From the Guidelines
Increased vaginal discharge during pregnancy is normal and common, but it's essential to monitor its characteristics to ensure it doesn't indicate an underlying infection. Most pregnant women experience more discharge, which is typically white or yellowish in color and has a mild odor or no odor at all. This increase happens because of higher estrogen levels and increased blood flow to the vaginal area, which stimulates the mucous membranes to produce more secretions. The discharge, called leukorrhea, helps protect the birth canal from infections by maintaining a healthy pH balance and flushing away dead cells. While abundant discharge is typically normal, you should contact your healthcare provider if the discharge has a strong unpleasant odor, is green or gray, causes significant itching or burning, or is accompanied by redness or swelling. These could indicate an infection like bacterial vaginosis, yeast infection, or sexually transmitted infection that requires treatment, as noted in guidelines for treating STDs 1. Don't douche or use scented products to manage discharge, as these can disrupt your vaginal flora and potentially cause infections. Instead, wear cotton underwear, avoid tight clothing, and use unscented panty liners if needed to stay comfortable. It's also important to note that bacterial vaginosis (BV) during pregnancy is associated with adverse pregnancy outcomes, including premature rupture of the membranes, preterm labor, preterm birth, and postpartum endometritis, as highlighted in the 2002 guidelines for treating STDs 1. Therefore, if you experience any unusual symptoms or concerns, it's crucial to consult your healthcare provider for proper evaluation and treatment, as they may recommend testing and treatment for BV or other infections, and a follow-up evaluation to verify the effectiveness of therapy 1.
From the Research
Normal Discharge in Pregnancy
- A certain amount of white or yellow discharge is normal in pregnancy, but excessive discharge can be a sign of an underlying infection 2, 3.
- Bacterial vaginosis is a common cause of abnormal discharge in pregnancy, and it can be treated with antibiotics such as metronidazole or clindamycin 2, 3, 4.
- However, not all discharge is caused by bacterial vaginosis, and other conditions such as candidiasis (yeast infection) can also cause abnormal discharge 5, 6.
When to Seek Medical Attention
- If the discharge is heavy, foul-smelling, or accompanied by other symptoms such as itching, burning, or pain, it is recommended to seek medical attention 2, 3, 4.
- Pregnant women with symptoms of bacterial vaginosis or candidiasis should be treated to prevent complications and relieve symptoms 2, 3, 5, 6.
Treatment Options
- Metronidazole and clindamycin are commonly used to treat bacterial vaginosis in pregnancy 2, 3, 4.
- Fluconazole and clotrimazole can be used to treat candidiasis in pregnancy 5, 6.
- A combined treatment approach using both systemic and topical therapies may be effective in preventing recurrent candidiasis 6.