Protein discharge in pregnancy

Discharge of leucorrhoea during pregnancy is a fairly common occurrence, and its nature can indicate a particular problem. Often women do not suspect the changes that can occur during pregnancy, so you need to know about all the possible causes and symptoms that are accompanied by discharge of different nature. The need for treatment and its main principles depend on the type of pathology that contributes to such discharge.

Epidemiology

The epidemiology of the problem of developing diseases of the genital organs in pregnant women is associated with infection with various microorganisms during this period due to the state of immunosuppression. More than 90% of such diseases are accompanied by the release of leucorrhoea, which helps in diagnosis. Cases of primary infection during pregnancy are insignificant, since when pregnancy occurs, women try to take care of their health. Therefore, about 78% of cases of diseases are characterized by secondary infection or activation of a chronic process.

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Causes whitish discharge in pregnancy

To understand the reasons for the discharge of leucorrhoea, it is necessary to know what it should be like under normal conditions and why it occurs.

The female body is exposed to many sex hormones throughout life. They regulate not only the function of the genitals but also the normal functioning of many internal organs of the female body. The main sex hormones that affect the female body throughout the cycle are progesterone and estrogens. The concentration of these hormones changes throughout the cycle, and thus the structure and functioning of the internal genitals changes.

Speaking about the discharge that a healthy woman has throughout her life, it should be noted that normally such discharge has characteristic features. Naturally, this process is individual and their quantity is also special, but there are normative values that are accepted as normal discharge, and are called leucorrhoea. In its structure, this secretion consists of the mucous contents of the vagina, epithelial cells, some bacteria and their membranes, as well as some acids. During the menstrual cycle, the epithelium of the cervix, vagina, endometrium has the property of going through different phases of mitotic division. As a result, all old cells are replaced by new ones, and all unnecessary dead cells are exfoliated into the cervical canal. In addition, opportunistic bacteria called Doderlein's bacilli live in the vagina under normal conditions. These bacteria perform a very important function - they convert glycogen of cells into lactic acid, and in turn, lactic acid provides an acidic environment in the vagina, which prevents pathogenic microorganisms from multiplying. Under the influence of progesterone, the glandular cells of the cervical canal secrete a certain amount of mucus, and all these components - mucus, lactic acid, desquamated cells - are the secretions that are called leucorrhoea. Such secretions are cyclical throughout the cycle, and due to this, most often at the beginning of the cycle, the greatest amount of secretions, and then, due to the decrease in the effect of progesterone, their amount also decreases. The color of the leucorrhoea can fluctuate - under normal conditions, the color is either white or transparent, and the amount can be from insignificant to abundant, which is a feature of each woman. Leucorrhoea should not cause any odor or unpleasant sensations.

Pregnant women usually experience an increase in the amount of leucorrhoea, which is associated with increased progesterone activity. But despite this, their nature does not change - they are still white or transparent, odorless and without additional properties. There are cases when women notice that the nature of their discharge has changed during pregnancy, and in order to find out the reason, it is necessary to know these factors that can influence the change in their nature.

Pregnancy is a period of immunosuppression of the female body. At the same time, all systems can suffer from reduced immunity, and the organs of the reproductive system are no exception. When the body is not ready to fight pathogenic microorganisms with the same force, it can be exposed to the development of diseases to a greater extent, so the very fact of pregnancy can already be a risk factor for the development of changes in the nature and properties of leucorrhoea. Symptoms of the development of different diseases are characterized by different properties. Among the main reasons for changes in the nature of leucorrhoea is infection with pathogenic microorganisms such as fungi, trichomonas, gonococci, genital herpes, ureaplasma and some other organisms. Therefore, the main reason for changes in the nature of leucorrhoea during pregnancy is a local infectious disease. But we should not forget about other possible causes, such as taking antibacterial agents. In this case, antibiotics not only kill the cause of the disease for which they are taken, but they also kill the "good" opportunistic bacteria of the intestines and vagina, in this case, Doderlein's bacilli. Therefore, simply taking antibiotics can cause candidiasis or bacterial vaginosis, which are the cause of leucorrhoea during pregnancy.

If any chronic process is activated during pregnancy, for example, chronic adnexitis, then this may also be accompanied by the release of leucorrhoea. But in addition to this, there are other symptoms that need to be taken into account.

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Pathogenesis

The pathogenesis of abnormal discharge patterns in certain diseases is that bacteria disrupt the normal life processes of the cells of the cervical canal and vagina, and those dead cells are released with the secretion. The local immune system reacts to the bacteria entering the genitals, and those leukocytes that kill the pathogen are also released with the secretion. Therefore, the nature of the discharge changes.

