Human papillomavirus (HPV) during pregnancy

Human papillomavirus (HPV) during pregnancy

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What is human papillomavirus?

Genital human papillomavirus (HPV) is the most common type of sexually transmitted infection in the United States. Up to three-quarters of sexually active women and men will be infected with genital HPV at some point in their lives, but most will never know they had it because it often causes no obvious symptoms and usually resolves on its own.

You're most likely to get a genital HPV infection from vaginal or anal intercourse. It's possible but uncommon to transmit the virus through genital contact without penetration, through oral sex, or by touching the genitals. And a mother can transmit HPV to her baby during birth, but this is also uncommon.

What are the symptoms?

In many cases, there are no obvious symptoms. If you do get symptoms, they can take anywhere from a month to a year or longer to show up after you're exposed to genital HPV.

A few of the more than 40 different strains of genital HPV may cause you to develop genital warts. (Some types of HPV cause the common warts you can get on your hands and feet, but genital HPV strains usually affect only the genital area.)

Genital warts are very contagious. Researchers estimate that about 65 percent of people who have sex with a partner with warts will end up developing warts themselves.

The warts usually show up in or around your vagina and vulva, near your anus and in your rectum, on your cervix, and sometimes on the skin near the groin area. (You can also get warts in your mouth and throat from performing oral sex on an infected partner, but this is rare.)

The warts are soft and skin-colored or lighter. They can be small or large, flat or raised. There may be one or many, sometimes growing in clusters with a cauliflower-like appearance. They're usually painless, though they may occasionally itch, burn, or bleed.

In about 20 percent of women, the warts go away on their own within three months. For most other women, treatment will help to clear up the warts, though they may recur.

In some cases, genital HPV causes changes in your cervical cells that are detectable on a Pap smear. Often these changes are mild and go away on their own.

But if you have one of the so-called "high-risk strains" of HPV, it may cause more serious cell changes. These cell changes may turn into cancer – usually many years later – if you don't get the necessary treatment.

These high-risk strains are the cause of almost all cervical cancer. (Note that these strains are not the same ones that cause genital warts.) That's one reason it's so important for all women to get regular Pap smears and for those who have abnormalities to follow up with any necessary testing and treatment.

The good news is that in the vast majority of cases, the immune system keeps the virus under control or destroys it – even the high-risk strains. Most women are free of the virus within a year or two after they're diagnosed.

Only a small percentage of women with HPV develop cell changes that need to be treated, and with proper screening and treatment, only rarely does HPV lead to cervical cancer or other types of genital cancer.

Can HPV affect my pregnancy?

HPV is unlikely to affect your pregnancy or your baby's health. If you have genital warts, they may grow faster during pregnancy, possibly from the extra vaginal discharge that provides the virus with a moist growing environment, hormonal changes, or changes in your immune system. In most cases, the warts won't pose any problems for you or your baby.

It's possible for you to pass the virus to your baby, but this doesn't happen very often. Even if your child does contract HPV, he's likely to overcome it on his own without any symptoms or problems.

If your child gets the type of HPV that causes genital warts, he may develop warts on his vocal cords and other areas sometime in infancy or childhood. This condition, called recurrent papillomatosis, is rare but very serious.

Will I be tested for HPV during pregnancy?

Moms-to-be are not routinely tested for HPV. Most women find out they have the virus if they develop warts or if they have an abnormal Pap smear.

One test can detect the most common types of high-risk HPV, and some practitioners do it in conjunction with a Pap smear on women age 30 and older.

However, you may have this test at any age in certain circumstances – for example, if your Pap smear shows mildly abnormal changes and your practitioner needs to determine whether further follow-up is necessary. (Some practitioners ask the lab to automatically do HPV testing on the same specimen if the Pap is mildly abnormal.)

How is HPV managed during pregnancy?

There's no drug that can get rid of the virus. If you have warts, your practitioner may decide not to treat them during your pregnancy, because they often get better on their own or even disappear altogether after you give birth.

There are various treatments, however, that can be used to remove the warts safely during pregnancy.

If your practitioner decides removal is necessary, she may use a special acid solution, freeze them off with a liquid nitrogen solution, or remove them by laser, by electrocautery, or surgically.

Two prescription products that women apply themselves are used to treat genital warts, but they're generally not recommended during pregnancy. And don't ever try to treat genital warts with drugstore medications meant for common warts.

If your Pap smear is abnormal, your practitioner may examine your cervix and vagina with a special microscope in a procedure called colposcopy. (A colposcopy is no more uncomfortable than a Pap, though it takes longer.) If your doctor sees suspicious changes in your cells, she may take a biopsy of the tissue, which can cause some temporary discomfort and bleeding.

If there's no evidence of invasive cancer, your practitioner will most likely wait until after you give birth to further treat the abnormal cells. (Depending on your situation, the colposcopy may need to be repeated during your pregnancy.)

Your practitioner will follow up with another colposcopy about six to eight weeks after you give birth to see if the problem persists. In many cases, the abnormal changes go away on their own after delivery, making further interventions unnecessary.

How can I avoid getting HPV?

You can reduce your chances of getting HPV by having sex only with a partner who has sex only with you and does not have any obvious warts. (Of course, your partner may not know if he or she has HPV and may be contagious without having symptoms.)

The more sex partners you or your partner has, the more likely you are to contract the virus. And even if you already have (or have had) HPV, being infected with one strain of the virus doesn't protect you from other strains.

Using latex condoms correctly and consistently also greatly reduces the risk of contracting HPV and many other STIs. One recent study found that women whose partners used condoms every time they had sex were 70 percent less likely to become infected with HPV than those who didn't.

(Condoms don't provide total protection because even though HPV can't penetrate latex, the virus may be present in areas that aren't covered by the condom, and a condom can slip or break.)

After you give birth, you may be able to get vaccinated against some types of HPV. Both vaccines on the market – Gardasil and Cervarix – protect women against two high-risk strains of HPV that account for about 70 percent of cervical cancers. Gardasil also provides protection against two additional strains of HPV, helping to prevent about 90 percent of genital warts as well as anal, vulvar and vaginal cancers.

The vaccine has been approved for females and males from 9 to 26 years of age. Even if you do get vaccinated, using condoms will help protect you from the HPV strains not covered by the vaccine.

Watch the video: There is No Shame in HPV Infection (June 2022).