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How Does HPV Affect Pregnancy And What Are The Risks Involved?

HPV During Pregnancy

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The human papillomavirus (HPV) is the most common sexually transmitted infection (STI) of the reproductive tract. About 75% of sexually active women and men contract HPV at some point in their lives, while some remain undiagnosed as the infection resolves on its own (1).

HPV infection could be easily transmitted through unprotected anal or vaginal intercourse with an infected partner. The virus might also be transferred through oral sex and skin-to-skin contact in the genital area. But, could HPV infection affect your chances of getting pregnant or your pregnancy?

Here, MomJunction tells you how HPV might impact you and your unborn baby.

What Are The Signs And Symptoms Of HPV During Pregnancy?

HPV may not result in any specific symptoms, which makes it difficult to know the severity or status of the infection. There are over 100 different strains of HPV, but only some could cause problems. The high-risk strains may cause cervical cancer, while the low-risk strains are known to cause genital warts (2).

Some people report itchy warts that appear as:

  • Flat lesions
  • Small bumps with abnormal appearance
  • Finger-like tiny projections

These warts might develop on the skin near or the cervix, vagina, vulva, labia, and anus. They are not painful but may increase the likeliness of malignant transformations and may also revert after the treatment (3).

How Is HPV Diagnosed During Pregnancy?

Diagnostic tests for HPV are not a part of the routine checkup during pregnancy. However, genital warts could be diagnosed during serological examinations (blood tests which look for antibodies in the blood). The doctor may also identify external warts through careful physical examination. After that, a biopsy is suggested to confirm vaginal lesions.

The doctor might also advise a few other tests to confirm the presence of HPV and possible cancer cells.

Pap smear test involves scraping of the cervical lining cells and examining them under a microscope (4).

Colposcopy is done for further evaluation and involves the application of vinegar (acetic acid) over the cervix. Vinegar changes the color of the abnormal cells, which are then tested for HPV (5).

A DNA test on a sample of cells from the cervix checks for HPV DNA to analyze the presence of cancerous cells (6).

If the tests result positive for HPV, the doctor suggests the necessary course of treatment.

How To Treat HPV During Pregnancy?

Most HPV infections go away on their own. Treatment is required only when there are visible warts and abnormal cervical cells. Treatment options include:

  • Cryosurgery: Freezing or destroying warts using liquid nitrogen
  • Electrocautery: Burning of warts using electric current (7)
  • Loop electrosurgical excision procedure (LEEP): Removing abnormal cervical tissue using electrically charged wire loop (8)
  • Cone biopsy: Removing a cone-shaped portion from the affected cervical tissue (9)
  • Laser therapy: Destroying warts using a laser beam
  • Prescription creams: Medicated cream may be applied directly to warts. However, over-use is dangerous (10).

Your doctor may continue to examine the cell changes during your routine prenatal examinations.

Can HPV Affect Pregnancy?

HPV may affect pregnancy as it increases the estrogen levels in the body. This might lead to an increase in the number and the size of warts. That said, your doctor may not recommend removing warts, as that may increase the risk of bleeding and infection.

The treatment for warts is usually scheduled after the delivery unless the warts are big and are obstructing the vaginal area. They are then removed using chemical treatment or electric current (11).

Can You Pass HPV To Your Baby?

Babies born to mothers having active genital warts might not develop any HPV infections. Even if the baby develops the infection, it may be resolved in a few days as they are immune-competent.

In rare cases, babies may develop warts in the throat, a condition called laryngeal papillomas (respiratory papillomatosis) (12). This is a serious condition and could affect the baby’s breathing pattern. Repeated laser therapy could remove warts and clear the breathing passage (13).

If the warts are blocking the birth canal and making the delivery difficult, your doctor may proceed with a cesarean section. Your doctor may discuss all these risks before deciding on the best course of action during childbirth (11).

Can You Get Pregnant If You Have HPV?

HPV is not known to have a direct effect on your chances of getting pregnant. The virus may not affect your ability to conceive. In rare cases, HPV may develop cancerous lesions in the cervical region, which could affect your fertility and conception (14).

