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, so it must be eliminated in a timely manner.

Reasons for development

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

1. Inspection. At this stage, the first symptom of the disease is detected - abundant thick discharge with a pungent odor. The condition of the vaginal mucous membranes remains normal.
2. Smear. a 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.
3. PCR. Used to identify the causative agent of infection, bacterial culture for bacterial vaginosis turns out to be uninformative.
4. Determination of vaginal acidity. With dysbacteriosis, this indicator is more than 4.5.

Treatment

Treatment of gardnerellosis during pregnancy is aimed at eliminating the cause of its occurrence. Examination and treatment of the sexual partner is not necessary. Bacterial vaginosis responds well to treatment, 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 butter products are excluded from the diet, and they eat as much fermented milk products, fresh vegetables and fruits as possible.

Why is gardnerella dangerous during pregnancy?

If left untreated, the following consequences occur:

1. Inflammation of the amniotic membranes. May cause damage or complete rupture of the bladder. In the early stages of pregnancy, miscarriage occurs, in the later stages - premature birth. Microtraumas in the membranes lead to the penetration of infections that have a negative effect on the fetus. Complications vary from developmental delay to intrauterine death.
2. Leakage of amniotic fluid.
3. Association of other infectious diseases.
4. Postpartum complications. The most common among them is considered.
5. Decreased immunity. A pregnant woman's body becomes more susceptible to viruses and bacteria, which is why even a cold can lead to dangerous complications.

Prevention

In order to prevent bacterial vaginosis caused by gardnerella vaginalis, barrier contraceptives are used during pregnancy. Need to give up bad habits, which greatly increases the risk of developing the disease. It is not recommended to use scented 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. Before pregnancy occurs, sexually transmitted diseases are cured.

Bacterial vaginosis brings a lot of inconvenience and discomfort to women during pregnancy. This disease is one of the vaginal infectious diseases. Pathological processes are caused by the appearance of an imbalance of bacteria that live in the vagina.

According to statistics, every fifth woman has encountered symptoms of the disease in question. During pregnancy, the risk of bacterial vaginosis increases greatly.

Due to the fact that certain changes occur in the female body during pregnancy, at this time there may be an imbalance in the bacterial balance inside, including the vagina.

Typically, the microflora of the female vagina is supported by lactic acid bacteria. But in pregnant women their number gradually disappears. The body's immunity levels decrease, and harmful pathogens that cause bacterial vaginosis may begin to develop in the middle of the vagina.

The fact is that the infectious process in question can proceed for years without any symptoms. But at a certain point, especially during pregnancy, bacterial vaginosis will manifest itself with its symptoms. If the pathology is not treated, the disease can cause more serious problems:

• premature birth;
• diseases of the pelvic organs;
• premature birth;
• miscarriage.

To date, all the consequences of bacterial vaginosis have not yet been studied. But there are cases when the entire pregnancy, with the presence of the disease, proceeded without any problems, and the symptoms themselves gradually disappeared in women. But this happens very rarely.

Classification of the disease

There are degrees of bacterial vaginosis. They vary depending on the severity of the pathology:

• Compensated degree (when taking a smear, the absence of microflora and the presence of epithelial cells is observed).
• Subcompensated degree (decrease in the content of Doderlein's bacillus, increase in gram-negative and gram-positive flora, increase in leukocytes in the blood).
• Decompensated degree (lactic acid bacteria are absent, the symptoms of the disease appear more clearly, during laboratory analysis many different pathogenic and facultative, as well as opportunistic microorganisms are observed).

Depending on the course of bacterial vaginosis, there is an acute, torpid or erased and asymptomatic form.

Causes of the disease

The skin and mucous membrane of healthy women are not always sterile, since the human body is constantly in contact with many microorganisms that make up the microflora. Thus, the microflora of the female vagina consists of lactobacilli, the main inhabitants of the vagina (lactic acid bacteria).

Lactobacilli are capable of producing a certain amount of lactic acid, which helps maintain a healthy acidic environment in the female vagina. It acts as a protective factor that prevents the growth of other types of bacteria that cause other diseases.

