Fewer topics in obstetrics and virology will generate stronger opinions backed only by anecdotal data than the issue of human papillomavirus (HPV) infection during pregnancy. Any effort to address the topic of management of the pregnant patient with genital HPV must confront the vast literature from virologists, epidemiologists, obstetrician-gynecologists, dermatologists, and ears, nose, and throat specialists, each with its particular medical and philosophic bias. Few consensus opinions among these diverse disciplines exist, although most would agree that (1) HPV genital infections in women (and men) have increased dramatically in the past two decades, (2) our ability to detect smaller amounts of HPV DNA continues to improve, and (3) laryngeal papillomatosis (by far the worst neonatal “outcome” of maternal HPV infection) is an uncommon but potentially devastating problem best treated by prevention, if possible. The situation has become more complicated by the inevitable arrival of personal injury attorneys seeking damages for nonprevention of laryngeal papillomatosis by failure to perform prophylactic cesarean section in women with genital HPV infection. In addition, some effective therapies for HPV are medically contrain- dicated during pregnancy because of theoretical adverse fetal effects, thereby limiting our available “arsenal” against this agent.
KeywordsToxicity Dioxide Tuberculosis Interferon Peri
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