Bacterial vaginosis during pregnancy. Bacterial vaginosis: causes of the disease, effects on pregnancy, treatment

02.08.2019

Until recently, this disease was equated to sexual infections. But today, medical opinion on this matter has changed. Doctors consider vaginosis, rather, as a pathological condition, and not a disease in which favorable conditions are created for the development of other sexual ailments.

It occurs when the natural normal flora of the vagina is disturbed. Normally, the vaginal environment is 98% populated by lactobacilli that produce lactic acid, thereby maintaining an optimal acidic environment in the vagina - in the range from 3.8 to 4.5 Ph. With such acidity, the other 2% of the bacteria that make up the “bad” vaginal flora are not able to multiply. These are opportunistic microorganisms that are normally present in the female body and do not pose any danger as long as the specified percentage of all bacteria is maintained.

As soon as the number of lactobacilli begins to decrease or the acidity of the vagina changes, the pathogenic flora quickly becomes active. Against the background of such changes, vaginosis develops, which is a violation of the “correct” vaginal flora, in which the number of beneficial lactic acid bacteria decreases sharply, and harmful ones increase. Because of this, it is often referred to as vaginal dysbacteriosis.

First of all, gardnerella come to life. But a swab from a woman with bacterial vaginosis may also show other bacteria.

It is almost impossible to determine the exact cause of the development of vaginosis, since a variety of factors can affect the bacterial balance of the vaginal flora: a decrease in the body's immune defenses, bad habits, poor nutrition, vitamin deficiency and anemia, impaired metabolic reactions, taking certain medications (mainly antibacterial and hormonal ), intestinal dysbacteriosis, the use of spermicides and intimate hygiene products with triclosan in the composition, the abuse of hygienic tampons, frequent douching, stress, sudden climate change, etc., etc.

One of the reasons for the appearance of bacterial vaginosis may be hormonal disorders, which occurs, in particular, with the onset of pregnancy. Dysbacteriosis of the vagina in pregnant women has its own characteristics, which you should definitely know about.

Symptoms of bacterial vaginosis in pregnancy

It cannot be said that pregnant women are at risk for the development of vaginal dysbiosis. Rather, even vice versa. Medical statistics do not find a quantitative increase in the incidence during the period of bearing a child. But there are some nuances here.

Interestingly, nature has taken care of some protection for women from the development of pathogenic flora. In particular, with the onset of pregnancy, hormones begin to be actively produced in her body, and under their influence, epithelial cells are intensively produced, which feed on lactobacilli. As a result, they produce a lot of lactic acid, which suppresses the growth of pathogenic microflora. But the problem is that it is produced in excess, against which the acidity of the vagina increases markedly. Some harmful bacteria feel very good in such conditions - and are activated. Against this background, the number of lactic acid bacteria is suppressed - and the vaginal environment becomes alkaline, that is, favorable for the development of pathogenic microorganisms. Doctors say that bacterial vaginosis develops if the pH of the vagina exceeds the upper limit of 4.5. If the flora was disturbed even before pregnancy, but the woman did not feel it in any way, then now the consequences of such violations will “emerge” almost guaranteed.

Signs of vaginal dysbiosis are not specific, that is, they accompany many other diseases, which is why it is not easy to distinguish vaginosis on your own. However, there are symptoms that most likely indicate a violation of the female flora:

Viscous, frothy mucous discharge with the smell of fish - often plentiful. At the beginning of the disease, they have a white or grayish (earthy) tint, but over time they change to yellow or green and become more sticky.
Increased fishy odor after contact with male semen or smegma.
Feeling pain during sex.
Pain in the lower abdomen, in the region of the appendages.

It is noteworthy that a pregnant woman may not feel the presence of vaginosis at all, because very often it does not manifest itself in any way. Therefore, all obstetrically registered women are sent for tests to determine the purity of the vaginal microflora.

How to determine bacterial vaginosis during pregnancy: tests

Without fail, a smear from the vagina is taken from the expectant mother for the flora and bakposev is carried out. If necessary (and recently this analysis has also been included in the list of mandatory), PCR diagnostics are carried out.

Such a diagnosis makes it possible to detect bacterial vaginosis even in its latent form, that is, in the absence of any signs. Dysbiosis is indicated by the following indicators:

The presence of gardnerella (it is believed that with vaginosis they activate their growth necessarily, and the rest of the bacteria selectively).
Presence of key cells (which carry harmful bacteria).
Reduced number of lactic acid bacteria.
Alkaline vaginal environment (more than 4.5 pH).