Here is what you could do if you are infected with HPV before conception:

  • Your partner might get the HPV vaccine, which could also protect him from genital herpes (one of the STDs)
  • You may check with your doctor about the therapy for HPV (that usually includes three injections against the virus)
  • Your doctor would suggest cautery and other therapeutic methods to treat genital warts and any other active lesions

How to Prevent HPV?

The following tips could minimize your chances of contracting the HPV infection.

  1. Use latex condoms every time you have sex. They are likely to reduce the chances of contracting HPV and other STDs. A study showed that those who used condoms during intercourse had 70% fewer chances of being infected with HPV (15).
  2. Stick to a monogamous relationship. Having intercourse with only one partner, and who does not have any obvious warts might reduce the risk of HPV. Sometimes, your partner might not know if they have HPV and could be contagious without showing any symptoms.
  3. Get vaccinated before you try to get pregnant. There are three HPV vaccines, of which Gardasil and Gardasil9 are approved for men and women aged between 9 and 26. It offers protection against cervical cancers and genital warts. Another vaccine called Cervarix is recommended for women and offers protection against cervical cancers.

These vaccines are given in three dosages, the second shot two months after the first and third six months after the first. Though the vaccines cannot cure or treat the infection completely, they may protect you from contracting other strains of HPV (16).

Next, we answer a few commonly asked questions about HPV during pregnancy.

Frequently Asked Questions

1. Can the HPV vaccine cause any pregnancy complications?

HPV vaccines might not cause any pregnancy complications or congenital disabilities. They are noninfectious vaccines that may fall under a low-risk category (17).

2. Can a man with HPV get a woman pregnant?

HPV could cause genital warts, which may decrease the man’s libido and therefore affect his ability to get a woman pregnant.

HPV may not always be a serious condition, but it might create complications in pregnancy and during labor. So, it is important to take adequate precautions and undergo necessary treatment to rule out the possibility of cervical cancer. Talk to your healthcare provider for more details on HPV infection and the possible options in case of high-risk diagnosis.

Enjoy your time with your partner, but remember to be safe too. Do you have any experiences to share about HPV during pregnancy? Tell us in the comments section.

References:

1. Ankit H et al.; An update on oral human papillomavirus infection; Indian J Sex Transm Dis AIDS (2013)
2. Human papillomavirus (HPV) and cervical cancer; WHO
3. Genital warts; U.S. Department of Health and Human Services National Institutes of Health (2018)
4. Pap Test (Papanicolaou Smear); Harvard Health Publishing (2016)
5. Colposcopy and Cervical Biopsy; Harvard Health Publishing (2018)
6. The HPV DNA Test; American Cancer Society, (2016)
7. Human Papilloma Virus (HPV); OB-GYN 101: Introductory Obstetrics & Gynecology; Medical Education Division, Brookside Associates, Ltd (2005)
8. Loop Electrosurgical Excision Procedure (LEEP); American College of Obstetricians and Gynecologists (2017)
9. Cone Biopsy (Conization) for Abnormal Cervical Cell Changes; University of Wisconsin Hospitals and Clinics Authority (2019)
10. Human Papillomavirus (HPV); The Regents of the University of California, Davis campus
11. P. Singhal et al.; Pregnancy and sexually transmitted viral infections; Indian J Sex Transm Dis AIDS (2009)
12. Recurrent Respiratory Papillomatosis or Laryngeal Papillomatosis; National Institute on Deafness and Other Communication Disorders; NIH
13. Stamatis Katsenos and Heinrich D. Becker; Recurrent Respiratory Papillomatosis: A Rare Chronic Disease, Difficult to Treat, with Potential to Lung Cancer Transformation: Apropos of Two Cases and a Brief Literature Review; Case Rep Oncol (2011)
14. Questions and answers about HPV vaccination; World Health Organization (2017)
15. Consistent Condom Use Lowers Risk Of HPV Infection; ACS Journals (2008)
16. Human Papillomavirus (HPV) Vaccine Safety; Centers for Disease Control and Prevention (2019)
17. HPV Vaccine; Organization of Teratology Information Specialists (OTIS) (2018)
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