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 or abnormal Pap smears -- 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 can 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 their 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. The doctor also 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
Women with a history of HPV should be sure their doctor knows this. They should tell their doctor whether they have 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. Their doctor will want to monitor them closely, because more rapid cell changes can occur during pregnancy.
Pregnant, With HPV
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 them during the pregnancy to watch for cervical tissue changes. They should also let their doctor know if they have had surgical treatment of their cervix.
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.