In addition, at home, it is recommended from time to time to test for leakage of amniotic fluid and for the acidity of urine, so that in case of the slightest violation, consult a doctor and start treatment. It is necessary, even if the expectant mother does not experience any discomfort and does not feel any pathological changes: bacterial vaginosis is a great danger to the fetus and pregnancy.

Bacterial vaginosis during pregnancy: complications

To put it more correctly, vaginosis itself is not dangerous, but diseases that develop under the conditions of the activity of pathogenic microflora, which, in fact, occurs against the background of dysbacteriosis, pose a great threat to pregnancy and the fetus. After all, harmful bacteria multiply rapidly, resulting in the development of gardnerellez, mycoplasmosis, ureaplasmosis, staphylococcus, streptococcus or another disease - depending on which bacteria begin to develop. All of them act very aggressively and can damage the integrity of the membranes. This leads to leakage of amniotic fluid and infection of the fetus. The consequence of vaginosis can be a deterioration in blood flow in the vessels of the placenta, intrauterine hypoxia, impaired development of the unborn child, low body weight, and after his birth - problems with the functioning of the respiratory system, the functioning of the nervous system, skin diseases.

In addition, the pathogenic flora living in the female genital tract produces enzymes very similar to those produced by the amnion on the eve of childbirth. The presence of these enzymes gives a signal to the body that the uterus, cervix and fetus are already ready for childbirth - and the birth process starts. As you can already understand, the consequence of bacterial vaginosis can be a premature onset of labor.

Doctors say that women with impaired vaginal microflora are more prone to sexual infections, it is more difficult to bear and give birth to children. After childbirth, they are much more likely to develop infectious inflammatory processes in the genitals and chest.

Therefore, the disturbed flora must be restored without fail. How is it done?

Bacterial vaginosis during pregnancy: treatment

First of all, of course, it is necessary to pass tests for an accurate diagnosis. Women often confuse vaginosis with candidiasis (thrush) or trichomoniasis. But the treatment is different in each individual case, and with the wrong therapy, the condition can worsen significantly.

It is possible to distinguish vaginosis from other similar disorders by the nature of the discharge: with thrush, they are curdled and smell like sour milk, and with trichomoniasis, they are liquid (but also foamy and sticky), accompanied by burning and itching of the external genital organs. But it is precisely the laboratory study of vaginal discharge that will help to finally verify the nature of the pathology.

Depending on the bacteria identified in the smear, the doctor will select an antibiotic (approved for use during the period of bearing a child), effective in relation to the identified type of microorganisms. Most often, Metronidazole (Metrogil, Trichopol, Klion), Ornidazole (Tiberal), Salvagin, Clindamycin (Dalacin) are used to treat vaginosis in pregnant women.

Treatment is aimed primarily at the destruction of pathogenic flora. Natural - lactobacilli - after that should recover on its own. If this does not happen (repeated smears do not reveal an increased number of harmful bacteria, but unpleasant symptoms do not disappear), then lactobacillus preparations are prescribed to the woman. However, often doctors prefer to carry out therapy immediately in a complex manner.

At the same time, funds can be prescribed to increase immunity.

Treatment of bacterial vaginosis during pregnancy is carried out no earlier than after the 20th week of the term.

It is necessary to pay special attention to intimate hygiene, washing twice a day - at least. Change your laundry clean and dry as soon as you need to. It is better to change clothes once again than to use daily pads, obstetricians say.

Since bacterial vaginosis tends to recur, then 1-2 months after recovery, it is necessary to undergo a re-diagnosis in order to prevent relapse.

Especially for - Ekaterina Vlasenko

With the disappearance of lactobacilli, which performed protective functions, the body becomes more vulnerable, the balance of bacteria is disturbed.

In women, this disease is quite common, but its occurrence during pregnancy can be pretty dangerous moment., since the neglect of this disease can even lead to.

Reasons for the development of vaginosis

In fact, the causes of infection with vaginosis can be quite a lot. Consider the most famous:

intake and medications. This is the most common reason, since many medications help reduce the number of beneficial lactobacilli and disrupt the composition of the natural microflora of the vagina;
hormonal disbalance. Pregnancy is, in fact, a big hormonal failure for the whole organism, since during the formation of the fetus, many natural processes are disrupted and the body is rebuilt;
frequent use of intimate hygiene products. Frequent use of pads and tampons can adversely affect the microflora of the female genital organs;
the use of several types of contraceptives at once, as well as the use of spermicidal preparations;
inflammatory diseases of the genitourinary system, as well as injuries, operations and injuries of any kind;
wearing tight and uncomfortable underwear made of “non-breathable” fabrics;
allergic, chronic and endocrine diseases;
improper diet, alcohol abuse and smoking;
stress and anxiety situations;
difficult course of pregnancy.