Thus, leucorrhoea during pregnancy can be the main guide to the state of local immunity in a woman. Any changes in their nature can be a consequence of a disease that must be diagnosed and treated as soon as possible, because there is a risk of infection of the fetus.

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Symptoms whitish discharge in pregnancy

The color of leucorrhoea during pregnancy can indicate a lot about the development of a disease or a normal process in the reproductive system. Sometimes leucorrhoea, as a sign of pregnancy, can change its character, which can prompt a woman about the possibility of pregnancy. This happens because the increased secretion of progesterone stimulates the functioning of glandular cells and the amount of leucorrhoea increases when it occurs. They do not change their normal character, but abundant leucorrhoea during pregnancy is a normal phenomenon. Leucorrhoea during early pregnancy has exactly this character and white color. Discharge in the second trimester of pregnancy becomes more viscous, which protects the fetus with the gradual formation of a mucous plug. Therefore, during this period, they can have the appearance of a dense glassy transparent mass, which is not worth worrying about.

Symptoms of leucorrhoea during pregnancy should first of all be differentiated for each disease separately. The first signs of a particular pathology are a change in the color and nature of vaginal discharge.

Bacterial vaginosis is a disease whose main clinical symptom is the release of leucorrhoea, which has an unpleasant fishy smell, an alkaline environment and causes a lot of unpleasant sensations. Under normal conditions, the ratio of aerobic and anaerobic microorganisms is such that aerobes predominate. Under certain conditions, the number of aerobic microorganisms decreases, which leads to a violation of the microflora and a shift in the pH of the vagina, and this is a factor in the reproduction of various pathogenic microorganisms. Leucorrhoea in this disease, due to its alkaline secretion, irritates the mucous membrane and causes itching, burning, tingling and has a sharp unpleasant odor.

If the discharge is white or gray and cheesy, causing severe itching, then we are talking about candidiasis or thrush - a fungal infection. This often develops against the background of taking antibacterial drugs or simply against the background of decreased immunity.

Trichomoniasis is a disease caused by trichomonas and characterized by specific vaginal discharge. Such leucorrhoea is foamy in nature and yellow-green in color, its quantity is quite large and it also causes itching and burning of the genitals.

Gonorrhea is characterized by the appearance of green or yellow discharge, uniform mucous thick in nature. Gonococci, which cause this pathology, are located intracellularly, so the symptoms can bother for a long time.

If the cause of the discharge of leucorrhoea is an exacerbation of chronic adnexitis or oophoritis, then the leucorrhoea is purulent in nature, yellow or green in color and has a characteristic odor.

Complications and consequences

The consequence of untimely diagnosis of infectious lesions may be the penetration of bacteria through the placenta, which, depending on the gestational age, may manifest itself as a teratogenic effect on the fetus. Sometimes such bacteria can cause fetoplacental insufficiency or directly affect the fetus with the development of congenital defects.

Complications that may arise due to untimely diagnosis of infectious lesions are very serious, so it is necessary to pay attention to any changes in the nature of leucorrhoea, especially in pregnant women.

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Diagnostics whitish discharge in pregnancy

Diagnostics should be as broad as possible, and should begin with anamnesis. After all, thanks to a correctly collected anamnesis, it is possible to establish the moment when the nature of leucorrhoea first changed.

During a vaginal examination, it is sometimes enough to just see the nature of the discharge, which may suggest a possible diagnosis, but to clarify it, additional examinations are needed.

Tests that allow you to accurately determine the cause of changes in leucorrhoea are a study of vaginal secretions. This study involves taking a smear from the vagina and then placing this material under a microscope. If necessary, the material can be sown on a nutrient medium. The result of this study makes it possible to determine the pathogenic microorganism. For example, if the pathogen is gonococcus, then under the microscope you can see the pathogen inside the leukocytes in the form of coffee beans - this is a characteristic and specific sign of the disease. Sometimes leukocytes can be detected in the vaginal secretion, which indicates a purulent process. In bacterial vaginosis, key cells or gardnerella are detected in the vaginal secretion, which are a pathognomonic symptom of this disease. This is an important diagnostic sign.

Instrumental diagnostics when certain discharges appear can be limited to those cases when it is necessary to exclude chronic inflammatory processes. Sometimes, with chronic oophoritis or ovarian cysts, the nature of discharge in a pregnant woman can change. Then it is necessary to conduct an ultrasound examination and determine the function of the ovaries and surrounding tissues. In addition, ultrasound helps to diagnose the condition of the fetus and exclude developmental disorders. Sometimes, if necessary, it is possible to conduct a colposcopy and, using targeted biopsy, conduct a more accurate study of the secretion.

