Human Papillomavirus (HPV) is a very common sexually transmitted infection. Many individuals with HPV never experience symptoms, as the body often clears the virus within a couple of years. However, certain HPV types can cause genital warts or abnormal cell changes on the cervix. An HPV diagnosis during pregnancy can raise questions for expectant parents.
How HPV Can Affect Pregnancy
Hormonal shifts during pregnancy can influence existing HPV infections. Genital warts, caused by specific low-risk HPV types, may sometimes increase in size or number due to these hormonal changes and increased vaginal discharge. While these changes can cause discomfort or bleeding, they generally do not pose a serious health risk to the pregnant individual or the developing baby.
If an abnormal Pap smear result is identified during pregnancy, healthcare providers typically choose a monitoring approach. A colposcopy, a procedure to examine the cervix more closely, can be safely performed during pregnancy to assess any abnormal cells. However, more invasive procedures, such as a Loop Electrosurgical Excision Procedure (LEEP) to remove abnormal cervical tissue, are usually postponed until after delivery. Abnormal cervical cells sometimes resolve on their own following childbirth.
Transmission Risks to the Infant
Human Papillomavirus transmission from a pregnant individual to their baby is a common concern. While vertical transmission is possible, it is considered rare. The primary way HPV might pass to an infant is through direct contact with infected cells in the mother’s genital tract during a vaginal birth.
Even if a baby is exposed to HPV during delivery, most infants clear the virus without developing long-term problems. Rarely, an infant may develop a serious condition called Recurrent Respiratory Papillomatosis (RRP). This condition involves the growth of wart-like tumors, typically on the baby’s larynx or vocal cords, and is usually associated with HPV types 6 and 11. Healthcare providers emphasize the low probability of RRP occurring.
Labor, Delivery, and Treatment Considerations
A Cesarean section (C-section) is generally not recommended solely to prevent HPV transmission to the newborn. However, a C-section may be advised in specific situations, such as when very large genital warts physically obstruct the birth canal, potentially causing excessive bleeding or impeding a vaginal delivery.
When treatment for genital warts is necessary during pregnancy, certain options are considered safe. These include cryotherapy or surgical removal. Laser therapy may also be used for wart removal during pregnancy. Conversely, some topical treatments like podophyllin, podophyllotoxin, and imiquimod are typically avoided during pregnancy due to potential risks to the developing fetus.
HPV Vaccination and Postpartum Follow-Up
Current medical guidance advises against administering the HPV vaccine to individuals who are already pregnant. While research indicates no increased risk of adverse pregnancy outcomes, data on vaccination during pregnancy remains limited. The HPV vaccine is considered safe to receive after delivery, even for those who are breastfeeding.
After childbirth, postpartum follow-up appointments are important, particularly if abnormal cervical changes were monitored during pregnancy. Healthcare providers will typically perform another Pap test a few weeks after delivery. This re-evaluation helps determine if any cervical cell changes have resolved naturally or if further assessment and management are necessary.