Diagnosis of the disease

Usually only a doctor can diagnose the disease. The woman herself to determine what kind of infection she has - impossible because there are quite a few of them.

Usually a woman experiences discomfort and observes some changes, after which she should consult a doctor. The doctor should examine the woman and take a vaginal swab for analysis and blood for general tests.

After carrying out all the tests, you can confidently confirm or refute the diagnosis of vaginosis, determine what character it is and find out the cause of this disease. Based on the results obtained, treatment is determined.

Symptoms

With vaginosis, from the very beginning changes in the nature of vaginal discharge. They become much more abundant and change color.

They can also become thicker in consistency. In a large number of women, bacterial vaginosis is accompanied by a discharge that has an unpleasant odor, which can bring additional discomfort.

Itching it can also manifest itself, and if the disease is not treated, then the itching can only intensify.

Pain during urination. If it hurts to go to the toilet, then this is a mandatory reason to visit a doctor. Since such pains can accompany a very large number of different diseases, and out of ignorance, many women begin to be treated with medicines for completely different diseases.

During pregnancy this self-diagnosis prohibited, since the health of the unborn baby is easy to seriously harm. With vaginosis, itching is quite rare.

Pain during intercourse. This is a serious sign of any disease of the reproductive system, a doctor's consultation is required!

Why is vaginosis dangerous during pregnancy?

Any infectious disease during pregnancy can be very dangerous for both mother and baby and carry many serious consequences.

With bacterial vaginosis, inflammation of the fetal bladder can occur, as a result of which either a crack or a rupture can form on it. If a gap occurs, then miscarriage may begin or occur.

And if a crack forms, then through it the infection can enter the amniotic fluid and infect the child. Infection can have a different character - from inhibition of fetal development, to the appearance of sepsis.

The presence of a crack characterizes the leakage of amniotic fluid during pregnancy. When this symptom is detected, see a doctor immediately!

Also, in the presence of vaginosis, childbirth itself can have consequences. This is usually manifested by complications of various kinds, the occurrence of more serious inflammatory infections.

Also, the presence of bacterial vaginosis during pregnancy can reduce immunity, and a woman can become infected with complex and serious diseases.

Treatment and prevention

The basis of treatment is the restoration of the normal microflora of the vagina and the growth of the number of lactic acid bacteria.

Of the medications, antifungal drugs from the group are usually prescribed. nitroimidazoles. The form of release of such medicines can be very different - tablets, suppositories, creams.

Such drugs are not used in the first trimester due to the risk of high fetal susceptibility to medications. Candles containing lactic acid bacteria can be used.

During treatment, it is forbidden to use many types of contraceptives, for example, you can not use oral or vaginal, but it is allowed to use barrier (condoms).

It is also important to be treated under the supervision of a doctor, because there is a high risk of destroying harmful pathogenic bacteria, but not restoring the acid balance in the vagina.

Then a woman can be cured of vaginosis, but become infected with other diseases of the reproductive system, for example.

To maintain treatment, it is important to eat a lot of dairy foods and give up an abundance of sugar.

Pregnancy after bacterial vaginosis

As a rule, antibiotics kill most opportunistic bacteria, leaving only a small percentage of them. It must be said right away that in the body of any woman there is a certain percentage of such bacteria, and this is considered the norm.

Only when their number is steadily growing and suppresses beneficial lactobacilli is it considered a disease. Therefore, complex treatment and prevention of vaginosis, as a rule, give results and you can get rid of the disease within a month or even earlier.

If vaginosis did not bring significant complications, such as infection of the fetus, rupture or crack in the fetal bladder, as well as infection with severe infections, then the woman is considered healthy and usually nothing threatens her health or the health of the unborn baby. Such a pregnancy can continue without the risk of complications, miscarriage or premature birth.

If vaginosis has led to any complications, then only a doctor can observe the clinical picture. Most of the complications are treated or controlled with medications, so it is important to consult a doctor at an early stage of the disease or when you are just beginning to suspect its presence.

And remember - any deviations or discomfort in your body during pregnancy can lead to serious consequences. It is important not to forget about disease prevention, body hygiene and regular check-ups with doctors. Your health has a lot to do with your baby's health!

Any unpleasant manifestations can greatly alarm the expectant mother, therefore, having discovered that they are accompanied by irritation, pain and itching, women go to the doctor to find out the cause of their condition. Having learned the same diagnosis, they are surprised at him.

Meanwhile, bacterial vaginosis of pregnant women is a common disease. It is diagnosed in every fifth woman who is expecting an addition to the family. Of course, such a diagnosis can shock a woman, but not everything is as scary as it might seem at first glance.

