What should you know about genital warts in pregnancy and mode of delivery?

Hormonal and immune changes may make genital warts grow or become easier to notice during pregnancy. Lesions may be external or involve the vaginal opening, and their position matters more than the label alone. Warts that are small and away from the birth passage may be observed. Bulky, bleeding or painful lesions may require a closer examination and a discussion about treatment or delivery planning. This finding does not by itself prove anything about a partner's health or the baby's health.

Mention any genital skin change at an antenatal appointment and bring details about when it began and how it has changed. Do not self-treat with wart-removal products or prescription creams without pregnancy advice. Depending on the situation, a clinician may monitor the lesions, offer a procedure such as cryotherapy, or defer treatment until after birth. Keep the maternity team informed if lesions bleed, become painful or interfere with urination.

Seek prompt maternity advice for bleeding that does not settle, fast growth, severe pain, fever, foul-smelling discharge, urinary difficulty or a mass that seems to narrow the vaginal opening. Near labour, make sure the delivery team knows about the diagnosis or suspected lesions so they can examine safely and discuss the plan.

Do these lesions need confirmation or testing? Are they near the birth passage? What treatment is suitable at this stage of pregnancy? What circumstances would alter the planned mode of delivery?