Human Papilloma Virus (HPV)

INFORMATION FOR WOMEN WHO HAVE HUMAN PAPILLOMAVIRUS DURING PREGNANCY OR BREASTFEEDING

The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What is human papillomavirus during pregnancy?

Human papillomavirus (HPV) is a group of viruses that infects linings of various parts of the body, including skin, cervix, vagina, vulva, and anus. HPV often does not produce symptoms and resolves without treatment. However, infection also can cause irritation and later changes in cells that can lead to cancer or genital warts, which for women can be on the vagina, vulva, or anus and the surrounding area. More than 150 strains of HPV are known that can infect humans, but just a few of these strains cause disease, including cancer.

How common is HPV during pregnancy?

Approximately 70 percent of sexually active people have been exposed to HPV. This makes HPV the most common sexually transmitted infection (STI). Still, the prevalence of the virus among pregnant women ranges enormously from 5.5 percent to as much as 65 percent, depending on the location and demographics of the women due to differences in risk factors. The biggest risk factor is intimate contact with a partner who is at high risk of carrying HPV, due to a history of a high number of sexual partners. It is thought that many women over the age of 18 are infected, even if they have not lost their virginity, because intimate contact need not be actual sexual penetration. Being positive for human immunodeficiency virus (HIV), the virus that causes AIDS also increases the chance of acquiring HPV.

How is HPV during pregnancy diagnosed?

HPV is diagnosed with a test called HPV DNA testing, also called high-risk HPV testing, which identifies DNA sequences from HPV types 16 and 18, the two most common types of HPV that cause cancer of the cervix and other parts of the genitals. The test also identifies 12 other types of HPV that pose a high risk. If you are at least 30 years of age, and if you are screened every five years for cervical disease, your screen will include HPV DNA testing, either with or without Pap testing. However, if you are screened every 3 years, you may be screened with only a Pap smear without HPV testing, if you dont have any risk factors, such as immunosuppression or presence of HIV, a history of exposure to diethylstilbestrol (DES) when your mother was pregnant with you, or a history of cervical cancer/precancerous condition. If your HPV testing or Pap testing comes out abnormal, you may then be tested with a procedure called colposcopy in which your cervix is viewed with a device similar to a microscope, and a sample may be taken for testing.

Does HPV cause problems during pregnancy?

Strains of HPV are classified as oncogenic (causing cancer of the throat, anus, penis, skin, as well as the cervix), or as non-oncogenic, which cause genital warts. These warts consist of grey-to-flesh-colored swellings of the genitals. If concentrated together, multiple warts can appear like cauliflower. Affected areas may feel itchy or irritated, and can lead to bleeding during or after sexual intercourse. As for oncogenic strains, these can cause precancerous changes that will not produce any symptoms, but after many years they can lead to cancerous tissue that can metastasis and spread to other parts of the body, at which point it is much more difficult to manage and cure than cervical cancer that has not penetrated into the cervix beyond a certain distance. Cancer developing in the cervix may cause bleeding and vaginal discharge, and pain and/or bleeding during or after sexual intercourse, while advanced cervical cancer may cause back pain. Important for pregnancy, cervical cancer means that your cervix will not respond correctly to a vaginal birth; the cervix may not dilate adequately and/or it may bleed excessively, meaning that a cesarean section will be necessary.

Does HPV cause problems for the baby?

There have been studies suggesting that the virus can transmit from the mother to the baby in a small percentage of cases, but controversy surrounds the issue of whether or not HPV in the mother poses any risk to the baby.

What to consider about taking medications when you are pregnant or breastfeeding:

  • The risks to yourself and your baby if you do not treat the HPV infection
  • The risks and benefits of each medication you use when you are pregnant
  • The risks and benefits of each medication you use when you are breastfeeding

What should I know about using medication to treat HPV during pregnancy?

In some cases, your ob/gyn can apply an acidic solution, such as trichloroacetic acid to burn off genital warts. There also are creams, such as imiquimod and podofilox, which are thought to boost the immune system at the site where they are applied, but generally, conditions cased by HPV are treated with minor surgical procedures.

Who should NOT stop taking medication for HPV during pregnancy?

As noted above, medications are not the principal treatment strategy for HPV.

What should I know about choosing a medication for my HPV during pregnancy?

It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.

You may find Pregistrys expert reports about the medications to treat this condition here. Additional information can also be found in the sources listed below.

What should I know about taking a medication for my HPV when I am breastfeeding?

The creams and acidic medications described earlier are topical and present no issue for breastfeeding.

What alternative therapies besides medications can I use to treat my HPV during pregnancy?

The most effective alternative is to prevent HPV in the first place by receiving an HPV vaccine. There are a few versions of the HPV vaccine approved for clinical use. One version, called Cervarix, protects against HPV strains 16 and 18, which together are responsible for 70 percent of the type of cervical cancer that invades the body. Other versions, marketed under the names Gardasil and Silgard, also protect against HPV strains 16 and 18, plus two additional strains strains 6 and 11 that cause genital warts. Another HPV vaccine, called Gardasil-9, protects against nine HPV strains. Genital warts can be treated with procedures such as cryotherapy (warts are frozen with liquid nitrogen), electrocautery (warts are burned off using electrical current), laser therapy, or surgical removal. Precancerous lesions in the cervix can be removed, either with cryosurgery, laser surgery, cold knife conization (a cone-shaped wedge of the cervix is removed), or a loop electrosurgical excision procedure (LEEP), in which a looped wire with electrical current is applied to remove the affected section of the cervix. If a precancerous lesion is identified during pregnancy, generally, these procedures are performed after you deliver.

What can I do for myself and my baby when I have HPV during pregnancy?

Follow the instructions of your physician. Be assured that with screening, changes that lead to cervical cancer can usually be treated in a way that amounts to a cure.

Resources for HPV in pregnancy:

For more information about HPV during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations:

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Last Updated: 17-12-2019
General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.