The main reason why bacterial vaginosis can develop during pregnancy is, oddly enough, the pregnancy itself. Normally, the balance of beneficial and pathogenic microflora in the vagina is maintained by lactic acid, or lactobacilli. Therefore, even the entry of a small amount of pathogens is quickly suppressed by its own microflora.

But in pregnant women, immunity is overloaded, therefore it is reduced. The body's resistance decreases, and the number of lactobacilli decreases due to strong hormonal fluctuations and changes. As a result, the pathogenic microflora is activated and "goes on the offensive." If a woman had a vaginal infection even before pregnancy, which was oppressed by her own immunity and did not develop, then after the onset of conception, she may well “bloom in full bloom”. This is where bacterial vaginosis comes from, which is so frightening for expectant mothers.

In addition to pregnancy itself, the following factors can provoke the appearance of the disease:

Long-term use of potent drugs. These are mainly antibiotics, but hormonal, antifungal agents can have a similar effect.
Local use of antimicrobial agents - washing, douching, suppositories.
Spermicides.
Oral contraceptives.
Stress, nervous disorders.
Dysbacteriosis.
Insufficient intimate hygiene.

The reason for the development of bacterial vaginosis can even be hypothermia and wearing synthetic underwear, especially thongs. With the onset of pregnancy, any woman can develop this disease, but the risk is much higher in those who have previously been diagnosed with this disease.

First signs and symptoms

Most often, bacterial vaginosis during pregnancy occurs without any symptoms at all and is detected quite by accident during a routine examination by a gynecologist.

But in some cases, women themselves complain about the following signs:

Profuse discharge with viscous and sticky consistency. At the beginning of the disease, they are white or grayish in color, with neglected conditions they become yellow or greenish.
A characteristic "fishy" or sour odor that tends to intensify after intercourse.
Itching worse at night, after sexual intercourse or after bathing.
Discomfort and dryness of the vagina during intercourse.
Drawing pains in the lower abdomen.

All these symptoms can be significantly increased after intimate contact.These signs can manifest themselves in varying degrees of intensity or arbitrarily combine with each other, that is, the disease does not always lead to the appearance of a complete “set” of the listed symptoms.

But the appearance of at least one of them, especially during the bearing of a child, is an occasion to immediately visit a doctor and undergo an examination. At least just to exclude a dangerous disease or the same bacterial vaginosis.

Why is it dangerous for the fetus?

In most pregnant women, the presence of infection does not affect either its course, or the birth and condition of the baby. But there is a potential threat, especially in cases where a woman is weakened, she has various diseases, low immunity, miscarriages or problem pregnancies have happened before. Just as risky can be the lack of timely treatment of bacterial vaginosis.

If bacterial vaginosis is detected during pregnancy and the woman did not take the drugs prescribed by the doctor, or the disease passed without symptoms, the following events may occur:

Penetration of infection into the uterus and infection of the fetus.
Inflammation of the membranes, which can cause miscarriage or premature birth.
The birth of a child with underweight, lung damage, weakened, with low immunity. The presence of a chronic infection can adversely affect the further development of the child, cause poor digestion, poor weight gain, which can affect both the physical form and the mental progress of the baby.

After childbirth or a caesarean section, the presence of a bacterial infection can lead to poor healing of stitches, infection of the uterus, prolonged discharge, and even cause mastitis.

A timely detected and cured disease will not affect either the health of the mother or the formation and development of the fetus. It will also not affect the course of pregnancy.

Diagnosis of the disease

To detect infection, a woman is taken vaginal. Sowing helps to determine both the presence of the disease itself and to identify pathogens. This is important for the correct prescription of treatment.

Safe treatment and prognosis

Treatment for bacterial vaginosis during pregnancy is likely to begin after the 20th week of pregnancy. This is due to the fact that most drugs are dangerous to take during the formation of the organs of the fetus. After that, medications pose a minimal threat, although doctors still prescribe them only for health reasons.

The main way to combat the disease is to take antibiotics that are effective against a specific pathogen. However, the doctor will use them only in the most difficult situations. Also, after the end of the first trimester of pregnancy, drugs such as Trichopolum, Metronidazole, Klion, Ornidazole can be prescribed, especially if the pregnant woman has a combined infection. However, taking all these drugs uncontrolled is extremely risky. This can be done only as directed by a doctor and in certain quantities, strictly according to the instructions.

With unaggravated forms of vaginosis, a pregnant woman may be prescribed the use of local preparations, douching and suppositories, if there are no contraindications.

Mild vaginosis is best treated by stimulating the immune system and increasing the production of one's own defenses in the form of lactobacilli.

