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    Understanding STDs in Pregnancy -- Treatment

    What Are the Treatments? continued...

    Genital Warts

    The human papillomavirus that causes genital warts is spread during sexual contact with an infected partner. Many women discover that they have been infected by HPV when they have an abnormal Pap test. Other women may notice the warts. Although the virus never leaves the body, the warts can be treated with surgery or medications.

    Several other, extremely rare, problems related to HPV and pregnancy:

    • During pregnancy, warts may occasionally get larger. This is probably due to increasing levels of pregnancy estrogens. But they can be surgically removed — even in pregnancy — and preferably before labor to ensure a normal labor and delivery.
    • If warts on the external female genitalia, such as the labia, grow very large, this may sometimes prevent the baby from passing through the birth canal. Occasionally, cesarean section is required.
    • Warts located inside the vagina may make the vagina less elastic. This wart-infected tissue can tear and hemorrhage during a vaginal delivery.

    Small warts require no treatment, while larger, more bothersome, ones may be treated by chemical burning with acids or by cutting them away. During pregnancy, medications such as podophyllin or podofilox should be avoided since they are absorbed by your skin and can cause birth defects in your baby. Imiquimod should be used only if potential benefits outweigh the risks. Babies rarely contract warts from their mothers, so the CDC generally does not recommend cesarean delivery for women with HPV. However, your doctor will suggest a cesarean if warts block the birth canal or if there is a danger of warts tearing and bleeding during delivery. Some women find that their warts go away after childbirth.

    Because HPV may increase the risk of cervical cancer, be sure to get regular Pap smears if you have been infected — even if you've had the visible warts removed.

    Gonorrhea

    Bacteria spread through sexual contact with an infected partner cause gonorrhea. Oral antibiotics or an antibiotic injection can get rid of the bacteria. Both you and your sexual partners must be tested and treated, or the infection can recur. Routine pregnancy testing includes screening for gonorrhea in the vaginal and cervical secretions because it is such a common STD. Because gonorrhea can be present without symptoms, most doctors automatically treat the eyes of all newborns to prevent infection.

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