Vaginal discharge during pregnancy

Symptoms of normal discharge include:

• Thin or thick mucus
• White or milky colour
• Mild smelling
• Streaks of blood towards the end of pregnancy

Symptoms of infected or abnormal discharge include:

• Discolouration which could be yellow, green or grey in colour
• Odour which could be foul and strong
• Redness or itching
• Swelling of the vulva

The main causes of normal vaginal discharge include:

• Changes in the hormonal levels and the cervix (to allow baby to pass through)
• Bodily changes to help prevent infections
• Baby’s head pressing against the cervix (towards the end of the pregnancy)

Abnormal discharge can be caused by:

• Infections, commonly vaginal yeast infections
• Sexually transmitted disease (STD)
• Pregnancy-related complications, such as placenta previa or placental abruption
• A retained foreign material (tampon, condom) or inflammation (due to disinfectants, deodorants or lubricants)
• Cervical ectopy or polyps
• Tumours

The physician will take a complete history, including sexual and medication history, and also conduct a thorough examination of the vagina and the cervix using speculum, abdominal palpation and bimanual examination. Further tests which could be advised include:

• Testing the pH of vaginal secretions
• High vaginal swab (HVS)
• A triple NAAT (nucleic acid amplification test) for chlamydia, gonorrhoea and trichomoniasis
• Chlamydia screening
• Screening for STDs

Management of vaginal discharge includes preventive as well as treatment measures such as:

• Trying to avoid infection by using comfortable, loose cotton underwear and keeping the genital area dry.
• Adding yoghurt and other fermented foods to your diet to promote vaginal health.
• To treat infections, vaginal creams or suppositories are advised, which could include:
  • Fluconazole
  • Clotrimazole
  • Metronidazole
  • Clindamycin 2% cream
  • Itraconazole