This document discusses HPV and pregnancy. It states that HPV is unlikely to affect pregnancy or the baby's health. While rare, the virus can be passed from mother to baby during childbirth, which in very rare cases could cause throat warts in the infant. It also discusses HPV testing during pregnancy, monitoring for cervical changes if the mother has HPV, and delaying HPV treatment until after delivery in some cases.

1. PREGNANCY AND HPV
JOSEPH RUSSELL N. GORDA

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CAN HPV AFFECT MY PREGNANCY?
▸ HPV is unlikely to affect your pregnancy or your baby's health.
If you have genital warts, they may grow faster during
pregnancy, possibly from the extra vaginal discharge that
provides the virus with a moist growing environment, hormonal
changes, or changes in your immune system. In most cases, the
warts won't pose any problems for you or your baby.
▸ It's possible for you to pass the virus to your baby, but this
doesn't happen very often. Even if your child does contract
HPV, he's likely to overcome it on his own without any
symptoms or problems.

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▸ In the unlikely event that your child gets the type of HPV
that causes genital warts, he may develop warts on his
vocal cords and other areas sometime in infancy or
childhood. This condition, called recurrent papillomatosis,
is very serious, but fortunately it's also rare.

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WILL I BE TESTED FOR HPV DURING PREGNANCY?
▸ Moms-to-be are not routinely tested for HPV. Most women
find out they have the virus if they develop warts or if they
have an abnormal Pap smear.
▸ One test can detect the most common types of high-risk
HPV, and some practitioners do it in conjunction with a Pap
smear on women age 30 and older

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▸ However, you may have this test at any age in certain
circumstances – for example, if your Pap smear shows
mildly abnormal changes and your practitioner needs to
determine whether further follow-up is necessary. (Some
practitioners ask the lab to automatically do HPV testing
on the same specimen if the Pap is mildly abnormal

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HPV AND PREGNANCY
▸ Women who have HPV during pregnancy may worry that
the HPV virus can harm their unborn child, but in most
cases, it won't affect the developing baby. Nor does HPV
infection -- which can manifest itself as genital warts --
usually change the way a woman is cared for during
pregnancy. It is important, however, to let your obstetrician
know if you have HPV.

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TRYING TO GET PREGNANT, NO HISTORY OF HPV
▸ Women trying to become pregnant often ask if they need a specific test for
HPV just to be sure they are not infected with the virus. They don't.
▸ If a woman has been having regular Pap tests, any abnormalities on those
would have alerted her doctor to check further for HPV. Once a woman is
pregnant, a Pap test will be taken at the first prenatal visit for women who are
not up to date on screening. If it shows abnormalities, the doctor will order
more tests.
▸ Additional tests could include an HPV test. HPV is associated with cervical
cancer. Current recommendation is to reflex to HPV testing on ASCUS pap.
HPV testing would not/should not be done on LGSIL or HSIL. Or the doctor
may decide to do a colposcopy, in which a lighted device is used to closely
examine the cervix for abnormal tissue changes.

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TRYING TO GET PREGNANT, HISTORY OF HPV
▸ A woman with a history of HPV should be sure her doctor
knows. She should tell her doctor whether she has a
history of genital warts, tissue changes in the cervix (such
as an abnormal Pap test), a history of surgical treatment for
abnormal pap, or other problems. Her doctor will want to
monitor her closely, because more rapid cell changes can
occur during pregnancy.

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PREGNANT, WITH HPV
▸ No link has been found between HPV and miscarriage,
premature delivery, or other pregnancy complications.
▸ Also, the risk of transmitting the virus to the baby is
considered very low.
▸ If a pregnant woman tests positive for the high-risk types
of HPV associated with cervical cancer, the doctor will
monitor her during the pregnancy to watch for cervical
tissue changes.

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▸ In some pregnant women with HPV, the tissue changes may increase during
pregnancy. If possible, doctors postpone treatment, because it may lead to
premature labor.
▸ If a pregnant woman has genital warts, the doctor will monitor to see if the
warts get larger. Hormone changes during pregnancy can cause the warts
to multiply or get larger. Sometimes the warts will bleed.
▸ Depending on the extent of the warts, the doctor may postpone treatment
until after childbirth. But if the warts get so big that they might cause an
obstruction in the vagina, they may need to be removed before childbirth.
▸ Genital warts can be removed surgically, with chemical treatment, or with
electric current.

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▸ When developed during pregnancy, HPV treatment of the
mother is often delayed until after delivery of the baby. HPV can
cause genital warts to grow and sometimes genital warts can
grow even larger due to pregnancy hormones. If they grow big
enough to obstruct the birth canal, the baby may have to be
delivered via cesarean section (C-section). In very rare cases, a
mother can pass HPV to her baby during childbirth. An
extremely small number of these infants develop a condition
that causes tumors to grow in the throat called recurrent
respiratory papillomatosis (RRP). These tumors are surgically
removed, but often come back.

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HPV AND CHILDBIRTH
▸ The risk of HPV transmission to the baby during childbirth is very low.
Even if babies do get the HPV virus, their bodies usually clear the virus
on their own.
▸ Most of the time, a baby born to a woman with genital warts does not
have HPV-related complications. In very rare cases, a baby born to a
woman who has genital warts will develop warts in the throat. This
serious condition is called respiratory papillomatosis and requires
frequent laser surgery to prevent the warts from blocking the baby's
breathing passages.
▸ And even if the mother has a type of HPV virus that has caused cervical
cancer, the baby can be delivered safely.

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MANAGING HPV AFTER CHILDBIRTH
▸ If a Pap test was abnormal during pregnancy, the doctor
will likely do another Pap test a few weeks after childbirth.
Sometimes, the cervical cell changes go away after
childbirth and no treatment is needed.
▸ Sometimes, genital warts also go away. If not, the doctor
may recommend treatment after childbirth.