Bacterial vaginosis during pregnancy. What is the danger of an ailment while carrying a baby? Diagnostic methods for determining vaginosis

13.06.2019

Bacterial vaginosis occurs in every 2-3 pregnant women. This pathology is infectious, non-inflammatory. The disease must necessarily be treated even if there are no symptoms, as it can lead to unpleasant consequences during pregnancy.

What is bacterial vaginosis?

This disease is also called gardnerellosis or vaginal dysbiosis. With bacterial vaginosis, the vaginal microflora is disturbed, namely, the number of beneficial lactic acid bacteria decreases. This state provides a favorable environment for the reproduction of pathogenic microbes - gardnerella and anaerobes.

With bacterial vaginosis, one or several types of microorganisms can develop - in total, with such a disease, more than 200 of them are isolated. This diversity does not always allow us to identify the exact type of bacteria.

You should know that in each case of bacterial vaginosis the microflora is unique in composition, but gardnerella, the most common pathogenic microorganisms, are almost always detected.

Causes of bacterial vaginosis in pregnant women

Bacterial vaginosis begins for a single reason - a change in microflora. Many factors can cause this phenomenon:

drug therapy: most often, a change in the microflora associated with the intake of antibiotics, hormonal drugs, antifungal and antimicrobial agents;
hormonal changes that occur during pregnancy;
problems with the endocrine system;
antimicrobial products for intimate hygiene containing triclosan;
wearing synthetic underwear (especially thongs);
vaginal douching (especially with baking soda or antiseptics);
non-observance of intimate hygiene;
intestinal dysbiosis;
severe or chronic stress;
climate change;
the course of pregnancy with complications;
foreign body entering the vagina;
new sexual partner;
inflammatory process in the reproductive system (present or earlier);
high sexual activity;
unhealthy diet and bad habits.

Symptoms

The main symptom of bacterial vaginosis is a moderate (sometimes large) amount of vaginal discharge accompanied by an ammonia odor. It is usually described as the smell of rotten fish.

The first months of the disease is manifested by liquid discharge of white or grayish color. On a gynecological examination, the vaginal mucosa has a normal pink color. In rare cases, individual red dots can be found.

If bacterial vaginosis has been present for many months, then its symptoms become more pronounced:

discharge changes in consistency: they can be cheesy or slimy;
the color of the discharge also changes, becoming yellow-green;
even distribution of secretions along the walls of the vagina: they are quite thick and sticky, they can foam;
discharge becomes much larger in volume: at a rate of 2-4 ml, their amount can even increase 10 times;
long-onset bacterial vaginosis leads to burning, itching in the vagina, but these unpleasant sensations may be absent altogether or appear periodically;
soreness may appear during intercourse;
sometimes the process of urination is upset (becomes more frequent and painful);
with bacterial vaginosis during pregnancy, pain in the lower abdomen may occur.

Diagnostics

To confirm bacterial vaginosis, three stages of diagnosis are sufficient:

Inspection. At this stage, vaginosis is suspected if there is a foul-smelling discharge. But in some cases they may be absent.
Smear. Microscopic (bacterioscopic) examination of a smear stained according to Gram is performed. In a sample with vaginosis, a predominance of epithelial cells over leukocytes, a decrease in the volume of Doderlein's rods and visualization of special cells are detected. They are called key - it is on them that pathogenic microbes are found.
Bacterial culture (culture) for Gardnerella vaginalis is not informative; in difficult cases, only a PCR analysis for gardnerella can be carried out.
Acidity. This stage of diagnosis means determining the pH of the environment in the vagina. If the pH is greater than 4.5, then bacterial vaginosis has occurred.

The main direction of treatment for the disease is a course of antibiotics. Usually it is prescribed only from the II trimester of pregnancy, since in the first months the fetus is especially susceptible to all kinds of medications. Typically, for bacterial vaginosis, one of the following drugs is used:

metronidazole (Klion or Trichopolum tablets) - 250 mg 2 times a day for 7 days;
Ornidazole (Tiberal) - 250 mg 2 times a day for 5 days.

Antibiotics may not completely kill opportunistic bacteria. It should be borne in mind that their presence (small percentage) is the norm for every woman.

To recreate a normal vaginal environment, special vaginal capsules are prescribed (Vaginorm, Acylact, Lactobacterin, Lactozhinal, Bifikol or Bifidumbacterin, for example).

You need to know that you need to treat bacterial vaginosis only under the supervision of a doctor. In the course of timely started therapy, it is important to restore the normal microflora of the vagina.