To do this, your doctor may prescribe medications such as:

Lactobacterin
Bifidum or Bifidumbacterin
Acylact

In the menu of a pregnant woman, you need to increase the amount of healthy dairy products and fiber. It is also important to eat a sufficient amount of fruits and vegetables - at this time the body really needs trace elements and vitamins.

Intimate hygiene should be at its best, but the abuse of too aggressive detergents can cause excessive dryness and cause irritation of the mucous membranes of the genital organs, so it is worth using delicate products or special preparations for pregnant women.

For more information about bacterial vaginosis, see the video:

How to avoid bacterial vaginosis during pregnancy:

Of the preventive measures, protected sex is in the first place. The use of condoms can save you from infection with many dangerous diseases, especially in the absence of a permanent partner or in the presence of contacts with other people.
Intimate hygiene and the use of cotton underwear, selected by size, will help to avoid accidental infection. This is especially true of tight panties made of synthetics or thongs - because of their structure, an infection from the anus can easily enter the vagina.
Do not use scented intimate hygiene products too often. Many gynecologists oppose panty liners or insist on changing them several times a day, as they see them as a breeding ground for infection.
When preparing for pregnancy, you should stop smoking - it weakens the immune system. It is not in vain that doctors recommend sanitizing all teeth and healing sexual infections - during pregnancy, they can cause great health troubles.

With proper preparation, the pregnancy will pass without the slightest complications, and the baby will be born strong and healthy.

Very often, a woman carrying a child is exposed to serious pathologies, and all because her body is being rebuilt, it has to work for two, so the immune system is weakened. Often, women experience such diseases of the reproductive system, which, without proper treatment, can lead to miscarriage. One such disease is bacterial vaginosis. During pregnancy, it most often occurs and requires urgent treatment under the supervision of the attending physician. But what is this disease, how to treat it correctly, and what preventive measures to take?

What is vaginosis?

Vaginosis during pregnancy is a disease accompanied by disorders in the vagina with a rapid decrease in the number of lactic acid bacteria and a pronounced increase in opportunistic microflora. In rare cases, an inflammatory process appears. This is one of the most common ailments found in the fair sex in reproductive age. By chance, it can be diagnosed only in 30% of patients, in those who complain of whitish discharge - in 90% of cases, and in pregnant women - in 35%.

During pregnancy, or, as it is often called, dysbacteriosis, lactobacilli, which are responsible for the protective functions of the body, completely disappear, so the woman becomes vulnerable. During pregnancy, advanced forms can lead to fetal loss, so it is very important to detect the disease in time and start treatment.

The norm of bacteria in the vagina

In the vagina of every woman live special bacteria that protect the reproductive system from inflammation and other pathologies. The optimal number should be:

lactobacilli - 95%;
2.5-5% is conditionally pathogenic flora.

The number of pathogenic organisms is so large that it will not work to say exactly how many of them, each girl has her own set, but there are certain types that are present in everyone and they will definitely appear if dysbacteriosis begins. The main one of the bacteria is that it always manifests itself if vaginosis has begun during pregnancy. It is considered a kind of marker and almost all laboratory tests are based on it.

Classification of vaginosis

Before you understand the important issue for many women, how to treat vaginosis during pregnancy, you need to know exactly what severity of the disease are:

1 degree. It is determined if there is no microflora in the smear, but epithelial cells are present without changes and the possibility of becoming infected with other bacteria remains.
2 degree. In this case, the degree of Doderlein sticks decreases, and the gram-negative and positive flora increases, a slight increase in leukocytes is found in the blood.
3 degree. In this case, lactic acid bacteria are completely absent, the clinical picture of the disease is obvious.

Causes of vaginosis in pregnant women

When lactobacilli are normal, nothing threatens either the woman or her fetus. They monitor the balance of microflora and produce lactic acid, which maintains an optimal acid balance that is detrimental to most pathogenic microorganisms. But under the influence of certain factors, the number of beneficial bacteria can decrease, in which case there is a violation of the microecological system. A low level of lactobacilli leads to the uncontrolled growth of harmful bacteria: gardnerella, bacteroids, mobilincus, peptococci, mycoplasma, streptococci.

It is difficult to determine what exactly affects the microflora and causes vaginosis during pregnancy, but internal and external factors can influence the decrease in the number of lactobacilli:

taking antibiotics;
treatment with antimicrobial, hormonal and antifungal agents;
disruptions in the hormonal background after an abortion, labor or puberty;
vaginal douching;
the use of antimicrobial agents during intimate hygiene with triclosan;
use of oral contraceptives;

the use of spermicides, which are part of vaginal suppositories and tablets;
allergic or endocrine diseases;
climate change, stressful situations;
imbalance in the intestines;
wearing underwear made of synthetics;
pregnancy, especially with complications;
neglect of hygiene rules.

