What Are the Treatments for Genital Warts in Pregnancy?

Condyloma acuminatum (CA) is caused by human papillomavirus (HPV) infection. HPV is mainly parasitic in cells and symbiotic with infected cells. Under the warm and humid conditions of the human body, it is easiest to survive and reproduce, so it mainly occurs in genitals, perineum, and anus, and it displays epidermal tumor-like hyperplasia, so it is also called genital wart.

Chinese name: Condyloma acuminatum in pregnancy

Foreign name: complications with condylom acuminatum

Causes and common diseases of condyloma acuminatum in pregnancy

Because it can be transmitted through sexual life, it is a sexually transmitted disease (STD). The disease is one of the classic STDs, with a high incidence and difficult treatment. More and more research shows that CA is not only transmitted through sexual contact, another important transmission route is vertical transmission.

So far, infections of fetuses and newborns caused by condyloma acuminatum caused by HPV infection during pregnancy are rarely reported, but theoretically HPV can cause papilloma of the throat of the newborn through the birth canal or infection, causing breathing difficulties. As for the clinically induced abortion, premature birth, stillbirth or teratogenicity, no related reports have been reported.

Differential diagnosis of condyloma acuminatum in pregnancy

Diagnosis is not difficult based on a history of infection exposure and typical clinical manifestations. A typical verrucous lesion was found in the vaginal opening or vaginal wall, and the acetic acid test was positive (3% to 5% of acetic acid was applied to the suspected damaged skin, and the wart body was whitish). Early diagnosis of genital warts of the vagina has certain difficulties, and must be tested by histopathology and molecular biology.

Pregnancy with Condyloma Acuminatum

1. Cytological examination of the vaginal or cervical genital wart tissue smear for Pap staining, two types of cells can be seen: hollowed out cells and keratinized cells. This method is simple, cheap, high specificity and low sensitivity.

2. Histopathological examination This method is an effective diagnostic method for condyloma acuminatum and can exclude malignant lesions. The typical pathological changes of condyloma acuminatum are hyperkeratosis or incomplete keratosis of the epidermis; the spinal cell layer widens and there are typical hollowed out cells.

3. Molecular biology examination Using PCR technology and DNA probe hybridization for nucleic acid detection can determine HPV infection and type. In addition, HPV antibodies in serum can be detected by enzyme immunoassay, and HPV-Ag in cells can be detected by immunohistochemical examination.

Principles of treatment of genital warts during pregnancy

1. Condyloma acuminatum in pregnancy 1. Topical medication

1.1 Corrosive drugs

30% to 50% of trichloroacetic acid is not absorbed through the skin, but it can irritate the surrounding skin and cause tingling, but it does not cause inflammatory reactions and has no teratogenic effects. It can be used in pregnant women.

1.25% Imiquimod Cream

Imiquimod is a non-nucleoside isocyclic amine drug artificially synthesized in recent years, and is now widely used in skin diseases such as solar keratosis, superficial malignant tumors of the skin-basal cell carcinoma, perianal Condyloma Acuminata and External Genital Area

1.3 Topical interferon preparations

Recombinant human interferon -2b gel has a broad-spectrum antiviral activity and can regulate the body's immune function. It not only enhances the body's local cellular immune function after HPV infection, prevents the spread of the virus, but also enhances the activity of natural killer cells and the phagocytosis of macrophages, kills infected cells, and inhibits the continued proliferation of wart tissue And effectively prevent the recurrence of genital warts.

2. Condyloma acuminata during pregnancy 2. Physical or surgical treatment

2.1 CO ₂ laser

The basic principle of carbon dioxide laser is to use the thermal effect to vaporize and carbonize tissue to remove new organisms, which is very beneficial for tissue purification and regeneration. And by coagulating and closing small blood vessels to play a role in hemostasis and inhibit the further spread of the virus.

2.2 Microwave

Microwave is an extremely high frequency electromagnetic wave. Because the body tissue has a higher absorption of microwaves, it uses the body tissue itself as a heat source to generate non-conductive thermal energy, and uses the thermal effects generated by the tissue to achieve therapeutic effects such as cauterizing tissue and coagulating tissue proteins.

2.3 Freezing is one of the main treatments for genital warts in pregnant women.

3. Condyloma acuminatum in pregnancy 3. Immunomodulatory therapy

3.1 Systemic immune regulation

Condyloma acuminata is caused by a viral infection. Its recurrence and regression are closely related to the body's cellular immune function. When the cellular immune function declines, the CD4 + / CD8 + ratio is inverted. At this time, the immune system or some soluble factors controlled by the immune system are imbalanced, causing After being infected with HPV, its cells do not undergo morphological changes to escape the body's immune response. In addition, once these soluble factors are dysregulated, the host cannot inhibit the expression of the viral gene and activate the viral gene, which can infect more cells. Therefore, it can be understood that the incidence and relapse rate of various infectious diseases will increase significantly when the body's immunity is low. Including genital warts, especially during physiological changes during pregnancy, the body's immune function is suppressed, and the susceptibility to HPV16 / 18 is selectively increased. There are many immunomodulators for systemic treatment of diseases caused by viral infections. In addition to the earlier-used interferon (IFN), transfer factors, and interleukins, BCG polysaccharide nucleic acid and thymosin are now more commonly used.

3.2 The embedding method of wart body is one of the special methods for treating viral warts.

4.ALA- Pregnancy with genital warts 4. ALA-photodynamic therapy

Aila-Photodynamics (ALA-PDT) is a new technology that has emerged in recent years and has been widely used in the treatment of genital warts, acne, and benign and malignant tumors on the superficial skin.

5.HPV Condyloma acuminatum in pregnancy

There are three types of HPV vaccines: preventive vaccines to prevent HPV infection, but they are not effective against HPV infection or cervical cancer; therapeutic vaccines are mainly aimed at HPV infections, and they focus on removing body lesions from both humoral and cellular immunity; the third type A vaccine that is both preventative and therapeutic is ideal.

6. Condyloma acuminatum in pregnancy 6. Intracellular antibody treatment

Intracellular antibody simply refers to the artificial synthesis of a new engineered antibody in the cell, which mainly acts on certain components in the cell. It is a new gene therapy method nowadays.

7. Condyloma acuminatum in pregnancy

7.1 Pateline Pateline is a pure traditional Chinese medicine preparation extracted and purified from 20 flavors of traditional Chinese medicine, such as Hedyotis diffusa, Sophora flavescens, Daqingye. It is a new type of traditional Chinese medicine preparation extracted by modern technology. The traditional Chinese medicine preparation can effectively clear the latent virus of lesions and normal skin of surrounding tissues. The most basic principle that Petrin can prevent recurrence: epidermal renewal theory. Accelerate the metabolism of epidermal cells, promote the exfoliation of epidermal cells in the wart body and the surrounding latent virus area, and make HPV parasitic in epidermal cells have no time to replicate and reproduce as the cells are detached and completely removed.

7.2 Oral or add local fumigation and washing of traditional Chinese medicine.