HPV and pregnancy
By Laura E. Stachel
Melissa Massillon
Vaginal warts are caused by a virus called HPV, or human papilloma virus. The HPV virus is acquired by skin-to-skin contact, and is the most common sexually transmitted infection in the U.S. There are many different strains of this virus. Some cause small cauliflower-like growths called warts that can be seen on your skin; others cause genital cancers and pre-cancerous changes. Most commonly the infection causes no symptoms at all, and can be passed silently between sexual partners.

HPV infections are present in half of sexually active Americans, and cannot be completely prevented by using condoms. Occasionally, vaginal warts will resolve on their own, but more commonly they will remain present throughout your pregnancy and should be treated during or after the pregnancy. It is unlikely that the baby will acquire the virus during the delivery; however, very rare cases of wart-like growths in the baby’s larynx have been reported. Your doctor can decide whether to treat the warts during your pregnancy, but cannot remove the virus from your system. Some forms of treatment are not safe to use in pregnancy and should be postponed until after your delivery. The most common kinds of self-applied treatment are creams that can damage the wart or creams that boost your immune system to destroy the wart. These creams cannot be used in pregnancy. Other treatments that your health practitioner can provide are: freezing, cauterizing the wart, or carefully applying a chemical acid on the wart to “burn” it away. Sometimes the wart can be removed at the time of a vaginal delivery by surgically excising it.

Unfortunately, once someone has the virus in their system, they can have it forever. As some strains of virus are considered pre-cancerous, it is important to have Pap smears at least every year, and to inform your health care providers if you have ever had genital warts. Even if your warts are treated and gone, the virus can remain in your genital tract. Scientists are working on a vaccine that can prevent women from ever acquiring HPV. But women will need to be treated at an early age, before they have ever been exposed to HPV.

If the warts are very large or seem to grow during your pregnancy, it might be best to treat them. Discuss this with your doctor to get appropriate advice for your situation.