How does the ratio of bacteria change during pregnancy?

Lactobacilli help to break down glycogen, which is formed from the cells of the squamous epithelium of the vagina, which is necessary in order to build an invisible protective barrier. But these cells do not live long, and all because in the body of every lady the hormonal background is constantly changing and not always for the better.

At a time when a woman is carrying a baby, under the influence of corpus luteum hormones, the number of squamous epithelial cells increases significantly. As a result, it turns out that the store of glycogen is large enough, so the level of lactobacilli increases, and the degree decreases and, as a result, the pH becomes lower. The body tries to clean the birth canal on its own by the time labor begins and the baby gets acquainted with the healthy microflora, which will settle in his intestines.

At first glance, it seems that everything should be just perfect, but in most cases, too acidic environment leads to the fact that some forms of transient infections grow, including Candida fungi, mycoplasma, ureplasma, and eventually vaginosis begins to develop during pregnancy.

What happens with vaginosis?

Under the influence of one of the mechanisms, the amount of useful substances decreases. The degree of lactic acid quickly decreases, the pH rises and the pathogenic flora begins to multiply, primarily gardnerella, which further inhibits beneficial bacteria. It turns out a "vicious circle", as a result of which lactobacilli die in large numbers.

The rapid development of pathogenic microorganisms leads to the fact that a woman has unpleasant symptoms, indicating that vaginosis has appeared during pregnancy.

Symptoms in pregnant women

Not always in the early stages of the disease is manifested by severe symptoms, but if the disease progresses, then the following signs appear:

abundant leucorrhea of a slightly grayish hue, and if the ailment has not been treated for years, then the discharge can become greenish, frothy and viscous;
a characteristic fishy smell appears, it is especially heard during intercourse of partners;
there is pain during intercourse, burning;
discomfort in the lower abdomen does not allow you to live in peace, on examination, hypertonicity of the uterus is found;
unpleasant burning during urination, but this symptom is much less common.

After the first symptoms appear, you need to urgently seek advice from a gynecologist who will conduct an examination and be able to accurately diagnose.

Diagnostic methods for determining vaginosis

Most often, only a doctor can diagnose a pathology. On her own, no woman will be able to say what kind of infection is progressing in her body, since there are many varieties of bacteria that cause it. Most often, discomfort is simply felt in the lower abdomen and vagina, so you should seek the advice of a doctor. He, in turn, examines the woman, takes a smear for analysis and takes a blood sample in order to conduct additional studies and identify which infection provoked the development of the disease.

After carrying out all the necessary studies, it is possible to accurately confirm or refute the diagnosis, and only after that begin the treatment of vaginosis during pregnancy.

What is the danger of an ailment during the bearing of a baby?

Any infection can cause serious harm to the health of not only a woman, but also her unborn baby. During vaginosis, inflammation of the amniotic sac may occur, as a result of which a crack and even a rupture may appear on it. If this happens, then the woman may begin premature birth or spontaneous abortion. When a crack appears, the infection can enter the amniotic fluid, and as a result, the baby will become infected.

Such infection can lead to serious consequences: the development of the fetus will stop or sepsis will appear.

That is why it is important to detect bacterial vaginosis in time during pregnancy. Treatment should be started immediately after confirmation of the diagnosis and all recommendations should be strictly followed.

Treatment of vaginosis during pregnancy

If the patient has a confirmed diagnosis, then first of all the doctor recommends taking a course of antibiotics that are safe for a woman in her position.

It is very important to follow all the recommendations of the doctor, from the first to the last day, until all symptoms disappear. But it is worth remembering that the disappearance of symptoms may indicate that the infection has subsided, but as soon as the medication is stopped, they may reappear. And relapses are usually much more severe, and therapy affects them worse.

But even if the patient fully follows all the recommendations - take antibiotics, put suppositories from bacterial vaginosis during pregnancy, it is possible that the infection will appear again.

Nearly a third of women who receive treatment experience a recurrence of symptoms in the first three months after taking antibiotics. The relapse is due to the fact that taking such drugs killed most of not only pathogenic bacteria, but also beneficial ones. And so far no way has been found that could make beneficial bacteria multiply faster, so pathogenic microorganisms continue to multiply.

If a relapse occurs, then the woman is prescribed repeated therapy, while the drugs are selected individually, because everything possible must be done to protect the fetus. A gynecologist can accurately answer the main question of how to treat bacterial vaginosis during pregnancy, who knows exactly about all the diseases of a woman and will take all measures so as not to harm the health of the patient and her unborn baby.