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Differential diagnosis

Differential diagnostics of discharge is aimed at identifying a particular pathogen in order to accurately establish a diagnosis, since treatment is strictly etiological in nature.

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Treatment whitish discharge in pregnancy

Treatment of different types of leucorrhoea depends directly on the pathogen, because there are microorganisms that are sensitive to certain antibacterial agents. The main principle of treatment is complex. It is important to use systemic antibiotics against the background of local therapy. The best means of local treatment are suppositories.

1. Josamycin is an antibiotic from the macrolide group, which is the drug of choice for the treatment of pathologies caused by intracellular microorganisms, such as gonorrhea, ureaplasmosis, trichomoniasis. The use of this drug is systemic, but it must be combined with local agents. The drug penetrates the cell and blocks the work of the microbial wall, thus neutralizing the bacterium itself. The dosage of the drug is one tablet twice a day. The course of treatment is selected individually, depending on the pathogen. Side effects are possible in the form of stomach pain, dizziness, decreased blood pressure. Precautions - do not take if you have kidney disease.
2. Metronidazole is an antibacterial drug from the imidazole group, which is the drug of choice for the treatment of trichomoniasis and some diseases caused by anaerobic microorganisms. It is especially effective against anaerobes, so it can be used to treat bacterial vaginitis and vaginosis. The drug is used in the form of vaginal tablets or suppositories and its dosage is one suppository once a day for ten days. Side effects of spiramycin are paresthesia, impaired skin sensitivity, numbness of the arms and legs, tremor, impaired bile flow, and dyspepsia. Precautions - the use of the drug during pregnancy for the treatment of trichomoniasis is decided only by a doctor, because the drug can be toxic to the child. Therefore, it is necessary to consider the ratio of benefits and harms.
3. Terzhinan is a combination product that contains two antibacterial drugs (neomycin and ternidazole), an antifungal drug (nystatin) and a hormonal drug (prednisolone). Due to this composition, it has a wide spectrum of action and, due to its local action, helps to get rid of acute infections. The drug is available in tablet pharmacological form and the dosage is one tablet at night for a course of ten or six days. How to use the drug - one vaginal tablet must be inserted into the applicator and inserted into the vagina with the applicator at night. After this, you need to lie down for some time in a horizontal position for the best effect of the drug. Side effects are rare due to the predominant local action of the drug, but dizziness and headache may occur, as well as local burning and itching in the area of application of the drug.
4. Pimafucin is an antifungal drug that is considered the most suitable for treating candidiasis in pregnant women, as it penetrates the fetoplacental barrier to the least extent. The active ingredient of the drug is natamycin, an antibiotic from the macrolide group, which acts on fungal flora. The method of administration of the drug is in vaginal tablets at the same time of day. The dosage of the drug is one tablet per day for three or six days. Side effects are possible from the gastrointestinal tract in the form of stool disorders, nausea, a feeling of bitterness in the mouth, and fluid retention is possible. Precautions - in case of using antibiotics, the effectiveness of the drug is reduced, so it is necessary to dose the drugs correctly and take into account their interaction, taking medications with a break.
5. Local remedies for restoring microflora and improving local immunity function after antibiotic treatment are a mandatory component of treatment, especially for pregnant women. For this purpose, probiotics are used, which are best applied locally - this promotes rapid restoration of the function of Doderlein bacilli and other aerobic opportunistic bacteria.

Ecovag is a drug from the group of combined probiotics, the main active ingredient of which is lactobacilli of two different types. Due to this composition, the drug has a two-way effect - normalization of the vaginal microflora and enhancement of the effect of the treatment. The drug is used in the form of tablets. Dosage - one tablet per day, method of administration - vaginally. Side effects are rare, local manifestations of discomfort and burning are possible.

Vitamins and physiotherapy treatment of infectious diseases during pregnancy can be used in combination if there are no contraindications from the woman and the fetus.

Surgical treatment of this pathology is not used.

Folk remedies for leucorrhoea during pregnancy

Traditional methods of treating infectious lesions of the genital tract during pregnancy are very effective, so they are widely used in complex treatment.

