Sexually Transmissible Infections in Clinical Practice

30. A Pregnant Woman with Genital Warts

Alexander McMillan1, 2  

(1)

Department of Genitourinary Medicine, NHS Lothian, Edinburgh Royal Infirmary, Edinburgh, Uk

(2)

University of Edinburgh, Edinburgh, Uk

Alexander McMillanFormerly, Consultant Physician, part-time Senior Lecturer

Email: a.amcmm@btinternet.com

Abstract

Linda ( Case 15), a 22-year-old woman, is referred to a Sexual Health clinic by an obstetrician. She is 16 weeks pregnant and has noticed lumps appearing on her genitals. She has had the same sexual partner for 5 years and neither has had sexual contact with other individuals. Examination shows multiple warts on the labia majora, labia minora, and at the introitus (Fig

Linda ( Case 15), a 22-year-old woman, is referred to a Sexual Health clinic by an obstetrician. She is 16 weeks pregnant and has noticed lumps appearing on her genitals. She has had the same sexual partner for 5 years and neither has had sexual contact with other individuals. Examination shows multiple warts on the labia majora, labia minora, and at the introitus (Fig30.1 ).

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Figure 30.1.

Vulval warts in a pregnant woman.

She is very concerned (a) about the effect of the warts on the pregnancy, (b) about treatment, (c) will it be necessary to deliver the baby by Caesarean section, and (d) that the child will be born with or subsequently develop warts. She also wants to know how she could have acquired the warts.

30.1 What Do You Tell Her?

(a)

(b)

(c)

(d)

The appearance of genital warts during pregnancy does not necessarily indicate infidelity. Under hormonal influence, HPV is up-regulated in pregnancy, and as a result, latent virus, possibly acquired years previously, may become apparent.