Feb 8

Genital Warts and Pregnancy – A Must Read Guide

Human papillomavirus (HPV) infection and genital warts pose a special problem in pregnant women. There is risk of transmission to the fetus and during birth. Also, the changes that the body endures during pregnancy can stoke up a dormant HPV infection. Women with genital warts who are considering pregnancy or who are pregnant should be aware of several important facts about HPV. It is important to take steps to protect yourself and your baby.

Avoiding HPV infection

Genital warts are a sexually transmitted disease. In fact, HPV infection is the most common sexually transmitted disease in the United States. Fighting the disease begins with prevention. Heterosexual women are at increased risk for contracting genital warts over heterosexual men because of the mechanics of heterosexual intercourse. Participants that receive bodily fluids during intercourse are more likely to become infected with human papillomavirus and, as a result, develop genital warts and other diseases. Therefore the first step of protecting yourself and your unborn fetus is through prevention.

Unfortunately, barrier protection is only partially protective against HPV transmission. That is because the genital warts themselves have a significant amount of virus in them. Whether you use male or female condoms, various forms of sexual intercourse can still transmit HPV. While you should still use a condom during every sexual encounter, it is important to realize that condom use does not provide complete protection.

Abstinence is the only complete protection from HPV infection or inoculation. If total abstinence is not feasible, sexual contact should be avoided if one participant has visible, internal or external genital warts. This is especially true if the warts are bleeding, oozing, or the skin in or around the lesion is broken. However, genital warts can still shed virus when they appear dormant or stable. Thus the best solution is to postpone sexual relations until the infected party is treated. Even after treatment, the risk of sexual transmission of HPV is not zero.

Changes that occur during pregnancy and genital warts

If you ask any woman that has been pregnant, she will tell you how radically the body changes during pregnancy. From a physiological perspective, essentially every organ and cellular system in the body changes in some way during pregnancy. The skin and immune system are no different.

Several dermatologists and OB/GYN physicians have documented the changes that can occur with genital warts during pregnancy. Women that apparently have their HPV and genital warts under good control before pregnancy often notice a flare-up once they become pregnant. The immune system and skin go through major changes. Previously quiet or dormant genital warts can become active during pregnancy. In fact, it is not unusual for the most abundant and aggressive lesions to occur exclusively during pregnancy.

The prevalence of genital warts increases from the first to the third trimester. After birth, the lesions seem to “quiet” very quickly. Thus something about the HPV infection is fundamentally different during pregnancy. The risk of genital warts doubles during this time. If genital warts do occur during pregnancy, they can become very large, very rapidly. The growth of the genital warts is so rapid that the skin can break down. If this occurs, prompt medical or surgical treatment is usually required.

It is not clear whether women are more susceptible to contracting an HPV infection when they are pregnant. However, the rate of HPV infection certainly increases during pregnancy. Whether this increase represents new infection or simply the eruption of genital warts that were dormant or latent is not known. The prudent approach would be for women to be additionally careful about not contracting HPV during pregnancy.

HPV diagnosis during pregnancy

Pregnant women that receive appropriate prenatal care will be subjected to a battery of prenatal screening tests. These include blood type testing, sexually transmitted disease (STD) testing, along with testing for other infections. Despite this extensive testing process, human papillomavirus is not one of the STDs or infections that is tested.

This lack of testing is not an oversight, per se, but rather it is a matter of pragmatism and economics. The rate of HPV infection in the population is so high—approximately 24 million people in the United States have HPV—that diagnosis is not always needed. In most cases, unless there is an active genital wart lesion, the overall risk to the baby is low. However, under some circumstances, special considerations must be made.

First, it is possible to pass genital warts from mother to newborn, but the manner in which the virus is transmitted is not known. It does not seem that HPV crosses the placenta to any great degree. What is much more likely is that genital warts are passed to the newborn during vaginal delivery.

If genital warts are passed from mom to baby, the most worrisome outcome is childhood laryngeal papillomatosis or recurrent respiratory papillomatosis. This condition is rare but can be dangerous if it occurs. Large genital wart lesions in the airway can interfere with baby’s breathing.

In most cases, genital warts will not need to be removed prior to delivery, however if genital warts are on or near the cervix, inside the vagina, or on the vulva, it is reasonable to remove them prior to delivery. If it is not possible to remove all genital warts before delivery, the baby may be delivered through Cesarean section to avoid vaginal inoculation.

HPV treatment during pregnancy

Unfortunately many of the main drugs that are used to treat genital warts are not safe for use in pregnant women. They can cause irreparable damage to the developing infant or their effects on the unborn baby are not known. Therefore, genital warts treatment options are fairly limited during pregnancy.

In most cases, the treatment of choice for genital warts in pregnant woman is trichloroacetic acid or TCA. Trichloroacetic acid is a powerful caustic agent that burns the genital warts. It usually must be administered repeatedly over one to two months in order to achieve the desired result. Surrounding tissue (without warts) should be protected with petroleum jelly prior to treatment. The benefit of trichloroacetic acid is that very little of the substance is absorbed across the skin, if any.