1. Compresses are very useful for treating pathological discharge. For a compress, you can use ten drops of tea tree oil and calendula infusion, adding a few drops of olive oil to it. From this solution, you need to make a tampon and insert it into the vagina for two hours. Such a compress contains many antibacterial agents.
2. Sea buckthorn is recommended as an antibacterial and immunomodulatory agent. To do this, take sea buckthorn oil and apply the oil to a tampon, insert it into the vagina for twenty minutes. This product has excellent moisturizing properties, which will relieve irritation after treatment with suppositories or antibiotics.
3. A good remedy for treating vaginal discharge is considered to be the use of a solution of chamomile, plantain and kefir as a means for washing. For a liter of water, take three bags of chamomile or one hundred grams of grass, three plantain leaves and simmer for twenty minutes. After the solution has cooled, add three tablespoons of low-fat kefir and use such a bath for washing. Repeat the procedure for ten days.
4. Calendula ointment is a remedy that is widely used for this pathology due to its natural composition and rich properties. Calendula is a natural source of minerals and many microelements. Calendula flowers contain vitamins of different groups - A, C, D and various microelements. This plant contains active substances and polyunsaturated acids - which improves local metabolic processes in the cell and stimulates the metabolism of the whole body, providing antibacterial and antifungal agents. For treatment, calendula ointment can be used by diluting it in water and using it for washing. The use of pure ointment during pregnancy should be cautious.

Herbs are also widely used in the treatment of this pathology.

1. Infusion of modrina, rose hips and succession leaves is especially effective in treating leucorrhoea during pregnancy caused by anaerobes. To prepare a medicinal tea, take ten grams of herbs, pour half a liter of water, and then, after it has been infused for twenty minutes, strain and drink. Dosage - about a liter of tea should be drunk per day, controlling other fluids in the presence of edema.
2. Meadowsweet is a plant that helps stimulate the function of vaginal endothelial cells and activate local immunity, has an anti-inflammatory effect and prevents the development of secondary bacterial infections. To prepare a medicinal tea, take 50 grams of meadowsweet leaves, boil them over low heat for five to ten minutes and then strain. Drink this tea three times a day, half a cup at a time.
3. Yarrow has a tropism for vaginal tissue and helps reduce the severity of itching and dryness during the development of bacterial lesions. An infusion can be made by boiling yarrow leaves in hot water for ten minutes, and then after it cools down, take a shot of the solution twice a day. This remedy also has a systemic immunomodulatory effect.

Homeopathy is widely used in the treatment of leucorrhoea during pregnancy, especially in chronic inflammatory processes.

1. Carbonia is a homeopathic remedy that has a composition of organic agents and helps to normalize local immunity of the vagina, restore interferons and normalize microflora. Method of application - in the pharmacological form of homeopathic drops, dosage - three drops three times a day for the first month, then two drops a day. The course of treatment with the drug is long - about three months. No side effects have been identified. Contraindications to taking Carbonia are allergies to peonies.
2. Crocus is a plant that improves tissue trophism, reduces the severity of burning and vaginal dryness due to its softening properties and has a number of antibacterial substances. The drug is especially effective in the presence of early gestosis, which is accompanied by nausea and constipation, which further affects the vaginal microflora. The drug is available in granules and is dosed at six granules every six hours.
3. Granulosa phosphoricus is a homeopathic remedy of inorganic origin. The drug has a regenerating effect, improves local blood circulation and lymph flow, which increases the effectiveness of the drug in concomitant circulatory disorders in the placenta. The method of application of the drug is three drops three times a day, under the control of the heartbeat - if tachycardia occurs, the dose can be reduced. No side effects have been identified. Precautions - do not take if you are allergic to plant pollen.
4. Adonis vernalis is a homeopathic herbal remedy that is effective in inflammatory diseases of the ovary. It is used to treat leucorrhoea in patients with severe nagging pain in the lower abdomen due to its antispasmodic effect. It is available in the form of drops and is used in a dosage of eight drops per dose. Directions for use: drip the solution into 100 milliliters of boiled water and drink half an hour before meals. The course of treatment can be started before pregnancy if the woman has hepatitis, with a dose of three drops, and then take eight drops throughout pregnancy. Precautions: it is not recommended to use the drug in women with arterial hypertension or gestosis. Side effects are rare, allergic skin reactions are possible.

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Prevention

Prevention of the development of various complications that can be caused by pathological discharge of leucorrhoea during pregnancy consists of non-specific measures. It is necessary to undergo all diagnostic examinations during pregnancy in a timely manner, to take the necessary tests.

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Forecast

It is very important to stick to a healthy diet so that the intestinal microflora contributes to a high immune status. If any changes in health occur, you should consult a doctor to diagnose the problem, then the prognosis for resolving the problem will be favorable.

White discharge during pregnancy can often indicate the condition of a woman, because it is the secret of the vital activity of the local flora. In order for the pregnancy to proceed without complications and there to be no infectious lesions, it is necessary to monitor the hygiene, nutrition and general health of the pregnant woman. In case of any changes in vaginal discharge, you need to consult a doctor, because at the initial stages any pathologies are easier to treat.

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