The intestinal microflora is also restored with the help of bifidobacteria and lactobacilli.

When diagnosed with bacterial vaginosis, it must be remembered that the prescribed treatment must be continued to the end, even if there were no symptoms of the disease initially or they disappeared during therapy.

Pregnant women in the first trimester if necessary, prescribe drugs in the form of suppositories. Their advantage is in local action - the active components do not have a systemic effect on the body, as it happens when taking medications orally.

For the treatment of bacterial vaginosis, not only drug therapy is important, it is also important to pay attention to your diet. It is necessary to add fermented milk products to it. Sugar and products containing it will have to be abandoned for a while.

The doctor usually prohibits or recommends barrier contraception (condoms) during treatment.

Dangers of Untreated Vaginosis for Pregnant Women

If bacterial vaginosis is not detected in a timely manner and the correct therapy is not carried out, then there is a significant risk for both the mother and the fetus:

Inflammation of the membranes (chorioamnionitis). The inflammatory process can lead to micro-rupture or even complete rupture of the bladder. This can result in miscarriage or premature birth.
When a micro-rupture appears in the fetal bladder, there is a risk of infection entering the amniotic fluid. This can lead to infection of the fetus. The consequences in this case are unpredictable - from fetal lag in development to the spread of sepsis and fetal death.
If a "crack" appears in the fetal bladder, then amniotic fluid may leak - this is detrimental to the unborn baby.
Against the background of untreated dysbiosis, another inflammatory infection may develop.
If bacterial vaginosis is not completely cured, complications may arise during childbirth, and it is impossible to predict their nature in advance (most often women who refused treatment or did not completely undergo it and conscientiously suffer from postpartum metroendometritis).
Decreased immunity with vaginal dysbiosis makes the body more susceptible to many diseases. Even a common cold can end in serious complications.

Can you get pregnant with bacterial vaginosis?

Conception in the presence of bacterial vaginosis is a controversial issue. On the one hand, this disease changes the vaginal micloflora. Spermatozoa in it can die rapidly, so the possibility of conception is reduced.

On the other hand, there are many cases when such a disease did not interfere with conception at all. Thus, we can say that the possibility of conception with bacterial vaginosis is an individual matter.

It is important to know that bacterial vaginosis itself does not pose a particular danger, unlike the complications it causes. These can be various diseases, including infertility.

You can conceive with bacterial vaginosis, but you should not do this. It is best to treat the condition first and then plan to replenish the family. Treatment during pregnancy is complicated by the fact that most drugs cannot be used in the first months. In the meantime, the development of the disease can lead to various complications, including from the fetus, if intrauterine infection occurs.

Every woman planning a pregnancy must first undergo a comprehensive examination, pass various tests, and cure existing diseases. Only this will be the key to the normal course of pregnancy.

Video about bacterial vaginosis during pregnancy

The obstetrician tells about the possible danger, the reasons for the development, diagnosis and treatment of the disease during pregnancy in this video:

Bacterial vaginosis is a fairly common disease. At the very first symptoms, it is necessary to consult a specialist, and the prescribed treatment should be carried out to the end.

Currently, bacterial vaginosis is considered as a condition accompanied by the appearance of pathological vaginal discharge, in which a variety of microorganisms are found. This disease occurs in women of various ages, from little girls to older women. Its frequency ranges from 15 to 64%. Bacterial vaginosis can only conditionally be attributed to sexually transmitted infections - rather, it is a violation of "microbial balance", a kind of vaginal dysbiosis.

How does the disease develop?

As you know, the skin and mucous membranes of a healthy person are by no means sterile. We all live in collaboration with many microorganisms that make up the normal microflora of our body. So, in healthy women, the main inhabitants of the vagina are lactobacilli (lactic acid bacteria), they account for 95-98% of the total flora. They produce lactic acid, thereby maintaining an acidic environment in the vagina. It is a protective factor preventing the overgrowth of other 20-30 types of bacteria. Under the influence of unfavorable factors, the number of lactobacilli decreases, the acidity of the environment changes, and the vacant place is occupied by microorganisms that normally live in the vagina in small numbers. Among these bacteria, vaginal gardnerella (Gardnerella vaginalis) is most often found. She is the main, but not the only cause of bacterial vaginosis. Hence another name for the disease - gardnerellosis. In addition to gardnerella, with bacterial vaginosis, other microorganisms are often detected (bacteria of the genus Mobiluncus, bacteroids, peptococci, peptostreptococci, mycoplasmas).

