Common Discomforts of Pregnancy

Common Discomforts of Pregnancy

Caroline Derrick RN, BSN

TOPIC: Leukorrhea in Pregnancy

Physiologic basis:

During pregnancy, the increased blood flow to the vaginal area may cause an increase in vaginal discharge. This discharge is often times thin/thick, white and milky in consistency. It may have a yellowish tint as well as a mild odor. However, it should not have a bad odor, in which this would indicate a possible infection. This discharge generally increases as the pregnancy progresses and is a normal physiological finding of pregnancy.

Differential diagnosis:

· Candidiasis (yeast infection)

· STI such as:

1. Bacterial Vaginosis (BV)

2. N Gonorrhea

3. Chlamydia

4. Trichomonas Vaginalis

5. PID

Relief measures:

· Since there is more discharge during pregnancy, there may be an increased chance for vaginal infections. Be sure to wear cotton panties and avoid wearing panty hose and tight fitting clothing.

· Wash your hands thoroughly before contact with the vagina

· Wipe from front to back

· Try eating a cup of yogurt daily; it contains lactobacillus acidophilus, which fights infection.

· Purge refined sugar from your diet

· Sexual intercourse is permitted during pregnancy; however refrain from intercourse if a vaginal infection is present (partner may need to be treated as well). Avoid introducing new and/or multiple partners.

· Practitioners recommend NOT douching during pregnancy as the pressure of the douche entering the vagina may cause an air embolism or introduce infection. You may wear sanitary napkins (pads) to absorb any of the discharge during pregnancy.

· Do NOT use Tampons as they may introduce bacteria to the vagina.

· Do NOT assume that it is a vaginal infection and self treat.

· Notify the practitioner with ANY changes in discharge.

Patient education and counseling:

The normal presence of the discharge during pregnancy will be thin/thick and white, but it may be a yellowish color without any bad odor accompanying the discharge. If you have an infection, the discharge may be yellow or greenish in color and may have a bad odor accompanying the discharge. The vaginal area may be irritated and you may notice redness, burning, swelling or itching. Vaginal infections are generally termed as bacterial vaginitis, which may or may not lead to a yeast infection. Notify your practiotioner IMMEDIATELY with any changes in characteristics of discharge.

References

American Pregnancy Association (2004). Retrieved on January 2, 2004 from:

http://www.americanpregnancy.org/pregnancyhealth/vaginaldischarge.html

Hakakha, M.M., Davis, J., Korst, L.M., Silverman, N.S. (2002). Leukorrhea and bacterial

Vaginosis as in-office predictors of cervical infection in high-risk women.

Obstetrics & Gynocology, 100, 808-812.

McGregor, James A. MD, CM and Janice I. French (2000).Bacterial Vaginosis in Pregnancy.

Obstetrical & Gynecological Surve. 55(5) Supplement 1:1-19.

Riggs, Margaret A & Klebanoff, Mark A (2004). Treatment of Vaginal Infections to Prevent

Preterm Birth: A Meta-Analysis. Clinical Obstetrics & Gynecology. 47(4):796-807.