If trichloroacetic acid does not destroy the genital warts as anticipated, the next best option for treatment is cryotherapy. Cryotherapy involves the use of liquid nitrogen or other highly cooled liquid/gas to freeze and destroy genital warts. After three months of therapy, about 75% of patients receiving cryotherapy will be free of genital warts.

Carbon dioxide laser therapy may also be an option for treatment of genital warts in pregnant women. The laser is selective enough that complications and side effects are rare and usually mild.

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10 Comments

  1. Vera says:

    Genital warts during pregnancy can be uncomfortable for the women that suffer from them. Mostly because of the exposure of the genital warts to a lot of people during appointments and labor.

    Women may want to keep their warts private and pregnancy makes this hard.

    Unfortunately, during pregnancy the warts are usually at their worst.

  2. Jodi says:

    if the warts are in the vagina is it still possible to give a vaginal birth?

  3. Corinne says:

    Jodi,
    I am not sure but I do not think you can. My mom has warts and she had to have a c section with all three of her kids.

    If a mother had Genital warts can it cause a different strand of warts in her children? My brother, my sister, and I have all had foot warts and my little brother has hand warts not. Is it possible that this is because of our mother?

  4. Danielle says:

    Jodi,
    You can give vaginal birth if you have Genital Warts, however, it is not recommended. The mother can pass on the virus to her child after coming in contact with it, so most doctors will recommend a Cesarean delivery.

    Corinne,
    Genital Warts and the warts you have on your hands and feet are different viruses. Just as warts on your hands or feet cannot cause genital warts, genital warts cannot cause warts on your hands and feet. Also, it’s not fact, but it is popular belief that the HPV virus cannot travel through the placenta, as stated above, it is mostly conceived through vaginal delivery.

  5. Abigail says:

    i have genital warts. And I want to be pregnant. my partner now has no genital warts. if we contact will i pass the virus to my partner?

  6. anonymous says:

    i just found out i have genital warts, and im pregnate now. im scared my baby will get it but i want to give a natuarl birth. Is there anyway when they fall off i can get them tested to make 100% sure that its really genital warts. Like i just dont believe it , because i have had this skin growth for awhile and ive been to the doctors nd they said before that its normal that it wasnt genital warts and now a different doctor says it is. What can i do to get more proof?

  7. Alison says:

    I just received a diagnosis of genital warts today during my prenatal appointment. My OB doesn’t think it will affect my desire for a natural delivery, but is doing research to make sure given that they are all the way up inside and may compromise the birth canal.

  8. vickii says:

    Im 22 weeks and my warts sprouted up at around 16 weeks ive never had them before my mum had them while she had me and had them removed i wonder if she passed them to me during my birth now i have them carrying my daughter! They grew triple in size in a week i have never seen hpv on my.ex or.current partner so i have no idea ? If anyone has had the freeze method can you tell me is it uncomftable or does pain occur

  9. Shawn says:

    I am a mother who was diagnosed with HPV while pregnant. I will try to answer a few questions to the best of my ability.

    1) Does cryo treatment hurt? I haven’t tried it on genital warts per sey. I had 2 biopsied and what they did was numbed me a little (bullshit) and then cut them off, and used nitro to seal the resulting cut (cauterize it). It was horribly painful. I have dealt with regular warts my whole life- cryo treatment stings like a SOB and I don’t think I would want to do it on my sensative lady bits. Am I a wuss? Depends. I did natural child birth, no pain meds and toughed it out- but I whimpered when they put in the IV… a lot.

    2) Transmission – It is theorized that mothers pass HPV to their children. Personally I think this is how I got mine because I checked with all my past partners and no one seemed to have HPV, yet my mother told me she had skin tags that might have been HPV. I was born C-section, so if I got them from mom, C-section isn’t the solution. IMPORTANT NOTE: There are LOTS of different strains of warts, find out what kind you have before you make any major decisions. The kind I have are not cancer-causing, and are also not the kind that cause throat/eye/voicebox warts. Risk to my child was minimal, so I chose not to have a c-section unless I absolutely needed it.

    3) C-section – C-section is only really reccomended for when internal warts reach sized that block the birth canal. Seriously, this is a major surgery with plenty of its own risks. Find out what strain you have.

    4) What happened after birth? – My daughter is 2.5 years old and perfectly fine. My warts fell off on their own within a month of giving birth. I haven’t had an outbreak since. I’m on this site because I am pregnant again, and they might come back.

    Do more research. Be careful with what your doctor tells you. They have to be careful so they don’t get sued and are often willing to take unneccessary precautions to the extreme in hopes to avoid such. American medical is pretty crazy- arm yourself with knowledge.

    I’m looking into other solutions for the warts, if I find something that works, I’ll post on it.

    I’ll get off my soap box now…

  10. LOana says:

    I am pregnent and I have the genital warths I really hate it .. I’m due in three weeks an I’m scared I dont want to pass it to my baby .. Wath should I do I really need some advice I’m only 21 and I dont Want to get a c section but I think I have to… My doctor removed them twice but they still are coming back and bigger … An I think I’m getting Some on my nipple has that happen to anybody ? Help please I just don’t want my baby to get them its not his fault it’s mine …

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