As the disease progresses, other types of bacteria are also observed:

• Bacteroides;
• Peptococcus;
• Peptostreptococci;
• Mycoplasmas.

Factors affecting the microflora of the female vagina:

• during intestinal dysfunction;
• when using spermicides;
• with frequent excessive vaginal douching and use of antiseptic agents;
• with decreased immunity or an allergic reaction;
• when using unsuitable contraceptives or after installing an IUD;
• changes in the body's hormonal levels during puberty, after an abortion, after childbirth, during menstruation disorders;
• during changing climatic conditions, under various stresses;
• long-term use of antibiotic and hormonal drugs.

When symptoms of bacterial vaginosis appear, you should pay attention to the disease and see a doctor. There is no need to postpone treatment until the next day.

What is the danger of disease during pregnancy?

The danger of the disease in question lies in the fact that microorganisms may penetrate from the vaginal area into the vagina, infecting all internal genital organs, including the fetal membrane or any area of ​​the placenta. These types of migration can lead to the development of many complications in the female body, such as:

• the appearance of premature birth;
• earlier rupture of amniotic fluid;
• purulent decay of the fetal membrane;
• organ inflammation;
• chorioamnionitis;
• rupture of the membranes.

The pathological process can spread to the unborn child while still in the womb. But prolonged hypoxia, dysfunction of the placenta and its vascular system. With bacterial vaginosis, the baby may be born weak and with low body weight. A child may also be born with a number of diseases, such as pneumonia or nervousness.

If the birth took place using caesarean section, then the mother may also have a problem. Bacterial vaginosis in pregnancy has a number of complications, including inflammation of the lining of the uterus.

Diagnosis of the disease

Typically, diagnostic procedures are carried out by a gynecologist. But if there is insufficient information, he refers the woman to additional procedures or tests. It is important to correctly determine which infection could cause the pathology, because infectious bacteria are very diverse.

A woman whose disease progresses may experience serious discomfort. It is at this time that you should immediately contact specialists so that serious complications do not arise in the future.

During additional studies, doctors should carefully examine and take swabs from the surface of the vagina. And it is also important to do blood work and general tests. After this, based on the research conducted, treatment can be prescribed.

Symptoms of bacterial vaginosis

According to statistics, there are situations when women are able to tolerate bakvaginosis without any symptoms. This can greatly complicate the timely detection of manifestations of an infectious disease. But since the disease is not simple and can cause complications, there are recommendations for which symptoms it is important to consult a doctor:

• Pain during sexual intercourse.
• The appearance of sticky and viscous white discharge, sometimes gray. When the disease lasts for more than one month, the color may be yellow or even green.
• Pain during urination.
• Itching occurs in the evening, as well as at night. It can intensify after sexual intercourse and after taking a hot shower.
• Sour, fishy-smelling discharge. They intensify after sexual intercourse, especially after contact with sperm.

Pregnant women diagnosed with bacterial vaginosis are able to give birth to a completely healthy child, and the disease goes away on its own after birth. Vaginosis is dangerous because it makes the body weak and susceptible to many infectious pathologies. And there is also a risk of infection with chlamydia or gonorrhea.

Treatment of vaginosis in pregnant women

If gynecologists have diagnosed bacterial vaginosis, then there should be no panic. First of all, doctors will prescribe treatment using antibiotic drugs, which are safe even during pregnancy. It is important to take the problem at hand more seriously. If any symptoms disappear, it is important to continue visits to the gynecologist for several more months.

Vaginosis is not difficult to treat, but if it is constantly not fully treated, the disease can manifest itself again and again. After some time, the pathology can become chronic. Today there are medications that effectively kill harmful flora, leaving lactobacilli behind.

More often, manifestations of the disease begin in the fifth month of pregnancy. If such problems arise, mothers can be treated with the following drugs:

According to doctors, such medicines will not affect the fetus and its development. But it is important to know that their use in the early stages of pregnancy is not recommended.

