HPV infection in pregnancy can present different symptoms, but most of the time it is asymptomatic. What women who want to become pregnant need to know is that the HPV vaccine cannot be given during pregnancy and that it does not treat an existing infection.
Dr. Mihaela-Alexandra Radu, specialist in obstetrics and gynecology, provides more details about HPV infection during pregnancy.
Symptoms of HPV infection in pregnancy
HPV strains (human papilloma virus) are responsible for the appearance of genital warts or cervical and vaginal dysplasia.
Appearance of genital warts – this is a visible symptom, represented by lesions also known as warts, usually located in the genital area, small or large in size, which can cause discomfort, stinging or pruritus (itching). However, it should be noted that not all women infected with HPV develop genital warts.
The appearance of precancerous lesions – some strains of HPV can cause precancerous lesions on the cervix, called cervical dysplasia or squamous intraepithelial lesions, which are usually asymptomatic and are detected through screening tests, i.e. the Babeș-Papanicolau test.
All the HPV virus is responsible for the appearance of vaginal dysplasia. In case of the appearance of these changes during the Babeș-Papanicolau exam, colposcopy is necessary, i.e. microscopic examination of vaginal and cervical lesions. Colposcopy is performed in the office, it is not painful, but slight discomfort may be felt when applying the substances used for the examination.
How the fetus is affected by HPV infection in pregnancy
It should be noted that most pregnant women infected with HPV have a healthy pregnancy and give birth to healthy babies, because the infection does not directly affect the fetus or cause complications. However, in some rare situations, there is theoretically a risk of transmission of the virus to the fetus during pregnancy or during vaginal delivery.
In these cases, the presence of the virus in the fetus is not significant, being spontaneously inactivated most of the time. Rarely, it manifests itself through an oropharyngeal infection that leads to the appearance of warts in the newborn’s respiratory tract (in the mouth or throat). However, the risk of HPV transmission to the fetus is small.
In addition, there are management measures available to minimize the risks associated with HPV infection during pregnancy, such as close monitoring of cervical lesions and case-by-case assessment to determine the optimal delivery option. The presence of HPV before getting pregnant is not a contraindication for it.
The risks of HPV infection during pregnancy on pregnant women
As far as the pregnant woman is concerned, the risks of HPV infection refer to the possibility of developing cervical lesions (of the cervix). These lesions may require additional monitoring and treatment to prevent progression to cervical cancer.
Also, extremely rarely, some complications can occur during childbirth. If there are genital warts that are large or located near the area where the baby is supposed to come, they can cause bleeding or interfere with the natural process of vaginal birth. In this case, to avoid complications, it may be necessary to perform their excision before birth or opt for cesarean section.
Anti-HPV vaccination during pregnancy, contraindicated
HPV vaccination is not recommended during pregnancy. Vaccination before pregnancy or after birth is indicated.
However, it should be noted that the HPV vaccination does not treat an existing infection, but rather protects against the most common strains that are associated with the development of genital warts and cervical cancer.
Vaccination aims at prevention and is more effective before exposure to the virus. The most widely used vaccine today is 9-valent, meaning it protects against 9 aggressive strains.
How to treat HPV infection in pregnancy
There is no targeted treatment for HPV either during or outside of pregnancy. Most of the time, the virus is spontaneously inactivated by the immune system.
Treatment refers to warts and precancerous lesions on the cervix and vagina. Treatment during pregnancy varies depending on the situation and the degree of severity of the lesions produced by HPV.
In most cases, HPV infection during pregnancy does not require treatment. However, if treatment is deemed necessary for genital warts, the doctor may recommend local treatments to reduce or eliminate them.
However, certain treatments are contraindicated during pregnancy, which is why it’s important to talk to your OB/GYN about the safest options available.
If the pregnant woman has precancerous lesions (cervical dysplasia), she will be closely monitored through screening tests, such as the Babeș-Pap test and colposcopy (microscopic examination of the cervix).
Treatment of cervical dysplasia includes loop excision, but also other procedures. But, if possible, they will be postponed until after the birth, so as not to increase the risk of premature birth.
Treatment for HPV infection in pregnancy is more focused on monitoring and managing symptoms and progress, as well as the safety and health of the mother and baby.
2023-07-24 05:37:25
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