Diagnosing brown discharge in pregnancy

Only a doctor can reassure a pregnant woman or prepare her for the inevitable after a final diagnosis has been made, which will clarify the situation.

In the presence of severe bleeding and contraction-like pain in the lower abdomen at any stage, the best option would be to call an ambulance to your home. Patients with early pregnancy require urgent measures to preserve it, and doctors conduct diagnostics already on the way to the hospital and in the emergency room, in parallel with treatment that allows you to relieve uterine tone and stop early labor.

If the discharge is not intense and the expectant mother's health allows her to go to the children's clinic, she can come for a consultation with a doctor who will conduct a physical examination and, if possible, examine the woman on a gynecological chair, listen to information about the existing symptoms, study the patient's medical history for concomitant diseases (hereditary and acquired) and problematic pregnancies.

If there is any unusual discharge, the doctor takes a smear for microflora. If there is a suspicion of tumor processes, cervical dysplasia, endometriosis, cervical erosion, a colposcopy is performed and material is taken from the mucous membrane for cytological examination. A biopsy and histological examination if there is a suspicion of oncology is performed only if there are serious grounds and a threat to the life of the expectant mother, because this study is not so harmless and can harm the pregnancy.

A clinical blood test and coagulogram will help the doctor assess whether the expectant mother has a blood clotting disorder or inflammatory diseases without specifying their location. But a gynecological examination of the vaginal and uterine mucosa, as well as a smear for microflora will help give the inflammatory process an appropriate name and identify its infectious agent. A urine test will help confirm or refute urinary system pathologies, which are not uncommon in pregnant women and may be accompanied by the release of brown or red blood in the urine.

There are also specific tests that allow detecting fetal developmental abnormalities and the threat of miscarriage already in the early stages of pregnancy. There are 2 screening tests that can be prescribed when a pregnant woman has brown discharge. The first test is taken between the 8th and 13th week of pregnancy, when the threat of miscarriage and fetal fading are usually diagnosed. The test is called double, since it involves taking blood for human chorionic gonadotropin (hCG) and plasma protein A (PAPP-A).

At 16-20 weeks, a comprehensive study may be prescribed, consisting of 4 tests. In addition to the above, studies on alpha-fetoprotein (AFP) and unconjugated estriol (UE) are relevant at that time.

Pregnant women are required to take tests for syphilis, hepatitis and HIV infection when registering at a women's consultation center for pregnancy. But in some cases, a gynecologist may prescribe a repeat test if several months have passed from the time of pregnancy diagnosis until the appearance of brown discharge.

All these tests provide the doctor with information about the peculiarities of the pregnancy. But you shouldn't take a bad result as a death sentence, the risk of error is too high, for example, due to an inaccurately established pregnancy period. After all, each time period has its own clear norms for the content of specific hormones in the blood, and a deviation from these norms is considered a bad result. It is clear that if the pregnancy periods do not match or there is more than one embryo, deviations from the norm will be very likely, which is not at all associated with pregnancy pathology.

Instrumental diagnostics is considered more informative in case of pregnancy complications. Not all of its methods are equally safe for the expectant mother and the child in her womb. The most acceptable and quite informative diagnostic method during this period is ultrasound. It is on its basis that the doctor can establish a more accurate age of the embryo, and the features of its development, and various deviations from normal parameters, and pathologies of the placenta.

Ideally, a pregnant woman should undergo ultrasound at least three times over 9 months. That is, the expectant mother should be examined at least once per trimester. But if brown discharge appears, the doctor may prescribe an unscheduled examination, because ultrasound waves do not have a negative effect on the fetus and cannot provoke pregnancy disorders. But they are quite capable of identifying possible pathologies and visualizing them.

Differential diagnostics is a very important stage in identifying the problem causing symptoms of brown discharge during pregnancy. We have already tried to predict a possible diagnosis based on the nature, color, and time of discharge, and it turned out to be very difficult. The same symptoms can indicate completely different diseases and conditions. It is very important for a doctor not only to differentiate normal discharge from pathological ones, but also to identify the cause causing the appearance of such a non-specific symptom.

Usually, an accurate diagnosis can be made by studying the results of laboratory tests and instrumental diagnostics, as well as information obtained during the initial appointment with a patient complaining of a strange symptom. But in some questionable cases, additional diagnostic methods must also be prescribed: chorion biopsy (at 12 weeks of pregnancy), examination of placenta cells (placentocentesis is performed from 12 to 22 weeks), examination of the characteristics of amniotic fluid (amniocentesis is relevant at 15-16 weeks) and blood from the umbilical cord (cordocentesis is performed starting from the 20th week of pregnancy).

Additional research methods help to make a diagnosis in controversial situations and in the presence of several pathologies at the same time, when the symptoms of brown discharge during pregnancy do not allow to clearly determine their cause, and laboratory blood or urine tests and ultrasound have some discrepancies. However, such manipulations are associated with a certain risk for the fetus and the pregnant woman, so they are prescribed infrequently and only in cases of extreme necessity, when standard diagnostics are not able to identify the source of the problem.

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