HPV, a sexually transmitted disease caused by the human papillomavirus, is responsible for various-sized warts in the genital area and accounts for 70% of cervical cancer cases. It is also considered the third leading cause of death among women throughout Brazil. Women are susceptible to this problem at any stage of life as long as they are sexually active, and so when the disease occurs at a stage that is not very suitable for treatments, and HPV appears during pregnancy, what should be done?
Fortunately, HPV during pregnancy does not pose risks to fetal development, but it should be properly treated by the 34th week of pregnancy to avoid the risk of infecting the baby during childbirth. Even though transmission is very uncommon, doctors exercise extra care in cases of HPV during pregnancy, because if the baby is infected, they can also develop warts in the genital area, face, mouth, larynx, and eyes. It is important to remember that having HPV during pregnancy is not an indication for a cesarean section, unless the lesions are large and considered severe.
The biggest concern mothers have when discovering HPV during pregnancy is the possibility of transmitting the disease to their baby. However, it has been proven that HPV does not cross or penetrate the amniotic fluid and also does not affect the blood, so the only concern is transmission during delivery.
Treatment of HPV During Pregnancy
Even though some treatments are not possible during pregnancy, fortunately HPV is not on this list, which makes it possible to treat the disease even during gestation. Of course, everything depends on the size of the lesions and their location; for example, if the lesions are located on the external genital area, they can be more easily removed with the use of acids. If the lesions are larger and more severe, surgical removal is necessary. Both treatments are recommended to be done by the 34th week of pregnancy to allow for healing before the baby is born.
Methods commonly used to treat and remove HPV warts, such as electrocauterization and immunomodulators, are not recommended during pregnancy because they pose risks during gestation. Electrocauterizers stimulate uterine contractions, increasing the risk of premature birth, and immunomodulators have neither proven action nor established safety, so it is better not to take the risk. It is quite common for lesions caused by HPV during pregnancy to disappear naturally after the baby is born. This happens because the woman’s immunity, which was previously lower due to pregnancy, begins to return to normal. Even if the signs disappear, follow-up with your gynecologist is recommended to assess the need for any additional treatment.
The best way to avoid HPV during pregnancy is to take care so that infection does not occur. The Ministry of Health makes the HPV vaccine available for free for girls aged 9 to 13 years and recommends it for women up to 26 years old, although for this age group the vaccine is only available in private clinics. Another reliable measure is the preventive Pap smear, which every sexually active woman should have at least once a year, thus preventing possible disease outbreaks, infections, and more serious lesions. Through the Pap smear, it is possible to detect the appearance of local bacteria, potential wounds, and begin treating any issues in the genital area in advance, thereby preventing future problems such as cervical cancer.
See Also: What Is a Pap Smear and How Is It Done?
Photo: Renée D´Avila
