Is increased vaginal discharge normal during pregnancy?

Is increased vaginal discharge normal during pregnancy?

Author｜Xiao Yanqun

Source｜Medical World Obstetrics and Gynecology Channel

Editor's Note: As the saying goes, "nine out of ten women experience vaginal discharge," which shows how common abnormal vaginal discharge is! For some young women who feel embarrassed to see a doctor about abnormal discharge, it's nothing to be ashamed of; gynecologists see it all... Whether during pregnancy or at any other time, if you experience any abnormalities, you should seek professional help and never self-medicate!

What is vaginal discharge? In layman's terms, it's vaginal secretions. The textbook definition is a mucus mixture of vaginal mucosal exudate, cervical canal secretions, and endometrial glandular secretions. Is increased vaginal discharge normal during pregnancy? This is probably the most concerning topic for expectant mothers. Below, we'll explain this from three aspects.

What does normal vaginal discharge look like?

Normal vaginal discharge is white, thin, pasty or egg-white-like, viscous, moderate in amount, and odorless. Its quantity and characteristics vary with the cyclical changes in estrogen and progesterone secreted by the ovaries.

As we all know, in women with normal endocrine function, each menstrual cycle, a dominant follicle in the ovary will mature and release an egg. If the released egg is not fertilized, menstruation will occur about two weeks after ovulation. The onset of menstruation marks the beginning of the next menstrual cycle, and so on.

In the first few days after menstruation ends, most women experience less vaginal discharge and vaginal dryness. This is because the follicles in the body are small and the secretion of estrogen is low at this time.

As the follicle develops and grows, the secretion of estrogen in the body gradually increases, and vaginal discharge also gradually increases with the increase in estrogen secretion. When the follicle matures, estrogen secretion reaches its peak, and vaginal discharge also reaches its peak. At this time, the leukorrhea is thin, transparent, and egg-white-like, reaching a length of up to 10 cm. Most women will feel that there is more vaginal discharge and the perineum is more moist at this time.

After ovulation, estrogen levels drop sharply, while progesterone levels gradually increase. Vaginal discharge decreases, loses its stretchy consistency, and becomes thicker. At this time, most women experience less vaginal discharge and vaginal dryness. This cyclical change in vaginal discharge is mainly influenced by estrogen and progesterone.

Is increased vaginal discharge normal during pregnancy? Which situations are considered normal?

Now that we understand the patterns and causes of cyclical changes in vaginal discharge, let's discuss the reasons for increased vaginal discharge during pregnancy and which types of increased vaginal discharge during pregnancy are normal.

After conception, the corpus luteum in the ovary secretes more estrogen and progesterone to maintain embryo implantation and development. Under the influence of high doses of estrogen and progesterone, the cervix becomes congested and edematous, the glands in the cervical canal proliferate and enlarge, cervical mucus secretion increases, and the vaginal mucosa becomes edematous and congested, with increased folds, vaginal exfoliated cells, and vaginal mucosal exudate. Therefore, pregnant women experience increased vaginal discharge, which is a normal physiological phenomenon.

Meanwhile, due to the increased glycogen content and lactic acid content in vaginal epithelial cells, the vaginal pH value decreases to a slightly acidic state, which is not conducive to bacterial growth. Therefore, normal vaginal discharge during pregnancy should be white, odorless, slightly acidic, and thin and pasty.

What are some abnormal signs of increased vaginal discharge during pregnancy?

Having understood the causes and normal situations of increased vaginal discharge during pregnancy, let's now discuss the abnormal situations of increased vaginal discharge during pregnancy.

■ Increased vaginal discharge that is frothy, grayish-yellow or yellowish-white and thin, or yellowish-green purulent discharge, accompanied by foul odor and itching or discomfort in the vulva and vaginal opening, should raise suspicion of trichomoniasis during pregnancy. The presence of trichomonads in vaginal discharge examination is sufficient to diagnose trichomoniasis during pregnancy.

■ Increased vaginal discharge that is curd-like or cottage cheese-like, accompanied by severe vulvar and vaginal itching, burning, pain, and dysuria, should raise suspicion of a fungal infection during pregnancy. If fungal spores and hyphae are found in the vaginal discharge, a diagnosis of fungal vaginitis during pregnancy can be made.

■ Increased vaginal discharge that is grayish-white, uniform, milky, thin, and has a fishy odor, along with clue cells and a positive sialidase test in vaginal secretions, can be diagnosed as bacterial vaginosis during pregnancy.

■ If vaginal discharge is coffee-colored or bloody during pregnancy, and if a pre-pregnancy examination has ruled out vulvar, vaginal, or cervical lesions, or bleeding caused by hemorrhoids, and the discharge is accompanied by or without lower abdominal pain or discomfort, it is mostly a symptom of threatened miscarriage. If a gynecological examination reveals bloody discharge flowing from the external os of the cervix, threatened miscarriage should be highly suspected, and timely treatment to prevent miscarriage is necessary.

■ If you experience watery discharge from the vagina in late pregnancy, feel that your vulva is more moist than usual, or feel that there is urine-like fluid leaking from your vagina, you should consider the possibility of premature rupture of membranes and seek immediate medical attention at the obstetrics department.

In summary, the color and characteristics of vaginal discharge undergo a series of changes during pregnancy, and different colors and characteristics can reflect the health of the expectant mother and the baby in the womb. Some increases in vaginal discharge are physiological and normal, requiring no treatment. However, some increases in vaginal discharge accompanied by changes in characteristics and color are abnormal, often indicating various types of vaginitis. These infections can easily ascend and lead to chorioamnionitis, causing premature rupture of membranes, premature birth, or fetal intrauterine infection, fetal distress, miscarriage, or fetal death, requiring prompt and aggressive treatment.