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Human papillomavirus (HPV) is highly infectious, but most of them are not dangerous. Usually, papillomavirus infection is discovered and treated, if necessary, before pregnancy. More rarely, it can be diagnosed in pregnant women: various solutions can then be considered.
Papillomavirus during pregnancy: how is the diagnosis?
- Whether you are pregnant or not, Pap smear is the best way to discover papillomavirus infection. This smear is not part of the "mandatory" examinations of pregnancy: it is only prescribed, as a precaution, to pregnant women whose last smear of control is more than two years old. Women vaccinated against HPV are also concerned: the vaccine protects against viral strains most likely to cause cancer of the cervix (HPV 16 and 18) but it does not rule out 100% all risks.
- The cervicovaginal smear is preferably performed during the first trimester of pregnancy. You will be asked to lie on your back, in a gynecological position, then the gynecologist will gently take cells from your cervix with a small brush, after introducing a speculum into your vagina. This exam is safe for your future baby. It can only trigger a little more bleeding than usual, because the cervix is highly irrigated during pregnancy.
What to do in case of papillomavirus infection during pregnancy?
- Most of the time, cervico-vaginal smear reveals no abnormality during pregnancy or highlights a minor infection. If necessary, other examinations (eg biopsy or colonoscopy) can be done to refine the diagnosis.
- In practice, the majority of papillomaviruses only cause a benign infection, more or less quickly fought by the body: most of the lesions discovered are therefore likely to regress on their own. We speak of "low grade dysplasia", without any danger for the baby. In such cases, no treatment is necessary during pregnancy. The medical team is limited to controlling the evolution of the lesions: in general, other examinations are performed around the sixth month of pregnancy and a few months after delivery. In the rare cases where these lesions persist for more than eighteen months, a laser vaporization is usually proposed: painless and fast, this procedure is usually performed without anesthesia.
- Exceptionally, larger lesions due to papillomavirus can also be discovered during pregnancy. They are often treated after conidial delivery (anesthesia performed by removing a small part of the cervix) but depending on the case, treatment can also be done during pregnancy; in general, the intervention has no impact on the fetus. Finally, it happens that delivery is triggered a little prematurely, by cesarean, when there is a risk of contamination of the baby by the papillomavirus during vaginal delivery but it is really exceptional (very large lesions discovered in the third quarter).