How to Deal With a Vaginal Infection During Pregnancy

Increased vaginal discharge is usual in pregnancy, secondary to the hormonal changes that are common in pregnancy. Healthy vaginal discharge is clear, white, and odorless. However, when this discharge becomes excessive, changes color, and becomes smelly, then it could be a sign of an infection.

Overall, the chances of vaginal infection during pregnancy are increased as a result of hormonal changes, and pH shifts. Read on to know more about different vaginal infections during pregnancy:

Bacterial vaginosis

As mentioned before, excessive vaginal discharge is normal in pregnancy. However, if the excessive discharge becomes grayish in color, and is accompanied by itching, painful urination, then it could be due to vaginal infection during pregnancy, commonly bacterial vaginosis.

BV occurs when there is an imbalance between the natural flora of the vagina, and it overgrows, due to the shifting hormones. 

Data from studies of pregnant women infected with bacterial vaginosis suggests that they are at substantial risk for serious complications if BV is left untreated. There can be a risk of low birth-weight babies, premature rupture of membranes, chorioamnionitis, postpartum endometritis, and amniotic fluid infection. 

According to the American Academy of Family Physicians, infection with BV during the second trimester offers a greater risk of complications than later in pregnancy.

For this reason, the American Center for Disease Control and Prevention (CDC) recommends screening for BV in the second trimester to prevent vaginal infection during pregnancy. 

If you are having any of the symptoms of BV mentioned above, then talk to your healthcare provider. Provide a thorough history of your symptoms; your doctor will do a pelvic exam, and take a swab of the vaginal secretions to see them under a microscope. 

Treatment

After the confirmation of bacterial vaginosis, the recommended therapeutic measures include oral use of metronidazole combined with erythromycin. However, the use of metronidazole is not recommended during the first trimester, and therefore, only women in the later stages of pregnancy should be treated with this combination.  

Yeast infection during pregnancy

Another common vaginal infection during pregnancy is the candida or yeast infection. This fungus naturally lives in the vagina and can overgrow due to the hormonal changes during pregnancy.

The higher amount of estrogen and progesterone in pregnancy affords an ideal environment for candida to thrive. Candida infection can also occur as a result of the disruption of normal bacterial flora, secondary to antibiotic use.

Vaginal candida infections can cause itching, redness, burning, or swelling around the vagina. Moreover, the vaginal discharge associated with candidiasis is often described as ‘cottage-cheese’ discharge, and it may smell yeasty. There can also be irritation or burning during urination.

Mostly, a thorough history and examination can help in the diagnosis of candida infections. For confirmation, a clinician can use a swab to take a sample of the discharge for microscopic analysis. 

Many women want to go for home remedies for candida infections, however, it is counter-effective to use home remedies for candida infections while pregnant. It is better to seek the advice of your healthcare provider for safer and more effective treatment options. 

Treatment

Topical azole antifungals are the mainstay of the treatment of candida infections in pregnant women. Oral antifungals are not considered safe for pregnant or lactating women. Use a topical agent prescribed to you by your healthcare provider, and for the recommended period of time (mostly seven days).

Seven days is the minimum number of days for therapy, though it can take ten to fourteen days for complete relief. Shorter duration of treatment is associated with treatment failure. 

Along with the azoles, topical low-potency corticosteroids can also be prescribed by your doctor for combatting the local inflammation and itchiness. Population based studies have found that low-potency corticosteroids do not pose an increased risk of major malformation in the babies of mothers who use these in pregnancy. 

Group B Streptococcus

This type of bacteria normally resides in the body—vagina, rectum, or intestinal tract—and does not cause disease. However, in some individuals, it can end up causing serious infection, especially so a vaginal infection during pregnancy.

Moreover, there is a risk of passing the infection to the baby during normal vaginal birth, as the baby passes through the birth canal. Even though this happens in only 1 to 2 percent of cases, GBS is not to be taken lightly. In rare cases, GBS in newborns, has been known to be fatal, as well.

Infection with GBS can present with UTIs with burning or irritation on urination, cloudy urine, or sudden urge to micturate; more serious infections can also occur with GBS, and yet in some cases, it can have no symptoms at all.

Doctors test pregnant ladies for the presence of this bacteria usually between 35 and 37 weeks of pregnancy. The test is taken with the help of a swab from the vagina and rectum and it is then cultured for the presence of bacteria. 

Treatment

If a woman tests positive for GBS or has a history of a baby with GBS, then standard therapy is to use antibiotics during delivery. The most commonly used antibiotic is penicillin during labor. The same regimen is used for women who do not know their GBS status, to prevent infection in the baby.

If you are dealing with vaginal infections then reach out to your healthcare provider for a thorough physical check-up. Book an appointment with top gynaecologist in Lahore, Multan, and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT professional for your concerns.