If after treatment the symptoms of the disease resume, and during the analysis no candidiasis or gardnerella was detected, then you can use drugs that restore the microflora of the female vagina: Lactobacterin, Bifidin or Acylact.

Parallel treatment of the spouse, in the absence of sexual intercourse, is not required. It is worth noting that nutrition plays an important role during treatment. The diet should be enriched with fermented milk products. And also the composition should contain coarse fiber fibers.

When preventing bacterial vaginosis in women, you should adhere to the following rules:

• Have sex only with the use of contraception, especially with unfamiliar partners.
• Stop smoking – it greatly increases the risk of bacterial vaginosis and other diseases.
• You should not use fragrances if you maintain hygiene. They increase the risk of microflora imbalance in the female vagina.
• Be examined by a gynecologist more often during pregnancy, and also regularly take all required tests.

If a woman is just planning a pregnancy, then, first of all, many diseases need to be cured, including vaginosis.

Prevention

Preventive actions are aimed against bacterial and infectious infections of the female body. Even before fertilization occurs, it is important to undergo recommended screening for infectious diseases that can be transmitted through sexual contact.

If a woman is diagnosed with a disease, it must be treated before pregnancy occurs. At this time, antibiotics and agents can be used to restore the normal microflora of the female vagina.

If bacterial vaginosis often recurs during pregnancy, then special vaccines can be used. They do not in any way affect the development of the fetus and processes in the mother’s body, creating conditions for an increase in the number of beneficial bacteria. A feeling of recovery in the body appears a few days after the start of treatment.

Bacterial vaginosis is a serious disorder of the microscopic ecological system of the vagina with noticeable decreases or complete elimination of fermented milk bacteria and a clear increase in the number of conditional pathogenic flora. Inflammation is likely. However, this process occurs quite rarely. Bacterial vaginosis is considered the most common female disease that occurs in the reproductive age category. According to statistics, the disease is diagnosed accidentally in thirty-seven percent of cases, with heavy discharge in ninety-five percent, and during pregnancy in 37 percent of cases.

The structure of the vagina can be colonized by lactobacilli. Their rates are usually equal to ninety-five percent. The vast majority are Dederlein bacilli and lactobacilli. However, in addition to these elements, the body may contain forty types of various acidophilic bacteria that perform protective functions. Approximately five percent is opportunistic flora that does not cause any harm to the female body. In essence, the number of types of opportunistic microflora depends on the individual characteristics of the female body. It is important to note that they can manifest themselves when a woman experiences vaginal dysbiosis during pregnancy.

Normal lactobacilli are able to break down glycogen from vaginal epithelial cells into hydrogen peroxide and lactic acid, thereby creating a normalized acidic environment. In general, this acidic environment is considered the most optimal for the active growth of destructive flora and lactic acid bacteria. Lactobacillary colonies, together with the products of their own individual vital activity, form a glycocalyx, that is, a biological film that protects and lines the vagina.

During pregnancy, the combination of harmful and beneficial components may change. This is due to individual life expectancy and hormonal female experiences.

During the period of bearing a baby, under the active influence of yellow-bodied hormonal cells, a lot of free space becomes available. An inexhaustible supply of glycogen is formed, the number of lactobacilli increases significantly, the number of conditionally pathogenic microscopic flora decreases, and the pH level becomes much lower. Of course, the body strives to do its best. He tries to clear the birth canal by the time the baby is born. On the one hand, it seems that everything should be very good. But if you are more careful, you will notice that an acidic environment in thirty percent of cases begins to significantly stimulate the growth of most infections. These include mycoplasma, yeast-like fungi, and ureaplasma.

With bacterial vaginosis, under the influence of starting mechanisms, the number of lactobacilli located in the vagina decreases. Also, the level of lactic acid decreases sharply, increasing the pH and multiplying opportunistic flora. Thus, the normal activity of lactic acid bacteria is inhibited.

Based on all of the above, the concept of bacterial vaginosis can be deciphered as a disease caused by numerous forms of bacteria and microbes. With all this, gardnerella is not the only unfavorable element, despite its long existence.

