What should you know about genital warts during delivery?

Genital warts are caused by human papillomavirus and may enlarge or become more noticeable during pregnancy. Small external warts often do not change the planned mode of delivery. Larger, numerous or friable lesions can make examination or passage through the birth canal more difficult and may bleed with contact. The presence of warts alone does not determine the delivery method, and transmission concerns are weighed alongside the safety of the pregnant person and baby.

Tell your obstetric or midwifery team about known or suspected warts, including any change in size, bleeding or discomfort. Do not use over-the-counter wart removers on genital skin. Treatment decisions depend on pregnancy stage, lesion location and symptoms; some medicines are avoided during pregnancy. Clinicians may monitor lesions or discuss procedures such as cryotherapy or electrosurgery when treatment is needed. Keep scheduled antenatal visits and do not delay care because of embarrassment.

Contact the maternity team promptly for heavy or repeated bleeding, rapidly enlarging lesions, severe pain, inability to pass urine, fever or signs of infection. During labour, tell staff about the warts if they are not already documented. They can assess the birth passage and adjust the plan if a lesion obstructs delivery or is bleeding.

Where are the lesions and could they affect the birth passage? Is monitoring enough? Which treatments are suitable in pregnancy? What findings would change the delivery plan?