Very often, a woman bearing a child is exposed to serious pathologies, and all because her body is being rebuilt, he has to work for two, so the immune system is weakened. Often in women there are diseases of the reproductive system that, without proper treatment, can lead to miscarriage. One of such ailments is bacterial vaginosis. During pregnancy, it is most often found and requires urgent treatment under the supervision of a physician. But what is this ailment, how to properly treat it, and what preventive measures to take?
What is vaginosis?
Vaginosis during pregnancy is a disease accompanied by abnormalities in the vagina with a rapid decrease in the number of lactic acid bacteria and a pronounced increase in conditionally pathogenic microflora. In rare cases, an inflammatory process appears. This is one of the most common ailments encountered at women of 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%.
Bacterial vaginosis during pregnancy, or, as it is often called, dysbiosis, leads to the fact that lactobacilli, which are responsible for the protective functions of the body, completely disappear, so a woman becomes vulnerable. During pregnancy, neglected forms can lead to fetal loss, so it is very important to detect the disease in time and start treatment.
Norm of bacteria in the vagina
In the vagina of every woman, special bacteria live that protect the reproductive system from inflammation and other pathologies. Their optimal number should be as follows:
- lactobacilli - 95%;
- 2.5-5% is a conditionally pathogenic flora.
The number of pathogenic organisms is so great that to say exactly how many of them will not work, each girl has her own set, but there are certain types that are present in everyone and they will certainly manifest themselves if dysbiosis begins. The main bacterium is Gardnerella vaginalis, it always appears if vaginosis has begun during pregnancy. It is considered a kind of marker and almost all laboratory tests are based on it.
Vaginosis Classification
Before you understand the important question for many women, how to treat vaginosis during pregnancy, you need to know exactly what severity of the disease is:
- 1 degree. It is determined if there is no microflora in the smear, and epithelial cells are present without changes and the possibility of infection with other bacteria is preserved.
- 2 degree. In this case, the degree of Doderlein rods decreases, and the gram-negative and positive flora increases, a slight increase in leukocytes is detected in the blood.
- 3 degree. In this case, lactic acid bacteria are completely absent, the clinical picture of the disease is evident.
Causes of vaginosis in pregnant women
When lactobacilli are normal, nothing threatens any woman or her fetus. They monitor the balance of microflora and produce lactic acid, which maintains an optimal acid balance that is harmful to most pathogens. But under the influence of certain factors, the number of beneficial bacteria can decrease, in this case there is a violation of the microecological system. A low level of lactobacilli leads to an uncontrolled growth of harmful bacteria: gardnerella, bacteroids, mobilkusy, peptococcus, mycoplasma, streptococcus.
It is difficult to determine what exactly affects the microflora and causes vaginosis during pregnancy, but internal and external factors can affect the reduction in the number of lactobacilli:
- taking antibiotics;
- antimicrobial therapy, hormonal and antifungal agents;
- malfunctions in the hormonal background after abortion, labor or puberty;
- vaginal douching;
- the use of antimicrobials during intimate hygiene with triclosan;
- use of oral contraceptives;
- the use of spermicides, which are a part of the 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 break down glycogen, which is formed from 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 the hormonal background in the body of every lady is constantly changing and not always for the better.
While a woman is carrying a baby, under the influence of the hormones of the corpus luteum, the number of squamous cells increases significantly. As a result, it turns out that the glycogen supply is quite large, so the level of lactobacilli increases, and the degree of conditionally pathogenic microflora decreases and, as a result, the pH becomes lower. The body tries to cleanse the birth canal on its own by the time when labor begins and the baby gets acquainted with healthy microflora, which will settle in its intestines.
At first glance, it would seem that everything should be just perfect, but in most cases, a too acidic environment leads to the fact that some forms of transient infections grow, including candida fungi, mycoplasmas, ureplasmas, and eventually vaginosis begins to develop during pregnancy.
What happens with vaginosis?
