Even after removal of warts, patients may harbor HPV in surrounding normal tissue, as may persons without exophytic warts. Experts speculate that HPV infection may persist throughout a patient's lifetime in a dormant state and become infectious intermittently. Whether patients with subclinical HPV infection are as contagious as patients with exophytic warts is unknown. Special Considerations Pregnancy - The use of podophyllin and podofilox are contraindicated during pregnancy. Genital papillary lesions have a tendency to proliferate and to become friable during pregnancy.
Many experts advocate removal of visible warts during pregnancy.
HPV types 6 and 11 can cause laryngeal papillomatosis among infants. Hence, the preventive value of caesarean delivery is unknown. Caesarean delivery must not be performed solely to prevent transmission of HPV infection to the newborn. However, in rare instances, caesarean delivery may be indicated for women with genital warts if the pelvic outlet is obstructed or if vaginal delivery would result in excessive bleeding. Subclinical genital HPV infection is much more common than exophytic warts among both men and women.