HPV and Pregnancy

Women who have HPV during pregnancy may worry that the HPV virus can harm their unborn child, but in most cases, it won't affect the developing baby. Nor does HPV infection -- which can manifest itself as genital warts -- usually change the way a woman is cared for during pregnancy. It is important, however, to let your obstetrician know if you have HPV.

Here's what women need to know about HPV and pregnancy.

Trying to Get Pregnant, No History of HPV

Women trying to become pregnant often ask if they need a specific test for HPV just to be sure they are not infected with the virus. They don't.

If a woman has been having regular Pap tests, any abnormalities on those would have alerted her doctor to check further for HPV. Once a woman is pregnant, a Pap test will be taken at the first prenatal visit for women who are not up to date on screening. If it shows abnormalities, the doctor will order more tests.

Additional tests could include an HPV test. HPV is associated with cervical cancer. Current recommendation is to reflex to HPV testing on ASCUS pap. HPV testing would not/should not be done on LGSIL or HSIL. Or the doctor may decide to do a colposcopy, in which a lighted device is used to closely examine the cervix for abnormal tissue changes.

Trying to Get Pregnant, History of HPV

A woman with a history of HPV should be sure her doctor knows. She should tell her doctor whether she has a history of genital warts, tissue changes in the cervix (such as an abnormal Pap test), a history of surgical treatment for abnormal pap, or other problems. Her doctor will want to monitor her closely, because more rapid cell changes can occur during pregnancy.

Pregnant, With HPV

No link has been found between HPV and miscarriage, premature delivery, or other pregnancy complications.

Also, the risk of transmitting the virus to the baby is considered very low.

If a pregnant woman tests positive for the high-risk types of HPV associated with cervical cancer, the doctor will monitor her during the pregnancy to watch for cervical tissue changes.

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In some pregnant women with HPV, the tissue changes may increase during pregnancy. If possible, doctors postpone treatment, because it may lead to premature labor.

If a pregnant woman has genital warts, the doctor will monitor to see if the warts get larger. Hormone changes during pregnancy can cause the warts to multiply or get larger. Sometimes the warts will bleed.

Depending on the extent of the warts, the doctor may postpone treatment until after childbirth. But if the warts get so big that they might cause an obstruction in the vagina, they may need to be removed before childbirth.

Genital warts can be removed surgically, with chemical treatment, or with electric current.

HPV and Childbirth

The risk of HPV transmission to the baby during childbirth is very low. Even if babies do get the HPV virus, their bodies usually clear the virus on their own.

Most of the time, a baby born to a woman with genital warts does not have HPV-related complications. In very rare cases, a baby born to a woman who has genital warts will develop warts in the throat. This serious condition is called respiratory papillomatosis and requires frequent laser surgery to prevent the warts from blocking the baby's breathing passages.

And even if the mother has a type of HPV virus that has caused cervical cancer, the baby can be delivered safely.

Managing HPV After Childbirth

If a Pap test was abnormal during pregnancy, the doctor will likely do another Pap test a few weeks after childbirth. Sometimes, the cervical cell changes go away after childbirth and no treatment is needed.

Sometimes, genital warts also go away. If not, the doctor may recommend treatment after childbirth.

WebMD Medical Reference Reviewed by Nivin Todd, MD on September 26, 2014

Sources

SOURCES: 

Barbara Levy, MD, medical director, St. Francis Women's Health Center, Federal Way, Wash. Diane Harper, MD, MPH, professor of community and family medicine and obstetrics and gynecology, Dartmouth Medical School, Lebanon, N.H. American Social Health Association fact sheets: "HPV Myths and Misconceptions;" "HPV Cervical Dysplasia Questions & Answers;""HPV Genital Warts Q and A;" and "HPV." National Institute of Allergy and Infectious Diseases fact sheet: "Human Papillomavirus and Genital Warts." American College of Obstetricians and Gynecologists Practice Bulletin, "Clinical Management Guidelines for Obstetrician-Gynecologists," Number 61, April 2005. Alan Waxman, MD, professor of obstetrics and gynecology, University of New Mexico, Albuquerque.

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