Symptoms of bacterial vaginosis during pregnancy

Bacterial vaginosis is caused by the presence of some severe symptoms:

The fundamental criteria leading to the disease in question are:

1. Reduced female immunity of the whole body.
2. Local as well as systemic antibiotic therapy.
3. Diabetes mellitus and other endocrine diseases.
4. Active treatment with cytostatic and hormonal medications.
5. Anemia of various origins.
6. Pathologies of development of the genital organs.
7. Failure to comply with basic hygiene instructions and recommendations.

Course of bacterial vaginosis

It is noted that bacterial vaginosis is a very insidious disease. Treatment, accordingly, is just as difficult and fraught with many mysterious moments. It is not uncommon for pathogenic microorganisms to be detected in a vaginal smear, but a woman may feel well and not complain of any phenomena. For a long time, it was believed that female treatment has no meaning. You just need to monitor the dynamics of the disease. The vaginal ecological system is said to have the ability to recreate itself without medical intervention. However, women who do not seek medical attention are at highest risk due to the possibility of future rupture of the membranes. They are required to regularly visit a gynecologist, and also have a specialized kit at home for instant diagnosis of amniotic fluid leakage.

The group of women with very heavy discharge is considered the most complicated in terms of diagnostics. And this is not without reason, since during the period of bearing a baby, all physiological leucorrhoea intensifies, which is the cause of severe anxiety. This disease requires careful treatment. Multiple leucorrhoea is caused by differential diagnosis, leakage of water and candidiasis. Treatment of a leak is based on the results of the bacterial disease.

Bacterial vaginosis and complications

The most common complications of bacterial vaginosis during pregnancy are:

It is important to note that the treatment of the disease in question, that is, bacterial vaginosis, is strictly individual. Direct treatment involves the advance implementation of multiple diagnostic measures and consultations with many specialists. Self-use of various medications is strictly prohibited, as you can subsequently cause severe damage to your own health and the health of the unborn baby. Only the attending physician can extend treatment, since he is familiar with the pathogenesis of the disease, the medical history, the contraindications of the pregnant woman and individual physiological and emotional disorders.

Bacterial vaginosis- this is an imbalance of microorganisms in the vagina with an increase in opportunistic forms and a decrease in lactic acid bacteria. This disease can be sexually transmitted when pathogenic bacteria are introduced into the vagina from a man.

Bacterial vaginosis during pregnancy is a risk factor for microorganisms entering the uterus from the vagina. This can cause the development of complications such as infection of the membranes and placenta, which leads to purulent-septic diseases. Vaginosis during pregnancy early sometimes causes miscarriage, and later - premature birth due to bacterial damage to the structure of the amniotic membranes.

Causes

Most common reasons development of bacterial vaginosis:

1. A long course of antibiotics, which can lead to a decrease in the number of intestinal lactobacilli.
2. Inflammatory diseases of the reproductive system, causing an increase in opportunistic or pathogenic bacteria.
3. Changes in hormonal levels during pregnancy. Frequent use of intimate hygiene products, which can cause lactobacilli to be “washed out” from the vagina.
4. Uncomfortable underwear, causing microflora to enter the vagina from the rectum, or creating conditions for the proliferation of anaerobic bacteria (tight, non-breathable underwear).
5. Stress, poor diet and bad habits.

Signs and symptoms

The main symptom of bacterial vaginosis is a change in the nature of vaginal discharge:

• increased amount of discharge;
• a change in color, usually a yellowish tint, sometimes green or gray;
• liquid, sometimes foamy consistency of discharge;
• The discharge may be accompanied by an unpleasant odor.

In addition to the above, bacterial vaginosis can manifest itself as pain during urination and sexual intercourse. Very rarely, women experience itching and pain in the lower abdomen.

Treatment methods

Timely diagnosis of bacterial vaginosis is the key to successful treatment of this disease, therefore, if at least one of the symptoms described above appears, you should consult a doctor. At the first visit to the gynecologist, if signs of the disease are detected, a visual examination of the vagina will be performed for pathological discharge. With bacterial vaginosis, their number is increased, the consistency becomes liquid, foamy or creamy, and an unpleasant odor may appear.