How to restore the microflora?

After taking antibiotics, the microflora is disturbed, so it is very important to start taking biological products and use them intravaginally. Most often, doctors stop on such medicines:

To do this, you need to take 2 doses of the drug and dilute 5 ml of purified water, wet the swab and insert it intravaginally. The procedure is carried out twice a day. The course is up to 10 days.

But before starting this kind of therapy, it is better to ask the doctor for advice.

Prevention of vaginosis

To date, it has not been fully clarified what exactly causes dysbacteriosis in the female genital organs, so it is impossible to say exactly what preventive measures will give a positive result. But there are a few things you can do to slightly reduce your risk of getting bacterial vaginosis during pregnancy:

It is very important to adhere to the rules of safe sex, especially if you are not sure about your partner. It is not yet clear what role a woman's sexual life plays in the appearance of vaginosis, but statistics show that the pathology occurs more often in those patients who have several sexual partners at once.
It is important to quit smoking. There is an opinion that smoking leads to the fact that the risk of developing a pathology such as vaginosis in early pregnancy increases.

In no case should you douche and wash the vagina with a stream of water. Also, the doctor does not advise using sprays for intimate hygiene and soap for washing the genitals. All these means can upset the balance and lead to the development of pathogenic microflora.

Any diseases during pregnancy require a careful approach and careful treatment in order to prevent complications and harm the baby.

Bacterial vaginosis (sometimes the term "gardnerellosis" is used) is a violation of the vaginal microflora in the direction of reducing the number of lactic acid bacilli. Under these conditions, another, often pathogenic flora is activated, which can harm a developing baby in utero. Why does bacterial vaginosis occur, why is it dangerous for a pregnant woman and how to treat it correctly and safely?

Read in this article

Causes of bacterial vaginosis in the early stages

Often, bacterial vaginosis occurs unnoticed by a woman even before pregnancy. And if she did not undergo thorough preparation and examination the day before, there are many reasons why the pathology will be revealed only during gestation.

Bacterial vaginosis can develop in two cases:

In the absence of sexual infection. Often in such situations, a woman has other diseases that provoke this condition, for example, diabetes mellitus, hypothyroidism, and others.
Against the background of some sexual infection. At the same time, signs of STIs may be absent or be minimal and not attract attention.

During gestation, the activity of a woman's immunity decreases. This is necessary for the successful growth and development of a baby that is half alien in terms of genetic material. However, this leads to an increase in the likelihood of various infectious diseases, exacerbation of chronic pathology in women.

Under the influence of this, the number of Dederlein sticks in the vagina is somewhat reduced. Namely, they are the main "guardians" of normal flora and protection against infections. Therefore, during gestation, some women so often experience episodes or bacterial vaginosis. But you can never rule out the presence of some latent sexual infection.

The following factors can trigger the development of bacterial vaginosis during pregnancy:

Chronic diseases of the intestines, endocrine organs, urinary system and others. It is important that during gestation all of them are in a compensated state, otherwise it will be difficult for the body to cope with increased stress.

Especially often, bacterial vaginosis appears when (including with a latent course), when the thyroid gland (hypothyroidism) is disrupted, when the work of the adrenal cortex changes, and some others.

If antibacterial drugs are prescribed during pregnancy, this can also provoke a change in the vaginal flora. The result is thrush or bacterial vaginosis. Therefore, for prophylactic purposes, it is necessary to prescribe funds simultaneously with antibiotics to maintain the vaginal flora.
If there are any diseases of the cervix (erosion, ectopia, etc.).
With promiscuity, as well as oral, anal and other not quite traditional types of intimate relationships. Flora from these areas enters the vagina and immediately disturbs the delicate balance that exists there.
With excessive intimate hygiene, when useful microbes are simply “washed away”.
If you regularly wear synthetic underwear.
Also, the risk of getting sick is higher with the omission of the genital organs, even a slight one. Normally, the labia minora should cover the entrance to the vagina. This is a kind of protection. When the vaginal wall prolapses, it can come into contact with the environment, "absorbing" all microbes.

Symptoms in the expectant mother

If bacterial vaginosis in a girl is not associated with a sexual infection, then all the symptoms are quite meager. Most often, the pathology in this case is detected at the next examination after taking smears. But if you closely monitor your own health, you can notice the following:

Unpleasant "fishy" smell. Normally, vaginal discharge has a slightly sour tint.
Increasing whites. In this case, the discharge remains mucous, but can become whitish, viscous.
Beli can irritate the external genitalia, the inner surface of the skin of the thigh. This will lead to itching, burning in these places.

