The Vulva in Pregnancy and Delivery

  • Maya WolfEmail author


The vulva and vagina undergo profound anatomic and physiologic changes in pregnancy. The following chapter describes these changes. It also elaborates on a few unique conditions: vulvar varicose veins, pain, genital herpes in pregnancy, condylomata acuminata, episiotomy, and perineal laceration.


  1. 1.
    Facco FL, Kramer J, Ho KH, Zee PC, Grobman WA. Sleep disturbances in pregnancy. Obstet Gynecol. 2010;115(1):77–83.CrossRefGoogle Scholar
  2. 2.
    Rimoin LP, Kwatra SG, Yosipovitch G. Female-specific pruritus from childhood to postmenopause: clinical features, hormonal factors, and treatment considerations. Dermatol Ther. 2013;26(2):157–67.CrossRefGoogle Scholar
  3. 3.
    Tunzi M, Gray GR. Common skin conditions during pregnancy. Am Fam Physician. 2007;75(2):211–8.PubMedGoogle Scholar
  4. 4.
    Verma SB. Varicosities of vulva (vulvar varices): a seldom seen entity in dermatologic practice. Int J Dermatol. 2012;51(1):123.CrossRefGoogle Scholar
  5. 5.
    Martin AG, Leal-Khouri S. Physiologic skin changes associated with pregnancy. Int J Dermatol. 1992;31:375.CrossRefGoogle Scholar
  6. 6.
    Huancahuari N. Emergencies in early pregnancy. Emerg Med Clin North Am. 2012;30(4):837.CrossRefGoogle Scholar
  7. 7.
    Keriakos R, Bhatta SR, Morris F, Mason S, Buckley S. Pelvic girdle pain during pregnancy and puerperium. J Obstet Gynaecol. 2011;31(7):572.CrossRefGoogle Scholar
  8. 8.
    Henry L. Chiropractic management of postpartum pubic symphysis diastasis: a case report. J Can Chiropr Assoc. 2015;59(1):30.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Kimberlin DW. Neonatal herpes simplex infection. Clin Microbiol Rev. 2004;17:1.CrossRefGoogle Scholar
  10. 10.
    Roberts S. Herpes simplex virus: incidence of neonatal herpes simplex virus, maternal screening, management during pregnancy, and HIV. Curr Opin Obstet Gynecol. 2009;21:124.CrossRefGoogle Scholar
  11. 11.
    Mahnert N, Roberts SW, Laibl VR, et al. The incidence of neonatal herpes infection. Am J Obstet Gynecol. 2007;196:e55.CrossRefGoogle Scholar
  12. 12.
    Wald A, Zeh J, Selke S, et al. Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons. N Engl J Med. 2000;342:844.CrossRefGoogle Scholar
  13. 13.
  14. 14.
    ACOG Committee on Practice Bulletins. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists. No. 82 June 2007. Management of herpes in pregnancy. Obstet Gynecol. 2007;109:1489.CrossRefGoogle Scholar
  15. 15.
    Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep. 2015;64:1.CrossRefGoogle Scholar
  16. 16.
    Patel H, Wagner M, Singhal P, Kothari S. Systematic review of the incidence and prevalence of genital warts. BMC Infect Dis. 2013;13(1):39.CrossRefGoogle Scholar
  17. 17.
    Aubin F, Prétet JL, Jacquard AC, et al. Human papillomavirus genotype distribution in external acuminata condylomata: a Large French National Study (EDiTH IV). Clin Infect Dis. 2008;47:610.CrossRefGoogle Scholar
  18. 18.
    Steben M, LaBelle D. Genital warts: Canadians’ perception, health-related behaviors, and treatment preferences. J Low Genit Tract Dis. 2012;16:409.CrossRefGoogle Scholar
  19. 19.
    Manhart LE, Koutsky LA. Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia ? A meta-analysis. Sex Transm Dis. 2002;29:725.CrossRefGoogle Scholar
  20. 20.
    Ferenczy A. HPV-associated lesions in pregnancy and their clinical implications. Clin Obstet Gynecol. 1989;32:191.CrossRefGoogle Scholar
  21. 21.
    Arena S, Marconi M, Frega A, Villani C. Pregnancy and condyloma. Evaluation about therapeutic effectiveness of laser CO2 on 115 pregnant women. Minerva Ginecol. 2001;53:389.PubMedGoogle Scholar
  22. 22.
    Silverberg MJ, Thorsen P, Lindeberg H, et al. Condyloma in pregnancy is strongly predictive of juvenile-onset recurrent respiratory papillomatosis. Obstet Gynecol. 2003;101:645.PubMedGoogle Scholar
  23. 23.
    Patsner B, Baker DA, Orr JW Jr. Human papillomavirus genital tract infections during pregnancy. Clin Obstet Gynecol. 1990;33:258.CrossRefGoogle Scholar
  24. 24.
    Coats PM, Chan KK, Wilkins M, Beard RJ. A comparison between midline and mediolateral episiotomies. Br J Obstet Gynaecol. 1980;87:408.CrossRefGoogle Scholar
  25. 25.
    Friedman AM, Ananth CV, Prendergast E, et al. Variation in and factors associated with use of episiotomy. JAMA. 2015;313:197.CrossRefGoogle Scholar
  26. 26.
    Gabbe SG, Niebyl JR, Simpson JL, Landon MB, Galan HL, Jauniaux ERM, Driscoll DA. Obstetrics—normal and problem pregnancies. 6th ed. Philadelphia: Elsevier; 2012.Google Scholar
  27. 27.
    Sulaiman AS, Ahmad S, Ismail NA, Rahman RA, Jamil MA, Mohd Dali AZ. A randomized control trial evaluating the prevalence of obstetrical anal sphincter injuries in primigravida in routine versus selective mediolateral episiotomy. Saudi Med J. 2013;34(8):819–23.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Maternal-Fetal Unit, Department of Obstetrics and GynecologyGalilee Medical Center, Azrieli Faculty of Medicine, Bar-Ilan UniversityNahariyaIsrael

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