Pregnancy is a lot more complicated than it seems. It involves extensive anatomical, biochemical, physiological, psychological, immunological as well as social changes in a mother’s life. Thus a mother becomes more prone to many diseases. TORCH syndrome is such a group of disorders which are more susceptible in a pregnant woman. TORCH syndrome includes toxoplasmosis, rubella, cytomegalovirus, hepatitis b and others like herpes. One of these susceptible infections is bacterial vaginosis.

Bacterial Vaginosis During Pregnancy

What is Bacterial Vaginosis?

Bacterial vaginosis is infection of vagina with bacteria. It leads to milky discharge through vagina. A woman is more susceptible during the child bearing period. There is no inflammation, only infection thus there is no fever or rashes. Vaginosis is also caused by fungus and protozoa, but bacterial is more common.

Causes

Bacterial

• Peptococcus
• Gardenella vaginalis
• Mobiluncus
• Mycoplasm homnis

Protozoan

• Trichomonas vaginalis

Symptoms

• Discharge from vagina– there is gray white discharge from vagina. It is greenish yellow to white in colour. It is thin but adherent to vaginal wall.
• Whiff test– whiff test may be ordered by the doctor. Whiff test is a simple test done at bed side. In this test some of the discharge is taken and 10% potassium hydroxide solution is added to it. It turns out to be positive in an infection.
• Odour of discharge– the vaginal discharge gives a fishy smell.
• Itching– sometimes you may even experience itching near the vaginal area.

Complications

Pelvic inflammatory diseases– recurrent infection of bacteria may cause pelvic inflammatory diseases. Pelvic inflammatory disease is the infection of the upper reproductive organs like uterus and ovaries. Infection of uterus is very dangerous during pregnancy. Symptoms of pelvis infection may be lower abdominal pain, vaginal discharge, bleeding during pregnancy, itching and uneasiness in vagina. Any vaginal infection should be prevented and treated immediately during pregnancy.

Abortion– if the infection travels to the uterus there is risk of abortion or even foetal malformation. The bacteria may cause hindrance in growth of the baby.

Vaginal cuff cellulites– vaginal cuff cellulites is the infection of upper layer of tissue of vagina. Patients with continuous moderate bacterial infection may suffer from it. It is very dangerous in pregnancy. It should be treated as soon as possible.

Complications in pregnancy– bacterial infection may cause complications in pregnancy such as hindrance in growth and development of the foetus. Labour may be delayed or advanced. Miscarriage in 2^nd trimester is also possible.

PROM– premature rupture of membranes is possible. Sometimes due it bacterial infection there may be a premature rupture of sac containing the baby. It may happen before the beginning of the labour.

Pre term birth– there may be pre term delivery of the baby. Caesarean section or assisted births are required. Even some organs of baby may remain under developed due to which there may be formation of anomaly in baby.

Endometriosis – endometrium means the inner wall of the uterus. During pregnancy it grows very thick to support the baby. The infection may spread to the endometrium, which is very risky for the baby.

Prevention

Maintaining proper vaginal hygiene– proper vaginal hygiene should always be maintained. Some of the points to be taken care are-

• Clean and washed underwear should be worn. Cotton underwear are preferable, they allow your skin to breath and also absorb the sweat.
• Do not wash your vagina with soap and water, it increases the vaginal ph. Vaginal ph is a important defence mechanism against various bacteria
• Drink plenty of water to flush out toxins from your body.
• Avoid sexual intercourse if your partner is suffering from any type of infection.
• Avoid sexual intercourse in late pregnancy.

Taking proper vaccination during pregnancy– mother is given rubella, hepatitis and other required vaccine during pregnancy to protect her and the baby from various dangerous infections; all those vaccine should be taken. Vaccines protect your child from bacteria and virus which may be proven most dangerous during pregnancy.

Not missing any antenatal or post natal visits- there are a schedule of antenatal and post natal visits, they should not be missed. Antenatal visits include monitoring the growth and development of your child as well as monitoring your health. Postnatal visits mainly include vaccination and checking the growth of your baby. To be secure and stress free do not miss these visits.

Avoiding any external applications to vagina– during pregnancy avoid applying any king of gel, jelly, cream or powder to your vagina unless prescribed. Avoid using any kind of self prescribed drugs.

Consulting doctor for problems– for any kind of unusual pain, uneasiness, unusual discharge or bleeding, consult your doctor immediately.

Obtaining information from trusted sources- of course you will be excited about knowing more about pregnancy and your baby. But gain that information from trusted websites, trusted people and reliable sources only.

Making sure your sexual partner is healthy- before having sex during pregnancy, always make sure your partner is completely healthy. It is always better to use condom even if there is no risk of pregnancy.

Treatment

Tablets– doctors may prescribe antibiotic. Complete the course of antibiotics. Do not leave the course in middle. Otherwise infection may reoccur. A recurrent infection causes serious effects and complications. Also they cause resistance in bacteria for the drug. So complete your course regularly and get checked from time to time.

Gel– an antibacterial gel might be prescribed to apply to vagina. It has to be applied either by clean hand or directly by the tube. Before applying, hands must be washed properly, dried and then it should be applied.

Diagnosis

Doctor may tell you that clue cells are present in your discharge. They are nothing but vaginal epithelial cells which get covered by bacteria which have caused the infection and thus our cells appear stippled. If these stippled cells are observed under microscope than a diagnosis of bacterial vaginosis can be made. This is confirming diagnosis. But this test requires time so some clinical methods for diagnosis are-

• Checking the nature of the discharge.
• Litmus papers test to test the vaginal ph. It increases in this vaginosis.
• Odour of discharge.

Thus as we can see any type of vaginal infection during pregnancy is very dangerous to the baby as well as to the mother. It should be treated as soon as possible. All the medications should be taken as indicated. And efforts should be made to prevent these infections. After all a healthy mother nurtures a healthy baby!