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Human Papillomavirus (HPV) is the most common type of sexually transmitted disease in America. You can pass it to someone else through oral, anal, or vaginal sex without knowing you have it. Most people with HPV have no symptoms. HPV can cause vaginal warts and it can also cause cancer. There is no cure. Since up to 75 percent of sexually active women will be infected by HPV, this infection would be a true disaster if it affected pregnancy. The good news is that it doesn’t.
Women with HPV can get pregnant, have normal pregnancies, and normal babies just like women without HPV. That said, there are some things you should know about HPV and pregnancy.
Genital Warts and Abnormal Pap Smears
Unlike other sexually transmitted diseases, there is no simple screening test for HPV. The only warning signs are genital warts and changes in the cells of your cervix, that are found during a routine Pap smear exam. Most people with HPV never have these signs, and never know that they have HPV. In most cases, HPV will go away on its own and never cause any health problems.
If you have ever had genital warts or an abnormal Pap smear, you should let your pregnancy health care provider know. Genital warts can be seen on the outside of your vagina or your anal area. They can look like small bumps or cauliflowers. They can be raised, flat, small, or large. They may itch or bleed after intercourse. Both genital warts and cervical cell changes may get worse during pregnancy, due to hormone changes and reduced resistance to the virus.
During your prenatal exams, your doctor will check for genital warts and may do a cervical exam if you have not had a recent Pap smear. If your Pap smear exam is abnormal, your doctor may ask for the cells to be checked for HPV infection.
Active HPV During Pregnancy
If genital warts or your cervical exam suggest an active HPV infection, your pregnancy will be managed as usual. There is no evidence that HPV increases your risk for pregnancy complications. Your doctor may check to make sure your cervical cell changes are not getting worse, but any treatment will probably be delayed until after you have your baby. In some cases, the cell changes go away after pregnancy.
If you have genital warts during pregnancy, there is a very small chance that these warts can be passed to your baby during a vaginal delivery. Unless the warts become large and numerous, this risk is too low to recommend treating the warts during pregnancy. In rare cases, where warts have become large enough to interfere with a vaginal delivery, a cesarean delivery may be needed.
HPV Before and After Pregnancy
There are many types of HPV. Most do not cause cancer. Some types can cause cancers of the penis, vagina, anus, and throat. Genital warts are not caused by these types and they do not turn into cancer. The most dangerous types of HPV cause over 75 percent of cervical cancers.
Before or after pregnancy genital warts may be treated with medication, freezing, or surgical removal. Cervical changes can also be treated with freezing or surgery. In most cases, this will greatly reduce the risk of cervical cancer.
You can reduce your risk of HPV before and after pregnancy:
- Get vaccinated against the virus. Vaccinations are recommended for everyone through age 26. The vaccination is not given to pregnant women. Ask your doctor if you should get vaccinated after pregnancy, if you have not been vaccinated before.
- Practice safe sex. This includes using a condom and limiting your sexual partners. A monogamous relationship between two people who have been vaccinated for HPV is best.
- Keep all your routine pelvic and Pap smear exams. Cervical cancer can be prevented if early cell changes are found and treated.