HPV can worry pregnant women who have contracted the virus at some point in their lives or who have the possibility of it.
However, there is no greater risk, either for the mother or the fetus.
Although the subject may seem worrisome at first glance, the mother (and those closest to her) must inform herself as much as possible, to discern the reality of the myth and thus protect her health and that of her baby.
What is HPV?
The human papillomavirus is the causative agent of papilloma, a sexually transmitted disease (STD).
Epidemiological controls indicate that HPV is the most common STD in the United States. Approximately 80% of people come to carry the virus, but the vast majority remain asymptomatic.
That is, they do not show significant signs or symptoms.
The reason is that HPV is not a single microorganism. It is a term designated to a gigantic plethora of different types of HPV; most being benign.
Therefore, a large percentage of people with HPV do not perceive changes in their bodies and even the microorganism can be controlled without any antiviral treatment by immune action.
However, symptoms may appear, such as warts. They can appear on the skin (face and legs), hands, elbows, soles of the feet and even ankles.
Warts can also appear in the genital apparatus of the man or the woman, external or internal. They are generally benign and asymptomatic, others can cause itching or burning.
Certain types of HPV have been linked to the appearance of precancerous cells in the male or female genital tract. Among these, the cause of more than 70% of cases are types 16 and 18.
Of all the types of cancers that HPV can cause, the most common is cancer of the cervix.
HPV risks in pregnancy
During the routine medical check-up that every pregnant woman should have, the specialist must perform an extensive physical examination and laboratory studies to detect any possible abnormalities during pregnancy.
Among these is the Papanicolaou test. The doctor takes a sample (using a small brush) from the woman’s vaginal mucosa.
The aforementioned sample is taken to the laboratory to corroborate the presence of HPV or cancer cells.
Although it may sound worrisome, HPV infection during pregnancy usually does not carry a risk of complications for the mother and/or fetus.
However, the specialist must carry out a constant and meticulous study to observe the evolution during the pregnancy.
Risks for the woman
Most types of HPV are asymptomatic and benign. There is a group of around 40 types that can cause warts on the uterus, cervix, and even the vagina.
During pregnancy, estrogen levels rise. Estrogen stimulates a molecule called insulin-like growth factor.
This, in turn, stimulates cell replication and inhibits cell death, phenomena that favor the cell growth of warts produced by HPV.
When these grow, they can cause pain during pregnancy. In the worst case, the warts grow so disproportionately, obstructing the birth canal.
In which case, the wart(s) must be removed surgically, electrically, or other alternatives.
Risks for the baby
HPV has not been shown to be a teratogenic agent. That is, capable of negatively affecting the development of the fetus in any of the trimesters.
HPV can be passed from mother to child during childbirth, through exposure to infected warts on the vaginal wall.
An epidemiological study showed that 80% of newborns born to mothers with HPV were infected with the virus. However, most have no symptoms and the virus is cleared from the baby’s system over the weeks.
In the most serious of cases, there is recurrent respiratory papillomatosis, which consists of the appearance of warts in the larynx that obstruct the passage of air. However, its incidence is very low, 2 to 4 cases per year per 100,000 infants.
HPV treatment in pregnancy
Currently, there is no effective drug treatment against HPV. Most of the measures used manage to alleviate the symptoms, but not the cause.
Warts on the cervix or vagina do not pose a risk to the mother or fetus. But if they grow, they can cause discomfort, pain, and can even block the birth canal (as we’ve already discussed). Among the possible options to treat warts , we find:
Cryogenic therapy, in which small doses of liquid nitrogen are applied to the wart and the tissue around it to freeze it. The specialist then lets the wart thaw and starts the freezing and thawing process over again.
The number of cycles depends on the dimensions of the wart. The person may experience a moderate burning sensation during this procedure.
Studies published by the American Association of Gynecology and Obstetrics demonstrate the efficacy of the treatment.
However, there is a possibility that new warts may appear again since the microorganism is not eliminated.
On the other hand, there is laser therapy, used mainly for external warts, it is a complex and expensive treatment. A carbon dioxide laser is used that penetrates deeper into the wart than cryogenic therapy.
Comparative studies between these two methods published by Iranian researchers in the Iran Journal of Microbiology observed that the reappearance of warts was less frequent in patients treated by this method.
It is a quick, painless method, adverse effects are rare, and there is a low risk of infection.
Another method is electrocautery, in which an electrical current is applied that heats the surgical instrument to be used, which destroys the wart. It is used for deep and extensive lesions.
Finally, there is surgical therapy, which, like the previous one, is reserved for extensive and persistent lesions in which other methods have not been effective. A scissors or scalpel is used to separate the wart from the underlying skin.
HPV prevention in pregnancy
Although HPV is currently the most common STD, it does not mean that there are no effective strategies, based on scientific evidence, that reduce the risk of contracting the virus.
Next, we will mention some of the most popular recommendations to avoid infection by HPV:
An inverse association has been found between a diet rich in certain nutrients and vitamins and the development of cancerous HPV lesions.
The appearance of tumors is triggered by the synergy of multiple coexisting factors. A balanced diet appears to be an important contributor to this process.
American researchers published in The Journal of Infectious Diseases the findings and conclusions from the study and follow-up of 433 women.
A group of women demonstrated a lower risk of developing HPV for higher-risk types (such as 16 and 18) and also a lower probability of developing persistent infections.
Said group consumed, in a greater proportion than the rest, carotenoids (such as lutein and zeaxanthin), vitamin C, folic acid, and vitamin B12.
The underlying mechanism is still a topic of investigation, but it is suspected to be due to its antioxidant properties that prevent cell damage by free radicals.
Free radicals also disrupt the action of immune cells and the formation of healthy cells.
Vitamin C enhances the action of the immune system, decreasing virus replication and viral load.
Therefore, professionals recommend the consumption of foods rich in these phytonutrients; such as papaya, carrot, broccoli, orange and others.
The relationship between tobacco use and the risk of developing a plethora of different diseases is well known.
Cigarettes are made up of hundreds of chemicals that contribute to the formation of free radicals, promote inflammation, impede immune function, and damage cells.
All of these increase the susceptibility to suffering from any kind of infection. In the case of HPV, it could also contribute significantly to the formation of an anogenital tumor.
Safe sex is one of the few most effective and low cost methods. HPV is transmitted mainly through vaginal and anal sex.
By creating a physical barrier that prevents the contact of secretions, the probability of contagion is reduced. Consistent condom use also reduces the chances.
A study published in The New England Journal of Medicine found that sexually active women whose partners used condoms in most sexual encounters did not show lesions characteristic of HPV infection.
On the other hand, those women whose partners used condoms less frequently did demonstrate a higher probability of HPV infection.
Constant gynecological checkup
The gynecological check-up is of the utmost importance for the health of women, especially those who are sexually active.
Maintaining a constant check-up gives the woman knowledge about the current state of her body, how to take care of it, what to avoid, recommendations and much more from the gynecologist.
Also, regular visits to the gynecologist could detect infections (or any other condition) in early stages.
Vaccination after delivery
HPV vaccination has been shown to be an effective, fast, painless and low-cost tool.
Currently, there is no evidence linking HPV vaccination and complications of any kind during pregnancy, either for the mother or the fetus.
However, international medical entities do not recommend the use of the vaccine in pregnant women, since more evidence is still needed to affirm with certainty whether the vaccination is benign for pregnant women.