Friday, February 15, 2013

Genital Warts - Development and Management During Pregnancy

Genital Warts are caused by the Human Papilloma Virus (HPV) which invades through any breach in the skin within vicinity of sex organs. It is for all practical purpose a sexually transmitted disease (STD). The development and consequent symptoms of genital warts during the period of pregnancy would be identical to a woman who is not pregnant, and the development of lesions would be identical too. In both cases, these lesions are visible and can be felt, cause tremendous itchiness, create blood spotting, and sometimes an abnormal vaginal discharge.

Women have also complained of a burning sensation and bleeding after sexual intercourse. Now, if the woman is pregnant, there are internal hormonal changes, and the stress of pregnancy itself brings down her self-immune system to fend off any infection. Any sexual act during this period renders the woman highly vulnerable to pathogens, and the HPV takes full opportunity to invade.

Once the cauliflower-shaped lesions of genital warts make their appearance, it would be highly advisable to consult the obstetrician. Till such time, avoid touching the genital warts, and take proper hygiene measures to prevent their spread to other parts of the body as the causative HPV is highly contagious. The healthcare counsellors too may want to check and advise on either a treatment regimen, or the measures for delivery, depending on the stage of the pregnancy.

Let us be clear that genital warts have not known to cause infertility in either women or the men. However, a pregnant woman does suffer bouts of depression from anxiety of the risk to her unborn child. This may sometimes result in miscarriage or even premature delivery, though the connection has not been medically established. In fact, the mode of vertical transmission from to-be mother to unborn child has not been clearly understood, though there are evident reports of spread of infection during prenatal and postnatal period.

That means the threat exists even post delivery. In most cases, through proper observance and labor management, most infected women have delivered HPV-free and healthy babies. However, the genital warts do to an extent reduce the normal elasticity of the vaginal wall in preparation for birth, which can result in an extended labor necessitating the resultant delivery through a caesarean section.

During the term of the pregnancy, especially during the first and third trimester, any form of medication is as it is best avoided. Similarly, for the woman having developed genital warts during pregnancy, any form of medication is contraindicated. The main reason is that there are no reports to indicate that the effect of the drugs or of any medication would not compromise the safety of the unborn child.

At the most the doctors can adopt a counter-measure through cryosurgery for removal of genital warts during pregnancy. This removal is necessary as the warts would induce excessive bleeding during a normal delivery. But most obstetricians would prefer to adopt the caesarean section delivery as the HPV type 6 and 11 in the vaginal lesions could pose an infection threat of the life threatening 'laryngeal papillomatosis' to the new born. However, no controlled studies have been conducted to confirm that the caesarean delivery is a fool-proof method.

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