Once you are
pregnant, you may notice that your
vaginal discharge has increased. The discharge may be thick or thin, scanty or profuse.
Sometimes, you may find a little thick mucus sticking to your panties. Or the discharge may be so much as to make your panties wet and you need pads for protection.
Increase in the amount of vaginal discharge in pregnancy is perfectly normal.
The high level of estrogen necessary to maintain pregnancy stimulates the glands in the cervix. These respond by producing more mucous.
The glands in the walls of the vagina also responds to the circulating hormones to secrete fluids to keep the vagina wet and lubricated. These also leak out to some extent as vaginal discharge.
Vaginal secretions may be safely ignored unless there are certain signs of abnormalities.
Look at your secretions carefully –What colour are they? White or creamy? Or are they brown, red, greenish or blackish? The color of the vaginal discharge is an important indicator of infection.
Is there any smell – a foul or a fishy odour? Is there any associated itching? Is your vagina or other parts of the external genital organs red and swollen?
If you notice any of these conditions, visit your gynecologist for a checkup. You may be suffering from infections that can affect your baby. Or if your discharge is dark brown, red or blackish, there may even be blood mixed with your discharge.
White or Creamy discharge: This is normal if you do not have any itching or swelling around your genitals. If it is excessive, you can use pads for protection.
Dark Brown / Red vaginal discharge: A reddish or brownish colour usually mean the presence of blood in the discharge and indicates bleeding somewhere in the reproductive tract. A red colour points to fresh blood while a brown colour means old denatured blood.
Causes of Blood Stained Vaginal Discharge due to Bleeding
Causes of bleeding may be different at different stages of pregnancy.
- In early pregnancy the commonest cause is impending abortion. Most abortions start with the leaking of blood from the uterus. An ultrasonography will tell your doctor if your baby is all right. Immediate treatment may even keep your pregnancy safe and sound.
- In late pregnancy, there are three main causes of bleeding:
- Placenta praevia : In this condition, the placenta is positioned abnormally near the opening of your uterus. As the uterus enlarges in size, bleeding can occur from the placental base.
- Placental Abruption: There may be sudden bleeding at the base of the placenta where it is fixed to the uterine wall. This condition is called placental abruption and is more common if you have high blood pressure.
- Labour: Most labour pains start with mild bleeding from the cervix (mouth of the uterus).
- Local causes of bleeding: Sometimes local causes of bleeding in the birth canal like a cervical polyp (a small tumour of the cervix), cervical erosion or injury to the vagina either due to scratching by sharp nails or due to rough intercourse can also cause a red or brown vaginal discharge.
Dirty Discharge: Occasionally if the genitals are not kept clean, the discharge may be stained with a light brown colour. This can be differentiated from bleeding in that this discharge smells dirty and goes away after the genitals are washed thoroughly.
Infections Causing Increased Vaginal Discharge in Pregnancy
- Trichomonas vaginalis: The trichomonas vaginalis organism can be identified in as many as 20 % of all pregnant women. But it is usually dormant in most cases. Infections causing the typical symptoms of itching, irritation and foamy discharge is comparatively less. It is diagnosed by examining fresh vaginal secretions under a microscope. The organism shows up as a tiny pear-shaped body with a tail and active movements.
It is believed that acute trichomonas infections can cause premature labour or premature rupture of membranes, but this belief has not been confirmed.
Treatment: of this infection is by metronidazole tablets. But metronidazole given orally in the first trimester of pregnancy is believed to cause fetal congenital abnormalities. So, it is better to take vaginal tablets of metronidazole as they are not much absorbed through this route.
- Candida Albicans: Candida also called vaginal yeast can be cultured in about 25% of all pregnant women. It has a typical fishy odour. Serious fetal infections by candida can occur but are very rare.
Treatment: If asymptomatic, no treatment is necessary. If it causes profuse, irritating discharge however, miconazole vaginal cream 2% should be used thrice daily.
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