Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Genital Warts during Pregnancy | | | QUESTION | | | Dear Dr. Greenfield,
I'm 25 weeks pregnant and have genital warts. I'm worried that they may affect the baby or the birth. I am having an active outbreak of them now and the doctor says they can't be treated until after I deliver. Could it hurt the baby or force me to have to have a C-Section?
— Worried in SD | | | ANSWER |
April 11, 2002 | | | Dear Worried,
Genital warts, as I am sure you know, are very common. They are caused by a sexually transmitted virus, human papilloma virus or HPV, and often get worse in pregnancy since the immune system is suppressed. Small warts can be treated in pregnancy using trichloro-acetic acid or bichloro-acetic acid (TCA or BCA) in the doctor's office, or at home with imiquimod (Aldara). If the area covered by warts is very large, laser treatment is usually the best choice, and this requires either general anesthesia or epidural, which may be more than you want to go through during pregnancy.
Some doctors recommend treating warts in pregnancy, while others figure that since warts often will recur anyway, it may be better to wait. Many women find that their warts go away as their immune system recovers after childbirth. If not, they can be treated in a few months.
Most mothers-to-be with genital warts deliver vaginally, unless the warts are so big that they are obstructing the birth canal or are expected to cause bleeding as the baby passes through. Occasionally a baby will get warts in the genital area or on his vocal cords in the first few years of life, and some experts believe that they may have caught the virus from their mothers. But some of these babies were born by cesarean, so cesarean isn't recommended to prevent transmission of HPV from moms with genital warts. Treating the warts during pregnancy also is not believed to prevent transmission to the baby. It is important to keep in mind that genital or vocal cord warts in babies are very rare, and genital warts in mothers are very common. The vast majority of babies born to mothers with HPV do not suffer any ill effects from it.
Genital warts are hard to deal with at any time of life. They are annoying to have and sometimes upsetting to think about. Many of my patients tell me that they feel guilty about having gotten them, or they are angry with themselves or with their partners for not taking better precautions. And during pregnancy, these feelings may be amplified, as you worry about implications for your birth experience and for your baby. Keep perspective that this is only one small (albeit aggravating) aspect of life--and that being a good mother is much more important than whether you had warts. Take good care of yourself and your baby-to-be, and enjoy your pregnancy and your growing family.
— by Marjorie Greenfield, M.D. |
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