Vaginal discharge during pregnancy is not uncommon as vaginal secretions increase, so a slight extra moistness is normal. However, if the discharge entails wearing extra protection and especially if it causes irritation of the vulval skin, the mother-to-be should consult her doctor.
This is the commonest cause of irritation and excessive vaginal discharge in pregnancy. It is caused by a yeast-like germ, called Candida albicans. The organism is a frequent inhabitant of the skin of normal healthy women and men, but it only causes symptoms and discomfort in conditions of warmth, moisture and sugar, all of which are present in a pregnant woman’s vaginal and vulval skin.
Sometimes the germ is passed on from the skin of the husband’s penis and he may also complain of a skin irritation. The discharge is white or yellow and looks rather like milk curds. The irritation is often severe and is especially uncomfortable in bed at night.
Fortunately, there are a number of effective treatments, the best known of which is nystatin. Putting a pessary of this substance into the vagina every night, and rubbing nystatin cream into the itching skin night and morning for a week, will usually clear up the symptoms rapidly. Recurrence is, however, common, and pessaries and cream should be kept readily available, so that a further course of treatment can be started as soon as the symptoms reappear.
Patients sometimes become discouraged in the first few days of treatment because the discharge does not show immediate improvement. It is important to remember that some discharge can be expected until the treatment is completed. Irritation should clear up within a day or two of starting treatment.
A vaginal infection caused by a trichomonas vaginalis germ is quite common in pregnancy. This causes an unpleasant vaginal discharge and irritation of the vulval skin. The infection comes from an infected man who often does not have any symptoms himself The treatment is a course of antibiotic tablets. The tablets are taken by mouth and the male partner needs to be treated at the same time if re-infection is to be avoided.
Gonorrhea is a common venereal disease which can occur in pregnant as well as non-pregnant women. It causes an excessive vaginal discharge, but no irritation. The germ involved is the gonococcus and the only way that it can enter the vagina is by the woman having intercourse with an infected man.
Any pregnant woman who experiences a heavy, yellow, vaginal discharge which does not irritate, or who thinks she may have had intercourse with an infected partner, should seek immediate medical advice. The infection can easily be cleared up with an injection or a course of injections of penicillin. Unless the infection is cleared up before delivery, the baby’s eyes may be infected and permanently damaged.
Very occasionally the herpes virus, which causes cold-sores on the lips, can infect the vulval skin and vagina. The small blisters that form are very painful and may cause a watery vaginal discharge. This condition usually clears up within ten to fourteen days without treatment, but the doctor should always be consulted in order to ensure that the infection is completely cleared up before the baby is delivered. In this way, infection of the baby can be avoided.
A blood-stained discharge may indicate a threatened abortion in early pregnancy or the onset of labor in late pregnancy. In mid-pregnancy a blood-stained discharge may follow intercourse if the patient has a cervical erosion. Cervical erosions occur on the cervix and are the result of thinning of the normal cervical skin covering.
The thinner skin looks red and bleeds readily when rubbed. Apart from causing a blood-stained discharge, the erosion does no harm and will often clear up spontaneously after the pregnancy is over.
A watery discharge in late pregnancy may be the result of ruptured membranes. In the normal course of events, there is a definite small gush of clear fluid when the membranes rupture, but sometimes the rupture is very small and the usual gush is replaced by a watery drip. labor is likely to start soon after, so the doctor should be consulted. If there is any doubt the woman should go into hospital.