The following factors can affect the composition of the vaginal microflora:

the use of antibiotics and other antibacterial drugs, hormones;
hormonal changes during puberty, after abortion, childbirth, in violation of menstrual function;
decreased immunity, allergies;
climate change, various stresses;
the use of oral contraceptives, intrauterine devices;
frequent and excessive vaginal douching, the use of antibacterial agents (for example, containing TRICLOSAN), antiseptic solutions;
the use of spermicides (substances that kill sperm - they are part of contraceptive suppositories and vaginal pills), hygienic tampons;
dysfunction and microbial composition of the intestine.

Symptoms of the disease

The incubation period is 3 to 10 days, after which symptoms of the disease appear. The main symptom is complaints of moderate (less often - abundant) discharge of a grayish-white color with an unpleasant smell of rotten fish. The odor is caused by amines formed during the life of gardnerella. The smell can be permanent, appear during menstruation, intercourse, when washed off with alkaline soap. At the same time, redness and swelling of the external genital organs and the walls of the vagina are usually not observed, almost never bacterial vaginosis is accompanied by itching. In some cases, the disease is complicated by inflammation of the internal genital organs, then there are pains in the lower abdomen, menstrual irregularities, long, heavy menstruation. With bacterial vaginosis, the incidence of complications after gynecological operations sharply increases, postoperative wounds are more likely to fester.

The course of pregnancy

An infection in the mother can lead to infection in the baby. Children with intrauterine infection are born weakened, with low body weight, congenital pneumonia, and after birth they may develop infectious skin lesions, inflammation of the umbilical wound. Prolonged oxygen starvation, due to insufficient function of the infected placenta, can lead to neurological problems in the baby.

In addition, bacterial vaginosis increases the incidence of postpartum complications in the mother, especially if the birth was performed by caesarean section. In particular, the frequency of inflammation of the inner surface of the uterus (endometritis), purulent inflammation of the mammary gland (mastitis) increases. The likelihood of endometritis with bacterial vaginosis is 10 times higher than that of healthy women.

Diagnostics

Diagnosis is based on clinical examination data and laboratory research methods. There are four main signs of bacterial vaginosis, and at least three of the four signs are required for a diagnosis:

1. The presence of symptoms characteristic of the disease, i.e. homogeneous, liquid, fishy-smelling discharge adhering to the vaginal wall.

2. Strengthening the "fishy" smell when adding alkali solutions to the vaginal secretion.

3. The alkaline nature of the environment in the vagina.

4. The presence of corresponding changes in the results of analyzes of vaginal smears.

Such changes, in particular, include the detection of "key cells" in smears. These cells are cells of the vaginal epithelium, covered, as if "peppered", small sticks (gardnerella). Such cells are found in the most common vaginal smear, which is taken from all pregnant women without exception.

In difficult cases, the identification of gardnerella DNA - polymerase chain reaction (PCR) can be used for diagnosis.

Pregnancy management and treatment

The goal of treating bacterial vaginosis is to restore the normal composition of the vaginal microflora and eliminate the symptoms of the disease, and not completely destroy the gardnerella. In non-pregnant women, treatment is only done if symptoms are present. Since the presence of bacterial vaginosis during pregnancy is associated with a high risk of complications, pregnant women need treatment even if they are asymptomatic, especially if there is a threat of premature birth. For the treatment of bacterial vaginosis in pregnant women, METRONIDAZOLE (TRICOPOL, KLION, METROGIL) or ORNIDAZOLE (TIBERAL) are most often used. Numerous studies have not revealed teratogenic effects (the ability to cause malformations) of these drugs on the fetus, however, due to the possible negative effects, they are not used in the first trimester of pregnancy. Treatment is usually given after 20 weeks of pregnancy. In parallel with taking the tablets inside, METRONIDAZOLE preparations are prescribed topically, in the form of vaginal tablets. Preparations based on CLINDAMYCIN (DALACIN) can also be used during pregnancy after 20 weeks by mouth, but CLINDAMYCIN vaginal creams are usually not prescribed, since there is evidence of an increase in the number of preterm births when using these forms. Antibiotic therapy, if necessary, is supplemented by the use of immunocorrectors (KIPFERON, VIFERON), antiallergic drugs, taking into account contraindications due to pregnancy.