Among the laboratory research methods, a vaginal smear is used. Microscopic examination reveals colonies of pathogenic microorganisms. The doctor also measures the acidity of the vagina using a test strip. With bacterial vaginosis, the pH is greater than 4.5.

Attention! Bacterial vaginosis during pregnancy can have a blurred clinical picture, therefore, if there is the slightest change in the nature of discharge from the genital tract, and, even more so, if other symptoms appear, you should immediately visit a gynecologist for timely diagnosis of the disease.

When a diagnosis of bacterial vaginosis is made, the goal of treatment is to normalize the vaginal microflora and destroy pathogenic microorganisms. These results are achieved by restoring the acidity of the vagina and stopping the growth of harmful bacteria. Local treatment of bacterial vaginosis during pregnancy is preferable, which reduces the likelihood of congenital pathologies in the unborn child.

Suppositories for vaginosis during pregnancy are the drug of choice in the treatment of this disease, especially in the first trimester, when systemic treatment can cause malformations in the fetus. - the safest and most effective drug for restoring normal vaginal microflora in pregnant women. When applied topically, there are practically no allergic reactions and effect on the fetus.

To correct local immunity, Kipferon is prescribed in the form of suppositories. Suppositories for vaginosis during pregnancy should be used strictly according to the instructions for a course of at least 5 days to avoid chronicity of the disease.

To prevent bacterial vaginosis, you should avoid promiscuous sex life, use contraception, and monitor hormonal levels, plan to visit a gynecologist. Counts useful strengthening immunity through exercise, diet adjustments and vitamin therapy.

Bacterial vaginosis during pregnancy is a disease that can cause severe complications, including miscarriage or premature birth. The main symptom of bacterial vaginosis is a change in the nature, color and smell of discharge from the genital tract. If signs of this disease appear, especially in pregnant women, you should immediately consult a doctor for early diagnosis and timely treatment. The drugs of choice for the treatment of bacterial vaginosis in expectant mothers are vaginal suppositories, since they do not have a pathogenic effect on the fetus.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Bacterial vaginosis during pregnancy

On average, about twenty percent of pregnant women experience bacterial vaginosis. Changes in the vaginal microflora during pregnancy contribute to the development of those harmful microbes that cause bacterial vaginosis. In normal conditions, the normal microflora of the vagina is maintained by lactic acid bacteria. But in pregnant women, the number of these bacteria decreases and immunity decreases. These factors contribute to the development of bacterial vaginosis.

Often, bacterial vaginosis in pregnant women is completely asymptomatic, but sometimes the disease causes great inconvenience.
If bacterial vaginosis is suspected, a microscopic analysis of the vaginal microflora is performed.

If you are pregnant and have been diagnosed with bacterial vaginosis, do not think that this is not a dangerous situation at all. Those microbes that provoke the development of bacterial vaginosis release toxic substances that contribute to the development of cancer. In addition, the infection can rise higher, causing inflammation in the uterus and appendages. These diseases greatly complicate the course of pregnancy and can lead to rupture of membranes and even spontaneous abortion. The presence of bacterial vaginosis almost triples the possibility of such complications. In addition, every hundredth pregnant woman gets sick chorioamnionitis– a disease caused by bacterial vaginosis and also dangerous and severe complications of pregnancy.

And even after the birth of a child, bacterial vaginosis suffered during pregnancy will remind itself of itself by the development of endometritis. Therefore, be sure to treat bacterial vaginosis.

Metronidazole

The main treatment for bacterial vaginosis in pregnant women is metronidazole. But if for ordinary patients metronidazole is prescribed in the form of tablets for oral administration, then for pregnant women it is preferable to use topical treatment with metronidazole.

Metronidazole gel is available in a concentration of 0.75 percent. Such a gel in a certain dosage is inserted into the vagina using the device included in the package. This should be done once a day, preferably before bed. The course of treatment is a week.

