Many women have vaginal discharge during pregnancy. A study conducted on 2395 women in 2010 published in Obstetrics and Gynecology International Journal suggested that 43% of pregnant women had pathological vaginal discharge.

Normal vaginal discharge can start appearing in early pregnancy. It can exist until the delivery. In most cases, it is normal vaginal discharge. There is nothing to worry about it. However, it can also indicate infection if it is yellowish and foul smelling and accompanies by itching, redness and swelling.

First, we need to understand which vaginal discharge is normal and which is abnormal during pregnancy.

Normal Vaginal Discharge

Normal vaginal discharge has the following characteristics:

  1. Thin or mucus-like
  2. The color of discharge can be white and may appear milky.
  3. Usually, it is odorless. Some women may have mild-smelling discharge.

The normal vaginal discharge does not cause itching, burning and irritation. These secretions may increase before approaching labor.

What is the composition of normal vaginal discharge?

Normal vaginal discharge contains:

  • Secretions from the vagina and cervix.
  • Dead cells.
  • Lactobacilli bacteria (normal bacteria live in the vagina).

Causes of Normal Vaginal Discharge

The normal secretions are produced from the glands inside the cervix and vagina. It helps to keep genital tract clean and serves an action to prevent infections. It bears off dead cells and microbes. So, normal vaginal discharge plays an important role in female’s life. It serves a function of cleaning the female reproductive tract.

During pregnancy, its smell can slightly vary. It may have a mild smell. If there is no strong smell and other symptoms, pregnant women should not worry about it.

Abnormal Vaginal Discharge

Abnormal vaginal discharge has the following characteristics:

  1. The discharge might be sticky. It can cause stains on the cloths.
  2. The color of discharge can be gray, greenish, reddish or yellowish.
  3. The discharge can have a strong smell and be like fishy smell, foul smell or rotten egg smell.
  4. Other symptoms may also associate with abnormal discharge including itching, redness, irritation and swelling of the vulva.

The major symptoms that indicate you should seek immediate medical attention are itching, burning, irritation and swelling of the vulva. These are signs of infection, which may require a proper treatment.

Causes of Abnormal Vaginal Discharge

Here are some common causes of abnormal vaginal discharge during pregnancy.

Vaginal Infection

Vaginal Infection

Vaginal Thrush

Pregnant women have a higher risk of getting vaginal thrush. It is because of hormonal changes. Generally, the elevated estrogen level in the body increases the risk of developing vaginal thrush during pregnancy. Due to the same reason, pregnant women may have recurrent yeast infections.

Vaginal thrush is the most common problem found in the women that cause vaginal inflammation and infections. Candida species especially Candida albicans are the major cause of this infection. It occurs when friendly bacteria lactobacilli decrease in number. The low level of friendly bacteria results in yeast and bacterial balance. It causes uncontrolled growth of yeast that leads to infection.

Discharge Characteristics: White curd-like and cheesy or thick discharge.

It also has following symptoms:

  1. Vaginal itching.
  2. Inflamed vulva.
  3. Itching.
  4. Scratching can also result into the torn

During pregnancy, oral antifungal medicines are contraindicated. Antifungal medicines can have toxic effects on the developing baby in the womb. However, your doctor may recommend the use of vaginal creams or pessaries.

Bacterial vaginosis

Bacterial vaginosis affects about 1 in 5 pregnant women. Studies have shown that it increases the risk of following problems during pregnancy:

  • Preterm birth.
  • Preterm premature rupture of membranes.
  • Giving birth to a low-birth-weight
  • Uterine infections after the delivery
  • Miscarriage in the second trimester, a few studies found.

When the level of friendly bacteria decreases in the vagina, it also causes bacterial infections. Because it increases the risk of entering and improves the vaginal environment for the survival of other bacteria. Gardnerella is a common type of bacteria that cause bacterial infection.

Discharge Characteristics: Discharge is generally clear, slippery or gray in color and has a fishy smell.

Bacterial vaginosis can increase the risk of preterm labor and other complications. Therefore, its treatment is highly recommended to prevent all these risks. Treatment includes the use of topical and oral medications.

Trichomoniasis

Trichomoniasis can also cause abnormal vaginal discharge during pregnancy. In addition, it can increase the risk of following problems and complications:

  1. Preterm birth.
  2. Giving birth to a low-birth-weight
  3. Birth defects.
  4. Death of baby.
  5. Infection can pass to the baby.

Trichomoniasis is a type of Sexually Transmitted Disease (STD), caused by a parasite – Trichomonas vaginalis.

Discharge Characteristics: Vaginal discharge can be green, yellow or gray in color. It often has a foul smell.