Treatment of sexual partners is not required, since this does not affect the success of treatment and the frequency of relapses of the disease in pregnant women. Antibacterial drugs only kill gardnerella, but do not create conditions for restoring the normal content of lactic acid bacteria. Therefore, vaginal candidiasis (thrush) often occurs after treatment. In addition, even after treatment at any stage of pregnancy, the symptoms of bacterial vaginosis may recur, therefore, three to four weeks after treatment, it is necessary to undergo a control study of the composition of the vaginal microflora. If the analyzes do not reveal gardnerella or candida, then drugs are prescribed that restore the normal microflora of the vagina (ACILACT, LACTOBACTERIN, BIFIDIN).

During treatment, it is necessary to eat more often fermented milk products enriched with live cultures of bacteria, as well as a product containing coarse dietary fiber.

Prophylaxis

Prevention of bacterial vaginosis is to exclude factors that affect the composition of the vaginal microflora. Before pregnancy, it is advisable to be screened for gardnerellosis and sexually transmitted infections. If diseases are detected, it is necessary to undergo a full course of treatment, including antibacterial drugs and agents that restore normal microflora. With frequent recurrences of bacterial vaginosis of pregnancy, it is possible to use the SOLKO TRIKHOVAK vaccine. After applying this vaccine, conditions are created for the growth of lactobacilli, which prevents recurrence of bacterial vaginosis. The first symptoms of an improvement in the condition begin to be felt three weeks after the application of the vaccine.

Many are dismissive of vaginosis, as it occurs in many pregnant women and believe that it is not worth treating at all. I want to refute this. Bacterial vaginosis is an insidious disease that leads to early childbirth due to. And it is very imperceptible. It is to him that the lion's share of all cases is given. The toxins released by microorganisms "undermine" the fetal bladder, leading to the formation of microcracks and microcracks with subsequent and early childbirth. And they themselves, penetrating into the cavity of the bladder, infect the fetus and the endometrium.

Currently bacterial vaginosis is considered as a condition accompanied by the appearance of pathological vaginal discharge, in which a variety of microorganisms are found. This disease is equally common in women of different ages, from little girls to very elderly women. Its frequency ranges from 15 to 64%. The disease can only conditionally be attributed to sexually transmitted infections, rather it is a violation of "microbial balance", a kind of vaginal dysbiosis.

How does the disease develop?

As you know, the skin and mucous membranes of a healthy person are by no means sterile. We all live in collaboration with many microorganisms that make up the normal microflora of our body. So, in healthy women, the main inhabitant of the vagina is lactobacilli (lactic acid bacteria), they account for 95-98% of all flora. They produce lactic acid, thereby maintaining an acidic environment in the vagina. The acidic environment is a protective factor, preventing the overgrowth of other 20-30 types of bacteria. Under the influence of unfavorable factors, the number of lactobacilli decreases, the acidity of the environment changes, and the vacant place is occupied by microorganisms that normally live in the vagina in small numbers. Among these bacteria, vaginal gardnerella (Gardnerella vaginalis) is most often found. She is the main, but not the only cause of bacterial vaginosis. Hence another name for the disease - gardnerellosis. In addition to gardnerella, with bacterial vaginosis, bacteria of the genus mobiluncus, bacteroids, peptococci, peptostreptococci, and mycoplasmas are often detected.

The following factors can affect the composition of the vaginal microflora:
- the use of antibiotics and other antibacterial drugs, hormones;
- hormonal changes during puberty, after abortion, childbirth, in case of menstrual disorders;
- decreased immunity, allergies;
- climate change, various stresses;
- the use of oral contraceptives, intrauterine devices;
- frequent and excessive vaginal douching, the use of antibacterial soaps for hygiene (for example, containing TRIKLOSAN), antiseptic solutions;
- the use of spermicides (substances that kill sperm - are part of contraceptive suppositories and vaginal pills), menstrual tampons;
- dysfunction and microbial composition of the intestine.

Symptoms of the disease

The incubation period is 3 to 10 days, after which symptoms of the disease appear. The main symptom is complaints of moderate, less often abundant, grayish-white discharge with an unpleasant smell of rotten fish. The odor is caused by amines formed during the life of gardnerella. The smell can be permanent, appear during menstruation, intercourse, washing with alkaline soap. In this case, usually, there is no redness and swelling of the external genital organs and the walls of the vagina, almost never bacterial vaginosis is accompanied by itching. In some cases, the disease is complicated by inflammation of the internal genital organs, then there are pains in the lower abdomen, menstrual irregularities, long, heavy menstruation. With bacterial vaginosis, the incidence of complications after gynecological operations sharply increases, postoperative wounds are more likely to fester.

