Human Papillomavirus (HPV) is a widespread viral infection. Discovering a positive HPV test result during pregnancy can cause apprehension, but this situation is common and generally poses no significant risks to the pregnancy. This article explains what to expect.
Understanding an HPV Diagnosis During Pregnancy
HPV is a common sexually transmitted infection affecting the skin and mucous membranes. During pregnancy, it is often detected incidentally through routine cervical cancer screening, like a Pap test, which identifies abnormal cervical cell changes. The virus can also be identified by the visual presence of genital warts. Low-risk HPV types typically cause warts, while high-risk types are associated with cellular changes in the cervix, known as dysplasia.
A positive HPV test indicates the virus’s presence but does not automatically signify active disease or immediate health complications for the pregnant individual or the pregnancy. Many HPV infections are transient, meaning the body’s immune system can naturally clear the virus over time. This spontaneous clearance can occur even during pregnancy without specific medical intervention.
Potential Effects on Mother and Baby
Pregnancy hormones can sometimes influence the growth of existing genital warts, potentially causing them to enlarge or multiply. Small warts are often monitored throughout pregnancy. If they become bothersome, bleed, or grow large enough to obstruct the birth canal, topical treatments or removal might be considered, though these are frequently deferred until after delivery to minimize intervention.
High-risk HPV types can lead to cervical cell changes, or dysplasia. Severe dysplasia is uncommon during pregnancy. Healthcare providers monitor these changes rather than immediately treating them, as procedures like biopsies carry minor risks during pregnancy, and changes often resolve or stabilize postpartum. HPV generally does not negatively impact the overall course of pregnancy, meaning it is not associated with an increased risk of miscarriage, preterm birth, or preeclampsia.
The risk of HPV transmission from the pregnant individual to the baby during a vaginal birth is very low. In extremely rare instances, if the baby contracts HPV during passage through the birth canal, they might develop Recurrent Respiratory Papillomatosis (RRP). This condition involves the growth of warts in the larynx or other parts of the airway, but it is exceptionally rare and usually linked to active, large genital warts in the birth canal during delivery. HPV does not cause birth defects or affect fetal development while the baby is in the womb.
Medical Management and Delivery
For most pregnant individuals with an HPV diagnosis, especially without active genital warts or severe cervical changes, medical management primarily involves careful monitoring. This often includes regular follow-up Pap tests or a colposcopy, a magnified examination of the cervix, if initial screening indicates cellular abnormalities. Invasive procedures like cervical biopsies or treatments for cervical cell changes are typically postponed until after delivery to ensure pregnancy safety. Small genital warts are generally observed; only very large, obstructive, or bleeding warts might require removal during pregnancy.
Vaginal delivery is generally considered safe and recommended for most pregnant individuals with HPV. A Cesarean section (C-section) is not routinely advised solely based on an HPV diagnosis. A C-section might be considered in very rare circumstances, such as when extremely large genital warts physically block the birth canal, or if there is a significant risk of severe bleeding if the warts were to tear during a vaginal delivery. The goal is to ensure the safest delivery method for both the pregnant individual and the baby, which for most cases, remains a vaginal birth.
Following delivery, continued follow-up care with a healthcare provider is important. This ensures ongoing monitoring of HPV status and cervical health, allowing for any necessary post-delivery assessments or treatments to address persistent HPV infection or cervical changes.