Under the influence of one of the mechanisms of useful substances is waning. The degree of lactic acid decreases rapidly, the pH rises and the pathogenic flora begins to multiply, in the first place it concerns the gardnerella, which further inhibits beneficial bacteria. It turns out the "vicious circle", whereby lactobacilli are killed in large numbers.
The rapid development of pathogenic microorganisms leads to the fact that a woman has unpleasant symptoms, indicating that vaginosis appeared during pregnancy.
Symptoms in pregnant women
Not always in the early stages of the disease manifests itself with severe symptoms, but if the disease progresses, then its symptoms appear:
- profuse leucorrhoea with a slightly grayish tint, and if the disease is not treated for years, then the discharge can become greenish, foamy and viscous;
- a characteristic fishy smell appears, it is especially audible during intercourse of partners;
- there is pain during intercourse, burning;
- discomfort in the abdomen does not live peacefully, at survey found hypertonicity of the uterus;
- unpleasant burning sensation during urination, but such a symptom is much less common.
After the first symptoms have appeared, you need to urgently consult a gynecologist who will conduct an examination and will be able to accurately make a diagnosis.
Diagnostic methods for determining vaginosis
Most often, only a doctor can diagnose a pathology. Independently, no woman can say which infection is progressing in her body, since there are many varieties of bacteria that cause it. Most often, discomfort in the lower abdomen and vagina is simply felt, so you need to consult a doctor. He, in turn, examines a woman, takes a smear for analysis and does a blood sampling to conduct additional studies and to identify which infection provoked the development of the disease.
After carrying out all the necessary studies, you can accurately confirm or refute the diagnosis, and only after that start treatment for 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, amniotic fluid inflammation can occur, as a result of which a crack and even a rupture may appear on it. If this happens, then the woman may begin preterm labor or miscarriage. When the cracks infection can get into the amniotic fluid, and eventually the baby is infected.
This infection can lead to serious consequences: development of the fetus will be suspended or sepsis.
It is therefore important time to detect bacterial vaginosis in pregnancy. Treatment should be started immediately after confirmation of the diagnosis and all recommendations should be followed strictly.
Vaginosis Treatment During Pregnancy
If the patient's diagnosis is confirmed, then first of all the doctor recommends taking a course of antibiotics that are safe for the woman in her position.
It is important to follow all recommendations of the doctor, from the first to the last day, until the 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 can again appear. And relapses usually are much more difficult, and therapy affects them worse.
But even if the patient fully follows all the recommendations - taking antibiotics, putting candles on bacterial vaginosis during pregnancy, it is possible that the infection will appear again.
Almost a third of the women who underwent treatment experienced a reappearance of symptoms in the first three months after taking antibiotics. Relapse is associated with the fact that taking such drugs killed most of the not only pathogenic bacteria, but also beneficial ones. And until now, a method has not yet been found that could cause beneficial bacteria to 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. An exact answer to the main question is how to treat bacterial vaginosis during pregnancy by a gynecologist 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 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 at such drugs:
- Apilak
- “Acylact”;
- "Bifidumbacterin";
- "Lactobacterin" and others.
To do this, take 2 doses of the drug and dilute 5 ml of purified water, soak a swab and introduce 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.
Vaginosis Prevention
To date, it has not been fully clarified what exactly causes dysbiosis in the genitals of a woman, therefore it is impossible to say exactly what preventive measures will give a positive result. But there are several ways that can help slightly reduce the risk that a woman will have bacterial vaginosis during pregnancy:
- It is very important to adhere to the rules of safe sex, especially if you are not confident in a partner. It is not yet clear what role a woman's sexual life plays in the appearance of vaginosis, but statistics say that pathology is more common in those patients who have several sexual partners at once.
- It is important to quit smoking. It is believed that smoking leads to an increased risk of developing a pathology such as vaginosis in early pregnancy.
- In no case should you douche and wash your vagina with a stream of water. Also, the doctor does not recommend using sprays for intimate hygiene and soap for washing the genitals. All these funds can upset the balance and lead to the development of pathogenic microflora.
Any diseases during pregnancy require a careful approach and thorough treatment in order to prevent complications and not harm the baby.