Increased vaginal discharge is a common complaint during pregnancy, and is the result of fluctuating hormones and increased blood circulation in the vaginal area. Heavier discharge can occur throughout pregnancy without concern. A pregnant woman should seek medical attention, however, if vaginal discharge becomes smelly, changes from clear or white to green or yellow, or if the vaginal area becomes itchy or irritated. These are signs of a possible vaginal infection and require treatment.
There are two types of vaginal infections with symptoms that include a smelly discharge—bacterial vaginosis, or BV, and a yeast infection. BV occurs when normal bacteria in the vagina grows out of balance. According to the Centers for Disease Control and Prevention, BV is the most common vaginal infection in women of childbearing age, whose symptoms include heavy discharge that can change in color, a strong and almost fish-like odor, pain, and itching or burning during urination.
Similar to BV, yeast infections are also common during pregnancy. They are caused by an overgrowth of the candida albicans bacteria, and doctors often use the term "candidiasis" when discussing yeast infections. Pregnant women are particularly susceptible to yeast infections, according to American Pregnancy.org. Symptoms include yellowish discharge with a yeast or bread-like smell, itching and irritation.
While a woman can often recognize both BV and a yeast infection based on symptoms alone, Blue Cross Blue Shield of Massachusetts says a health-care provider must confirm a diagnosis by analyzing vaginal fluid. Laboratory tests on a vaginal fluid sample look for specific bacteria. Based on the type of bacteria found, a diagnosis is made.
Warnings and Concerns
If untreated, BV bacteria can spread and infect the uterus and fallopian tubes, causing pelvic inflammatory disease, or PID. A history of PID is one of the risk factors for first-trimester ectopic pregnancy. In addition, the CDC states pregnant women with BV are at increased risk for premature or low-birth-weight delivery.
Although highly uncomfortable, yeast infections do not pose a major threat to the health of the fetus, according to Blue Cross Blue Shield of Massachusetts. A baby delivered to a mother with an untreated yeast infection may develop oral thrush, which poses no serious complications and is easily treated.
BV treatment is especially critical during pregnancy, and the CDC recommends checking and treating any woman with a history of premature or low-birth-weight delivery, regardless of symptoms. Both metronidazole and clindamycin can treat BV safely during pregnancy.
Yeast infections require a full course of antifungal medications, and doctors often allow pregnant women to self-treat with an over-the-counter product.
American Pregnancy recommends avoiding bubble baths, scented feminine products, tampons and douching, as these can interrupt the normal balance of bacteria during pregnancy. In addition, keeping the vaginal area dry by changing damp clothing and drying thoroughly after washing can help prevent infection.