If bacterial vaginosis occurs against the background of some kind of sexual infection, then, among other things, the following may also be observed:

Leucorrhea can be yellowish, milky, greenish and frothy.
Against this background, pulling pains in the lower abdomen may appear as a symptom of a threat during an infection.
Pain during intercourse.
Discomfort, pain during urination, increased urge.

What is dangerous vaginosis of mother and baby

Timely diagnosis and treatment of bacterial vaginosis will not bring much danger to mother and baby. Also, in most cases, an independent recovery of the body occurs when the provoking factors are eliminated. For example, after a period of time after a course of antibiotics, etc.

Of particular danger are forms of vaginosis in the presence of any STI. In addition, every day of delay in treatment can be the cause of the following conditions:

non-developing pregnancy at different times;
and premature birth;
leakage of amniotic fluid ahead of schedule;
and fetal hypoxia;
chorioamnionitis - inflammation of the membranes and many others.

Therefore, it is important to carry out timely and complete diagnosis for subsequent effective treatment.

Watch a video about bacterial vaginosis:

Diagnosis during pregnancy

Diagnosis of the disease includes laboratory methods and traditional examinations. The following is done:

Standard gynecological examination. At the same time, the doctor notes the abnormal nature of the discharge, their special “fishy” smell. Informative conduct aminotest. To do this, put some vaginal discharge on a glass slide and add potassium hydroxide. The “fishy” smell will intensify many times over.
Sampling of material from the posterior fornix of the vagina for microscopic examination. This is a normal smear on the flora. With bacterial vaginosis, the following changes occur in it: a normal or increased content of leukocytes, the appearance of gardnerella and often key cells, a decrease in the number of Dederlein sticks, abundant mucus, possibly fungi.
PCR diagnostics to clarify the presence/absence of other infections, since often vaginosis is just a "background" for more serious diseases.
Sowing the contents of the vagina on the flora, taking into account the sensitivity of pathogens to antibacterial drugs. So it will be possible to find out which microbes have violated the normal biocenosis of the vagina and how it is most rational to get rid of them.

Early treatment

Therapy for bacterial vaginosis in early pregnancy should be selected in such a way as to cause minimal impact on the still developing baby.

The first trimester in this regard is the most difficult, since it is undesirable to use many drugs.

First of all, you should try to identify the factors provoking the disease. If it is diabetes mellitus, it is more difficult to control the level of blood glucose, in case of disruption of the intestines, monitor stools, nutrition, and similarly treat all chronic pathologies.

Secondly, it is necessary to use topical drugs. Most often, these are suppositories or vaginal tablets and capsules. In a hospital setting, baths with hydrogen peroxide, chlorhexidine and other safe agents can be used.

In the first trimester, it is harmless and effective to use the following drugs:

based on chlorhexidine;
iodine-based suppositories - Povidone-iodine, Betadine and others.

Classical treatment of bacterial vaginosis based on metronidazole is allowed only from the second trimester of pregnancy.

If this treatment does not help, and if an additional infection is detected according to the test results, therapy should be expanded with antifungal agents. The following are often used:

candles Ginezol, Pimafutsin to combat yeast fungi;
tablets Azithromycin, Josamycin, Ampicillin and others, taking into account sensitivity and safety.

You should also use drugs for the general normalization of the microflora in the vagina and intestines. It can be suppositories, tablets or solutions. Bioflor, Laktozhinal, Vaginorm, Atsilakt and others are popular.

Preventive treatment in case of detection of STIs should also be given to the sexual partner.

Prevention of the appearance

It is not always possible to prevent the occurrence of vaginosis during pregnancy. The main thing is to diagnose and treat it in time. The main recommendations are:

Pregnancy should be planned and undergo a comprehensive examination the day before.
It is useful to monitor the work of the intestines, eat more vegetables, less - sweets, fast foods, etc.
It is better to wear underwear only from natural fabrics. After all, many bacteria die on contact with atmospheric air.
During treatment with serious, in particular, antibacterial drugs, one should not wait for the development of dysbiosis, but carry out its prevention in advance.
Useful all the techniques to increase the body's defenses during gestation.

Pregnancy after bacterial vaginosis

Timely detection, comprehensive examination and competent treatment will minimize any further complications of pregnancy. Sometimes a woman without any consequences can go through this problem several times during the entire period of gestation.

But if treatment is delayed or incomplete, the likelihood of infectious complications during pregnancy increases.

During gestation, women often have to deal with bacterial vaginosis and thrush. These are the first signals of a decrease in local immunity, activation of opportunistic flora and exacerbation of chronic pathology. Correct diagnosis and treatment will help avoid pregnancy complications and get rid of problems.