The course of pregnancy

During pregnancy, under the influence of hormones, favorable conditions are created for the life of lactobacilli. Therefore, the incidence of bacterial vaginosis in pregnant women is lower than in other women. Bacterial vaginosis during pregnancy occurs in 10-20% of all pregnant women, half of them have no symptoms. In pregnant women with bacterial vaginosis, a high concentration of microorganisms in the vagina can lead to the penetration of these bacteria into the upper genitals. In such women, infection of the placenta membranes is 2 times more likely, chorioamnionitis develops - a formidable complication of pregnancy that threatens the life of the mother and fetus. In addition, inflammation of the membranes can lead to them long before the expected due date. In this case, the pregnancy is terminated or premature birth occurs.
An infection in the mother can lead to infection in the baby. Children with intrauterine infection are born weakened, with low body weight, congenital pneumonia, and after birth they may develop infectious skin lesions, inflammation of the umbilical wound. Prolonged oxygen starvation, due to insufficient function of the infected placenta, can lead to neurological problems in the baby.
In addition, bacterial vaginosis increases the incidence of postpartum complications in the mother, especially if the birth was performed by caesarean section. In particular, the frequency of inflammation of the inner surface of the uterus (endometritis), purulent inflammation of the mammary gland (mastitis) increases. The likelihood of endometritis with bacterial vaginosis is 10 times higher than that of healthy women.

Diagnostics

Diagnosis is based on clinical examination data and laboratory research methods. There are four main signs of bacterial vaginosis, and at least three of the four signs are required for a diagnosis:
1. The presence of symptoms characteristic of the disease, i.e. homogeneous, liquid, fishy-smelling discharge adhering to the vaginal wall.
2. Strengthening the "fishy" smell when adding alkali solutions to the vaginal secretion.
3. Alkaline nature of the environment in the vagina. To measure the acidity of the medium, special test strips are used.
4. The presence of corresponding changes in the results of analyzes of vaginal smears. Such changes, in particular, include the detection of “key cells” in smears. These cells are cells of the vaginal epithelium, covered, as if “peppered”, with small sticks (gardnerella).
In difficult cases, gardnerella DNA identification can be used for diagnosis - polymerase chain reaction (PCR)

Treatment should be carried out by the attending physician after appropriate tests.

Bacterial vaginosis during pregnancy is the most common disease of the female genital organs, characterized by a change in the nature of vaginal discharge. It develops against the background of a decrease in the number of lactobacilli and the activation of representatives of opportunistic microflora.

The disease leads to dangerous consequences, therefore it must be eliminated in a timely manner.

Reasons for development

There are many causes of bacterial vaginosis in pregnant women, the most common among them are:

Symptoms of bacterial vaginosis during pregnancy

Gardnerellosis during pregnancy has the following symptoms:

Diagnostics

To identify gardnerella vaginalis during pregnancy, the following research methods are used:

Inspection. At this stage, the first symptom of the disease is found - abundant thick discharge with a pungent odor. The condition of the mucous membranes of the vagina remains normal.
Smear. The stained sample helps to identify changes characteristic of bacterial vaginosis - the predominance of epithelial cells over leukocytes, a decrease in the number of Doderlein rods and the presence of key cells covered with pathogenic microorganisms.
PCR. Used to identify the causative agent of the infection, bacterial vaginosis bacterial culture turns out to be uninformative.
Determination of the acidity of the vagina. With dysbiosis, this figure is more than 4.5.

Treatment

Treatment of gardnerellosis during pregnancy is aimed at eliminating the cause of its occurrence. Examination and treatment of a sexual partner is optional. Bacterial vaginosis responds well to therapy, but in most cases it reappears after a while. How to treat vaginal dysbiosis:

During the treatment period, a special diet is followed. Confectionery and pastries are excluded from the diet, they eat as much fermented milk products, fresh vegetables and fruits as possible.

Why is gardnerella dangerous during pregnancy?

If untreated, the following consequences arise:

Inflammation of the amniotic membranes. May cause damage or complete rupture of the bubble. In the early stages of pregnancy, a miscarriage occurs, in the late stages - premature birth. Microtrauma in the membranes leads to the penetration of infections that have a negative effect on the fetus. Complications are different - from developmental delay to intrauterine death.
Leakage of amniotic fluid.
Accession of other infectious diseases.
Postpartum complications. The most common among them is considered.
Decreased immunity. The body of a pregnant woman becomes more susceptible to viruses and bacteria, which is why even a cold can lead to dangerous complications.

