HPV, Genital Warts, and Pregnancy

A pregnant woman in a hospital gown talking to her doctor in the hospital

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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 tiny pieces of cauliflower. Genital warts are caused by human papillomavirus (HPV).

According to the Centers for Disease Control and Prevention, approximately 42.5% of the United States population aged 18 and over has been exposed to HPV. This means that many pregnant women have HPV.

It's also very common to have HPV and not have any visible warts or other symptoms. In fact, many people (pregnant women included) with HPV have no idea they have it. Additionally, this highly contagious condition can be spread when no symptoms are present.

Overview

More than 100 types of HPV have been recognized, many of which can be spread through sexual contact. In many cases, HPV causes no health problems and will simply go away on its own. However, some types of HPV can cause cervical and other types of genital cancers, as well as oral, anal, and penile cancers. Additionally, some types of HPV may increase the chances of infertility, preterm birth, and pregnancy loss.

There are about 14 million new cases of sexually transmitted HPV infections each year, and approximately 79 million people in the United States are already infected with this virus, making it the most common sexually transmitted infection.

How Do You Get Genital Warts?

Genital warts can be spread through all types of skin-to-skin sexual contact: oral, anal, and genital sex. As noted above, simply not being able to see warts doesn't mean the other person is virus-free or that you can't get them. It is also possible to get genital warts in the throat after oral sex with an infected partner.

Diagnosis

In women, genital warts are diagnosed with a Pap smear and physical exam. This infection is usually screened for in the first prenatal visit. You may also need a colposcopy, which uses a special device to look intensely and closely at the cervix and the walls of the vagina for genital warts, any changes to cervical cells caused by HPV, and any 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.

If genital warts are diagnosed prior to pregnancy, topical immunologic creams or topical trichloroacetic acid (TCA) can be used. However, if you don't have an active infection, you don't need to do anything special before getting pregnant except letting your doctor know that you've had genital warts in the past.

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. As noted above, some research indicates that some types of HPV may be linked to miscarriage, preterm birth, and fertility issues, but results are still inconclusive.

Additionally, there is no association between having the HPV vaccine and infertility; in fact, the vaccine helps to protect the fertility of both sexes.

If you have genital warts, you and your provider 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 and hormone levels.

If you have active genital warts at the time you give birth, it is highly unlikely to interfere with your vaginal delivery. Additionally, your baby may also be exposed to the infection even if you deliver by c-section. However, 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 sexual activity, particularly with any partner with whom you are not monogamous and/or using barrier protection (such as condoms). Checking your partner for lesions and having frank discussions around possible prior exposure, current sexual activity, exclusivity, getting the HPV vaccine, and being screened for STIs prior to sexual contact is also recommended.

Barrier methods like the male and female condom reduce the likelihood of transmission but do not make the risk zero. Gardasil-9 is the only HPV vaccine available in the U.S. currently, but it should not be given while you are pregnant.

A Word From Verywell

Being pregnant and knowing (or finding out) that you have genital warts or the virus that causes it (HPV) can be scary and worrisome. However, know that many, many pregnant women have this infection and the vast majority go on to safely deliver healthy babies with no or few complications from HPV. The important thing is to communicate any concerns you have to your doctor and get the care you need to protect your baby.

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Article Sources
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