Ask An Expert: Genital Warts and Pregnancy

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Ask An Expert: Genital Warts and Pregnancy

Question:

I am 23 weeks pregnant and I was just diagnosed with genital warts. Will this affect my baby during delivery?

Answer:

Vaginal warts, also known as condyloma, are caused by infection with the human papillomavirus (HPV). This is the same strain of virus (although often a different sub-type) that causes abnormal Pap smears or precancerous changes in the cervix. The virus is usually transmitted sexually, and men as well as women can be infected and have warts. All women with warts should have a Pap smear and be screened for other sexually transmitted infections.

In women, warts appear as bumps or bushy growths in and around the vagina and rectum. They can itch, burn, bleed (particularly if they rub against surrounding skin or clothing), and, although usually small, can grow to be an inch or more in size. If they are large or cause symptoms, condyloma are treated with medicines (creams or liquids applied to the warts, or injections), excision (cutting them off), freezing, or vaporization (burning with a laser). Once treated, it is important to avoid re-exposure and infection. Until your partner has been examined and treated, condoms should be used during sex.

Condyloma are common, and so having them during pregnancy is also common. In general, condyloma do not grow any faster during pregnancy than they would if a woman was not pregnant. Rarely, however, condyloma can be or become big enough to raise concern that they will obstruct delivery or make repair of any vaginal tear difficult. It is unusual, however, for Caesarean delivery to be recommended for this reason alone.

As babies pass through the birth canal they may be exposed to virus shed by the warts. Rarely, such exposure can result in a baby's airway — the larynx — being infected and developing warty growths. This condition is called laryngeal papillomatosis, and although very unusual, it can require a lot of treatment to remove the growths and prevent breathing complications. Because of both the rarity of the condition and the difficulty in predicting which women will be actively shedding virus into the vagina, Caesarean delivery has not been generally recommended for this reason alone.

If you feel your warts are large or causing you problems, or if you have other questions, your provider should be able to answer your concerns. Some treatments used in non-pregnant women can also be used in pregnancy. Your doctor or midwife can consider the appropriateness of treatment and any need to alter delivery plans.

Jeffrey Ecker, M.D. is an Associate Professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics and Gynecology at Massachusetts General Hospital, where he practices maternal-fetal medicine.

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Last updated:	January 24, 2007