant woman with doctor
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Genital warts are soft, fleshy growths in the genital area, on the cervix, or in the vagina. Warts can appear alone or in clusters, and resemble small pieces of cauliflower. Genital warts are caused by human papillomavirus (HPV). However, you can have HPV and not have warts— in fact, half the women who have HPV do not have symptoms.

There are more than 150 types of HPV that have been recognized, and about a third can be spread through sexual contact. Some types of HPV can cause cervical and other genital cancers, as well as oral, anal, or penile cancers.

There are about 5.5 million new cases of sexually transmitted HPV infections each year, and 20 million people in the United States are already infected.

How Do You Get Genital Warts?

Genital warts can be spread through all types of sexual contact: oral, anal, and genital sex with an infected partner. It's more common for women to get genital warts. Simply not being able to see warts doesn't mean you can't get them. It is possible to get genital warts in the throat after oral sex with an infected partner.

Diagnosis

A Pap smear and physical exam is the only way to diagnose genital warts since they are spread via skin to skin contact. This is screened for usually in the very first prenatal visit. You may also need a colposcopy, which uses a special device to look intensely and closely to the cervix and the walls of the vagina for genital warts, HPV, and other anomalies.

Treatment

Warts themselves may disappear, or they could grow into clusters of warts. Just because warts disappear doesn't mean that the HPV is gone—and they can also come back. Smaller warts may be frozen off in a process called cryosurgery or burned off with a laser or cautery. Both options are safe during pregnancy.

If genital warts are diagnosed prior to pregnancy, topical immunologic creams or topical trichloroacetic acid (TCA) can be used.

Genital Warts in Pregnancy

Genital warts themselves do not pose a problem to your pregnancy unless they grow large enough to obstruct your vaginal opening. After talking to your provider, you may decide to wait for treatment until after you give birth because some of the treatments aren't safe to use while you are pregnant.

Sometimes, genital warts can flourish and grow more quickly while you are pregnant because of the increased blood flow.

If you have active genital warts at the time you give birth, it is highly unlikely to interfere with your vaginal delivery. Your baby is not likely to contract the virus through birth.

Prevention

The transmission of genital warts and HPV can be minimized by abstaining from all forms of sexual activity. Checking your partner for lesions is also recommended.

Barrier methods like the male and female condom may reduce the likelihood of transmission but do not make it zero. HPV vaccines, like Gardasil or Cervarix, are available but should not be given while you are pregnant.

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Article Sources
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  • Genital Warts in Pregnancy. March of Dimes. September 2013. Last Accessed February 25, 2016.
  • Hamouda T, Freij MA, Saleh M. Clin Exp Obstet Gynecol. 2012;39(2):242-4. Management of genital warts in pregnancy.
  • Rozmus-Warcholińska W, Loch T, Czuba B, Mazurek U, Mucha J, Dworak D, Sodowski K. Ginekol Pol. 2007 Nov;78(11):888-91. [Genital warts associated with HPV infection during II and III trimester of pregnancy--a case report and analysis of treatment options].