The Effect of HPV and Genital Warts on Mode of Delivery

The cervix, also called the cervix, is the lowest point of the uterus that opens into the vagina.

Today, genital warts are one of the most common sexually transmitted diseases. While recurrent genital warts are annoying for many women, genital warts can recur due to the weakened immune system, especially during pregnancy. It often causes confusion among health professionals whether expectant mothers with genital warts can give birth normally.

In children, HPV can cause disease of the mucous membranes, conjunctiva (eyes) and larynx (airways). Laryngeal papillomatosis, papillomas (giant warts) that grow in a way that obstructs the airways, is a rare and severe condition. Children with this disease are usually diagnosed between the ages of 2 and 5 years and may need repeated surgical treatment throughout their lives.

Studies have shown a link between laryngeal papillomatosis and maternal anogenital warts. Seven out of every 1000 women with genital warts transmit HPV to their baby during pregnancy. The most common HPV types are types 6 and 11. Because of these problems, it has been questioned whether treating genital warts during pregnancy or having an elective caesarean section can prevent transmission of the disease to the baby.

No studies have investigated the effect of treating warts during pregnancy on the transmission of the virus to the baby. Treatment of visible lesions does not completely eliminate the HPV virus and does not treat the disease in the upper vagina and endocervical canal, so it does not eliminate the possibility of virus transmission to the baby. It has been suggested that administration of the quadrivalent HPV vaccine during pregnancy may stimulate the immunity of the mother and the baby and prevent transmission of the virus to the baby. However, there is no scientific data to support this. Since HPV vaccination during pregnancy is not approved, such an approach cannot be recommended.

Previous studies have suggested that the transmission of the virus to the baby occurs during passage through the birth canal. In DNA analysis of throat swabs of newborns, HPV virus was detected in 36% of babies born vaginally and 0% of babies born by caesarean section. However, since the number of patients in the study was limited, its reliability is low. However, transmission to the baby has been shown to occur even in cesarean sections performed without opening the membranes and HPV DNA has been detected in placental tissue, even in the umbilical cord. This shows us that the virus can be transmitted to the baby regardless of the mode of delivery. A large-scale study has also shown that caesarean section does not prevent neonatal HPV disease.

In the light of this information, considering the risks of cesarean delivery, cesarean delivery is not recommended in pregnant women with genital warts to prevent HPV transmission. In women with genital warts, cesarean section may be considered only if the warts obstruct the birth canal, or if the warts may break off and cause bleeding or soft tissue dystocia.

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