It also has following symptoms:

Trichomoniasis requires treatment with a single large dose of antibiotic. Treatment should be taken immediately to avoid risks of complications during pregnancy and development of diseases in the baby.

Pregnant Woman

Pregnant Woman

Leakage of Amniotic Fluid

Amniotic fluid contains hormones, nutrients, baby’s urine and immune system cells. All these things support and protect the baby in the womb. The leakage of amniotic fluid can also result in vaginal discharge. It usually occurs between 12 to 36 weeks of pregnancy. It can result in the following complications:

  • Miscarriage.
  • Birth defects.
  • Premature birth.
  • Stillbirth.

These complications can occur if leakage of amniotic fluid takes place during first or second trimesters. If leakage occurs during the third trimester, it can cause the slowed growth of the baby, increase the risk of C-section and may increase difficulties during labor.

Discharge Characteristics: Vaginal discharge due to leakage of amniotic fluid is usually clear, white-flecked, yellow or light pink in color. It can also be tinged with blood or mucus. Usually, it has no odor.

The difference between leakage of amniotic fluid and urine is that it does not smell like urine. It has no odor. However, in some cases, it may have a faint sweet scent.

If leakage of amniotic fluid occurs, pregnant women should seek immediate attention of health care provider. Usually, the baby will not be dry because one-third of the fluid is replaced every 60 minutes. However, rupture of membranes is also possible, which require immediate care. Because it may increase the risk of uterine infection by introducing bacteria into the uterus. If the color of the fluid is brownish yellow or green-tinged, it indicates the presence of meconium in the womb. It can result in breathing difficulties when baby born. So, it is important to rush to the hospital for further care.

Tips for Handling Normal Discharge

  • Don’t use tampons. Tampons can cause infections by introducing microbes into the vagina.
  • Avoid douche because it can disturb the balance of lactobacilli bacteria, which are essential for preventing infections. Low level of these bacteria increases the risk of bacterial as well as yeast infections.
  • Don’t try to treat it without consulting your doctor. In most instances, it is normal and does not require any treatment.
  • Using panty liners can help you make more comfortable by absorbing discharge. So, if required, use them.
  • If you see any changes in discharge color or smell or cause some symptoms including itching or burning, consult your healthcare

When to Seek Medical Attention

In the following conditions, you should contact your health care provider:

  1. If you find any symptom or sign given under heading of “Abnormal Vaginal Discharge” and health conditions causing vaginal discharge, then you should contact your healthcare provider.
  2. In addition, some women may also have spotting, clots and slight bleed. In such cases, you should also seek immediate medical attention. However, spotting can be normal in some cases, but you should stay on the safer side and notify your doctor.
  3. If you have cramps or pain that accompany by bleeding or spotting.
  4. If discharge increases abnormally, so you change your panty liners frequently. Especially, if the discharge is watery and clear fluid or gelatinous and thick. Preterm labor or rupture of membranes can cause these symptoms.
  5. If external parts of the genitalia get inflamed.
  6. If you have vaginal discharge that also causes pain while urination.
  7. If the discharge has a noticeable strong odor, or you observe changes in its amount, color and consistency.
  8. In the last phase of pregnancy, mucus secretions can also increase. Because mucus plug dislodges from the cervix. However, it is not necessary that your labor is going to start. The labor process might delay for hours or days. It can also occur before 37 weeks of pregnancy, which requires immediate medical care. You should notify your doctor immediately.

In this article, we have covered the aspects of normal or abnormal vaginal discharge taking place during pregnancy. Avoid the use of OTC products or medications and home treatment. Consult your physician for a proper diagnosis and getting the right treatment.

References

  1. Da Fonseca, Tânia Maria M. V. et al. “Pathological Vaginal Discharge among Pregnant Women: Pattern of Occurrence and Association in a Population-Based Survey.” Obstetrics and Gynecology International 2013. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703429/)
  2. Spence, Des, and Catriona Melville. “Vaginal Discharge.” BMJ: British Medical Journal 335.7630 (2007). (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099568/)
  3. Lima TM, Teles LM, de Oliveira AS, Campos FC, Barbosa Rde C, Pinheiro AK, Damasceno AK. [Vaginal discharge in pregnant women: comparison between syndromic approach and examination of clinical nursing practice]. Rev Esc Enferm USP. 2013 Dec. (https://www.ncbi.nlm.nih.gov/pubmed/24626373)
  4. Ross SM, Hoosen AA, Sheik AI. Diagnosis and treatment of vaginal discharge in pregnancy. S Afr Med J. 1980. (https://www.ncbi.nlm.nih.gov/pubmed/7423322)