Prophylaxis

In order to prevent bacterial vaginosis caused by gardnerella vaginalis, barrier contraception is used during pregnancy. It is necessary to abandon bad habits that greatly increase the risk of the disease. It is not recommended to use perfumed and antiseptic intimate hygiene products. It is necessary to regularly visit a gynecologist and take tests to help determine the state of the vaginal microflora. Sexually transmitted diseases are treated before pregnancy.

Until recently, this disease was equated with genital infections. But today the medical opinion on this matter has changed. Doctors view vaginosis as a pathological condition rather than a disease that creates favorable conditions for the development of other sexual ailments.

This happens when the natural normal microflora of the vagina is disrupted. Normally, the vaginal environment is populated by 98% of lactobacilli, which 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 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 remains.

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 the number of harmful ones increases. Because of this, it is often called also vaginal dysbiosis.

First of all, gardnerellas come to life. But other bacteria can be found in a smear from a woman with bacterial vaginosis.

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

One of the reasons for the appearance of bacterial vaginosis can be hormonal disorders, which occurs, in particular, with the onset of pregnancy. Vaginal dysbiosis in pregnant women has its own characteristics, which you should definitely be aware of.

Symptoms of bacterial vaginosis in pregnant women

This is not to say that pregnant women are at risk of developing vaginal dysbiosis. Rather, the opposite is true. Medical statistics do not find a quantitative increase in morbidity during the period of childbearing. But there are some nuances here.

It is interesting that nature took care of some protection of women from the development of pathogenic flora. In particular, with the onset of pregnancy, hormones are actively produced in her body, and under their influence, epithelial cells are intensively produced, which lactobacilli feed on. As a result, they produce a lot of lactic acid, which inhibits the growth of pathogenic microflora. But the problem is that it is produced in excess, against the background of 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 this in any way, 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 makes it difficult to distinguish vaginosis on your own. Nevertheless, there are symptoms that are most likely to indicate a violation of the female flora:

A stringy, frothy, fishy-smelling mucous discharge is often copious. At the beginning of the disease, they have a white or grayish (earthy) hue, but over time they change to yellow or green and become more sticky.
Increased fishy odor after contact with male sperm or smegma.
Feeling pain during sex.
Pain in the lower abdomen, in the area 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 women who are registered as obstetricians 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 on the flora is taken from the expectant mother and a bacterial sowing is performed. If necessary (and recently this analysis has also been included in the list of mandatory ones), PCR diagnostics are carried out.

Such a diagnosis allows you to identify bacterial vaginosis even with its hidden form, that is, in the absence of any signs. The following indicators indicate dysbiosis:

The presence of gardnerella (it is believed that with vaginosis, they activate their growth necessarily, and the rest of the bacteria - selectively).
The 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 conduct a test for leakage of amniotic fluid and for acidity of urine, so that in case of the slightest violations, consult a doctor and begin treatment. It is necessary, even if the expectant mother does not experience any discomfort and does not feel any pathological changes: bacterial vaginosis poses 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, occur against the background of dysbiosis, pose a great threat to pregnancy and the fetus. After all, harmful bacteria multiply rapidly, as a result of which gardnerellosis, mycoplasmosis, ureaplasmosis, staphylococcus, streptococcus or other disease develops, depending on which bacteria begin to develop. All of them act very aggressively and are capable of damaging 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 birth - problems with the functioning of the respiratory system, the work of the nervous system, skin diseases.

In addition, the pathogenic flora living in the genital tract of a woman produces enzymes very similar to those produced by the amnion on the eve of childbirth. The presence of these enzymes signals the body that the uterus, cervix and fetus are 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 susceptible to sexually transmitted 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 breasts.

Therefore, the disturbed flora must be restored without fail. How is this 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.

Vaginosis can be distinguished from other similar disorders by the nature of the discharge: with thrush, they are cheesy and smell like sour milk, and with trichomoniasis, they are liquid (but also frothy and sticky), accompanied by burning and itching of the external genital organs. But it is precisely the laboratory examination of vaginal discharge that will help to finally make sure of 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 gestation), effective in relation to the identified type of microorganisms. Most often, Metronidazole (Metrogyl, Trichopolum, Klion), Ornidazole (Tiberal), Salvagin, Clindamycin (Dalatsin) are used to treat vaginosis in pregnant women.

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

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

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

It is necessary to pay special attention to intimate hygiene, carrying out washing twice a day - at least. Change your laundry clean and dry as soon as necessary. It is better to change clothes once more than to use panty liners, obstetricians say.

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

Especially for - Ekaterina Vlasenko