HPV and this pregnancy, a few questions

[GinaRae]

I found out with my last pregnancy that I have HPV. It became apparent when a huge cluster of the lil buggers inhabited the bottom area of my vagina. The doc waited until delivery and then cut them off. He wasn't the kindest soul when he diagnosed me, nor when he "treated" me.

1) Has the rule changed about HPV and vaginal birth? I can still deliver safely?

2) Since the cluster came out from the hormones, I assume it will happen again this time. Should I have someone cut them off after the birth or just wait a while postpartum to see if they resolve? You know, the kinder, gentler treatment. They were uncomfortable, no doubt, but so is having a big scoop cut out of me. What is your experience with this?

3) I know I should have paps done every year, but I haven't had one since my last pregnancy. Should I have one now or due to surging hormones just wait until postpartum?

4) Anything else you can think of?

It's a not so nice feeling when you find out you're "dirty" enough to have HPV. It's a terribly embarassing way to introduce myself to new midwives and gynecologists. I hear some girls say their HPV went away. I don't believe mine has or will. I don't know how they got so lucky

Thanks for your help!

[sharksmum]

Heya

I can't answer most of your questions, but I wanted to add a few things in here. First, having HPV doesn't make you dirty : In fact, some medical professionals estimate that as much as 75% of the population carries the virus. It just doesn't pop out for everyone.

I had an outbreak several years before I had my daughter and they were taken off by a doctor. They have never come back, including during pregnancy. So it's definitely not a sure thing that you'll have an outbreak again during this pregnancy.

Take a deep breath and go find yourself a kinder care provider

[Alison Cole]

:


I do remember feeling dirty and like my body wasn't on my side when I was diagnosed with HPV, but then I learned that it's pretty common. Your health care provider should not be shocked by the fact that you have HPV, they should be used to it, and if they make you feel like a leper, find another provider!

I also do really buy the idea that your immune system can take care of it itself. I was dianosed and had warts removed via cryotherapy (burning off with dry ice, way less awful than it sounds) in '99, and nothing sinse on the HPV front. I've now been with the same partner for 5+ years and he made the informed decision not to use condoms, and he hasn't had any signs of the virus thus far.

I'd check out accupuncture, homeopathy and herbs for ways to prevent outbreak during pregnancy.


Good luck.

[GinaRae]

This time I am having a homebirth with midwives and I assume they'll be much more gentle in my care. I still wonder about getting the pap now or later, etc...

Thanks, girls!

[Jane]

It's really not uncommon at all for someone to have HPV. Or Herpes, for that matter. Unless the growth of warts closes off the vaginal opening, it's not a problem for birth. Your baby will be protected by your antibodies.
It is possible that you don't have HPV any longer. Many women clear the virus from their bodies after several years. The only way to find out is to have a series of clear paps and a negative test on a DNA proble on the pap smear.

As far as the pap - they are less accurate in pregnancy, but still accurate enough to recommend. What's your intuition? What level of reassurance do you need? Have you ever had a screen with abnormal cells?

[bobandjess99]

Unfortunately, having HPV - with or withOUT an actual outbreak at time of delivery- is now a reason to get a scheduled C-Section around here...I know, my little sister just had one. She didn't even have an outbreak.....she's just HPV+. Very, very sad.

[Jane]

Jess - HPV or Herpes? HPV (or human papilloma virus) is not usually a threat to the baby even in rare cases when it's transmitted. Herpes, however, can be life threatening for the baby.

[bobandjess99]

HPV. I tried to tell her...I showed her how even ACOG says SPECIFICALLY that being HPV+ is NOT by itself a reason to schedule a C/S......and we all know how rare it is for them to say that, LOL! But her doc told her a HUGE set of lies, telling her there was a 100% chance the baby would get HPV, and would get warts ALLOVER his face, and then he would have to burn off the warts with acid. Yes, he said this to her. She was sobbing but even when i tried to tell her the actual facts...she wouldn't believe me over the guy with the MD/OBGYN after his name. I even got her to go to a different doctor, who told her she could easily have a vaginal birth, would not be putting the baby in any danger, etc....but she wouldn't listen, because the sOB had terrified her so badly. She *did* have one outbreak of warts when she was younger, and yes, apparently, they burned them off with acid and no pain medicine, and it was this horrid memory for my sister, and so she was just so consumed with terror at the thought of her baby being burned with acid with warts supposedly all over his face from coming out of her vagina, that she just couldn't get past it. *sigh* there really are times when I think killing evil bastar...i mean, OB's should be legal. It's done and over and we just don't talk about it now to keep the peace.

[Jane]

OMG...what was his malfunction? Did she have some other reason to want to section her?

[doctorjen]

bobandjess99 - holy crap is about all I can say to that story! I've heard estimates of 80% of the population carrying HPV! I've taken care of numerous women with active or history of genital warts and never seen an affected baby. When I was a med student, I did meet a little girl who had vocal cord papillomatosis from HPV, thought to have been contracted at birth - but at that time they didn't have the viral test for HPV and her mom actually had no history of genital warts (likely she did carry the virus, but didn't know it.) That's the only case I've ever seen and it was a rarity - she was driving 6 hours to be treated at a tertiary care hospital, and even there they'd only ever seen like 1 other case.

On the pap issue. HPV has many strains. The strains that cause warts do not cause cervical dysplasia/cancer. However, the thought is if you've been exposed to one strain, perhaps you've been exposed to another. You should have a pap at some point. In the first trimester, I'd probably go ahead and do one (despite reading a lot about the concern that pregnancy causes falsely abnormal paps, I haven't actually found that to be true in my practice.) Out of the first trimester, I'd probably wait and do one post-partum just because it is harder to get a good pap specimen later in pregnancy due to the cervix tipping more posterior, the increased blood flow, and the increased discomfort to mom. The thing is, if you have an abnormal during pregnancy, then you have to decide if you want to proceed with further testing, and many moms might choose to wait on that until after pregnancy, so you'd want to think about whether you'd go any further during pregnancy or not before deciding whether to have a pap during pregnancy.

[GinaRae]

I've never had a bad pap before, but then again haven't had one done since diagnosis. And if I get a bad one now, I probably won't DO anything about it until after the pregnancy. Unless someone can say the pregnancy hormones could accelerate the problem. So I will probably wait until postpartum.

Thanks for letting me bounce this stuff off you all. I'll also ask my MWs and see what they say.

[mwherbs]

wait till after the birth to get a treatment- there are some topical treatments-- as well as the burning/freezing things-- be sure you are getting enough folate and vitamin C- and some women use calendula salve or cream it is safe and tends to be anti-inflammatory enough to keep to keep hpv settled down- you can by the homeopathic brand it has a standardized 10% or if you have a local herbalist that makes the oil or salve- it will most likely be fresh and strong enough--- this type of calendula salve or oil is used for yeast infections or cracked nipples --