Recurrence Risks After Genital Warts During Pregnancy

Cauliflower recurrence

Hello doctor, I was pregnant last year and at 20 weeks I was diagnosed with genital warts, which were located at the vaginal opening and inside the vagina.
I returned for follow-up visits before 30 weeks of gestation and had recurrences, undergoing electrosurgery three times for excision.
Before delivery, the doctor checked and said that there were currently no visible lesions, allowing for a natural birth, which I successfully had.
One month postpartum, during a follow-up visit, the doctor also stated that there were no visible lesions.
Does this mean that the lesions have completely healed, or is there still a chance of recurrence?

Omi, 20~29 year old female. Ask Date: 2017/03/23

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the current treatment methods for genital warts include various options such as cryotherapy, electrocautery, topical medications, or laser therapy.
These methods are limited to removing visible warts and do not completely eliminate the virus, with a recurrence rate of about 20%.
It is important to follow the prescribed treatment or medication.
Generally, patients who receive appropriate treatment can effectively manage the sexually transmitted virus without causing serious harm to their bodies.
Patients can try the following methods to alleviate symptoms and avoid infecting sexual partners: 1.
Keep the genital area clean and dry.
2.
Avoid using scented soaps or bath oils to prevent irritation of the wart-prone areas.
3.
Condoms can reduce the risk of transmission, but if the infected area is located on other parts of the body, such as the scrotum, condoms may not provide protection.
4.
It is recommended that regular Pap smears be conducted for stable female partners to reduce the risk of severe complications.
5.
Maintain a healthy lifestyle, including a balanced diet, regular exercise, and boosting immunity, which can decrease the chances of recurrence.
6.
The prognosis for genital warts is generally good, but the recurrence rate is relatively high.
7.
There is currently a vaccine for prevention, but it cannot be used for treatment.
8.
With combined treatment and healthy behaviors, there is a possibility for the virus to clear, which must be evaluated by a physician.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2017/03/23

More Info

Understanding the recurrence risks of genital warts (condylomata acuminata) during and after pregnancy is crucial for both maternal and neonatal health. Genital warts are caused by certain strains of the human papillomavirus (HPV), and while they are often benign, they can pose challenges during pregnancy.

In your case, you experienced multiple recurrences of genital warts during your pregnancy, which required several treatments, including electrosurgery. The fact that your healthcare provider did not observe any visible warts at the time of your delivery and during your postpartum check-up is a positive sign. It suggests that the visible lesions were effectively treated, and there may be no active disease at that moment.

However, it is important to understand that HPV can remain dormant in the body, and the absence of visible warts does not necessarily mean that the virus is completely eradicated. The recurrence of genital warts can occur due to various factors, including hormonal changes, immune system status, and stress, which can be particularly relevant during and after pregnancy.
Research indicates that the risk of recurrence after treatment for genital warts can be significant, with studies showing that up to 30% of patients may experience a recurrence within the first three months after treatment. The risk of recurrence can be influenced by the type of treatment used, the individual’s immune response, and the specific HPV strains involved.
In your situation, since you have had multiple treatments and have been monitored closely, it is advisable to continue regular follow-ups with your healthcare provider. They may recommend periodic examinations to ensure that any potential recurrences are caught early. Additionally, maintaining a healthy lifestyle, managing stress, and supporting your immune system can be beneficial in reducing the risk of recurrence.

It’s also worth noting that while genital warts are not directly harmful to the fetus, the presence of warts during delivery can pose a risk of transmission to the baby, which can lead to respiratory papillomatosis in rare cases. However, since you were able to deliver vaginally without visible lesions at the time, the risk of transmission was minimized.

In summary, while the absence of visible warts postpartum is encouraging, there is still a possibility of recurrence due to the nature of HPV. Regular follow-up appointments with your healthcare provider are essential for monitoring and managing any potential recurrences. If you notice any new symptoms or changes, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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