Metronidazole is available in the form of vaginal pills. They are also inserted into the vagina before bed, one pill per day. The course of treatment is ten days.

Metronidazole is also available as vaginal pills Klion-D. This remedy is also used vaginally for ten days.

Most often, only local treatment is sufficient to treat bacterial vaginosis in pregnant women. If you have a particularly complex form of the disease, you may be prescribed oral metronidazole, even despite pregnancy. This treatment tactic always gives good results. It can be used to treat expectant mothers who have already reached the twentieth week of pregnancy. Before this period, treatment for bacterial vaginosis is prescribed only in cases where the disease can cause dangerous complications.

Other drugs

In addition to metronidazole, you can use clindamycin or dalacin during pregnancy. These medications are available in both cream and pill form for oral administration.

Sometimes treatment with trichopolum is used for a week.
In addition, to normalize the vaginal microflora, drugs such as Lactobacterin, bifidin. The medicine is mixed with boiled water and poured into the vagina twice a day.

Consume vitamin and mineral complexes and you will help support your local immunity. One of the universal sources of vitamins and microelements is spirulina algae. The Tianshi Corporation produces dietary supplements (dietary supplements) based on spirulina, which is called Spirulina. This drug can be used during pregnancy, since Spirulina is a completely neutral plant that cannot harm you or your baby in any way.

Before use, you should consult a specialist.

Reviews

Tell me, who treated my husband with bacterial vaginosis? I am 4 months pregnant with Lechum Klion D 100.

At 27 weeks I was diagnosed and prescribed a bunch of medications. Metronidazole three times a day for a course of 7 days, terzhinan 10 days at night, vilprofen from the 3rd day of treatment 2 times a day for a course of 10 days, fluconazole 1st, 3rd and 7th day of treatment 1 tablet. I look at this treatment recipe and am horrified. There are doubts: is everything necessary?

Before pregnancy, I was diagnosed with bacterial vaginosis, was treated with Klion + Terzhinan, the symptoms went away, but I didn’t have time to take a control smear... I got pregnant, was registered in another hospital and then they diagnosed simple vaginosis... I took Vagilac - the discharge and itching remained, I did Betadine - zero result... now I’m using lactagel, I’ve been injecting the gel for 2 days already, another 5 days are left, but so far the unpleasant sensations remain... I’m tired, I’m very worried (((((((girls, what should I do if it doesn’t help) ?

Thank you for the article! I myself had such a nasty thing when I walked around with a pot-bellied - a terribly unpleasant thing (I remember I was cured with epigem (spray), for a couple of weeks I forgot. By the way, I spent a long time choosing what to treat, most of the remedies for pregnant women were not suitable..

Vagilak was also recommended to me, I took it, and the vaginosis went away quite quickly. I know rather vaguely about other drugs, but it seems to be the best, the price is normal, I didn’t notice any side effects (although it would be strange if such drugs had them).

By the way, not every remedy will do. Because during pregnancy it is generally better not to flirt with alkaline substances, I was also prescribed Vagilak as a milder drug to restore microflora. Moreover, they also told me that in general there are many drugs, but they usually use ordinary lactobacilli, as in the intestinal microflora, and in Vagilak - special, female ones.

An alkaline environment is detrimental only to fungi of the genus Candida, which are “responsible” for thrush. And for bacteria, for example, it is favorable. Lyudmila, you were very lucky during your pregnancy.
But in general, all manipulations in the vagina during pregnancy are dangerous, fraught with the threat of miscarriage. My gynecologist offered me the safest method of treatment when she discovered the tank. vaginosis - prescribed a course of Vagilac to restore normal vaginal flora. At the same time, intestinal function has improved, and the flora there has also been restored.

Very good article - thank you!

Of course, no one is guaranteed against such diseases. But if you constantly support your owl’s body, take vitamins and spend a lot of time outside, then the likelihood of getting such troubles during pregnancy will decrease slightly. Don't eat too much sweets yet. All pathogenic microbes love a sweet environment. And during pregnancy, I sometimes washed myself using a soda solution. An alkaline environment is detrimental to all harmful microbes.