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| |    Vaginal Infections during Pregnancy by Marjorie Greenfield, M.D. reviewed and revised by Marjorie Greenfield, M.D. While vaginal discharge in pregnancy is quite common, many women also experience the irritation, odor, or increased discharge that is caused by an actual infection. Most vaginal infections do not hurt the baby, but they can make mothers-to-be very uncomfortable. How can I tell if I have a vaginal infection? It's normal to have more discharge while you're pregnant than before you conceived. What's key is that this type of discharge is usually clear or white and odorless. You should not have itching or significant vulvar irritation. The presence of yellow or green discharge plus bad odor, external or internal irritation, or itching can all indicate vaginitis. Your practitioner can evaluate vaginal secretions if the cause of the infection is unclear. Yeast infections in pregnancy It's extremely common to get a yeast infection while pregnant because of the high levels of pregnancy hormones present. The mild immune suppression that comes with carrying a baby might also contribute to its development. You may notice an increase in thick white discharge, redness or irritation of the outer vaginal lips, and sometimes severe itching. Yeast infections in pregnancy do not normally travel up into the uterus or harm the baby in any way, and they only require treatment if the mother's symptoms are bothersome. In general, intra-vaginal treatments (either over-the-counter or prescription) are preferable to oral treatment with fluconazole (Diflucan), since they have been in use for longer without apparent problems and because less of the medication is absorbed into the bloodstream. A single dose of fluconazole does not appear to expose the baby to risk, although high continuous doses may cause birth defects. Bacterial vaginosis Bacterial vaginosis, commonly called BV, is an imbalance of the bacteria of the vagina, with more of the bad bacteria present than the good lactobacilli. This usually leads to a fishy odor that may be most noticeable after intercourse. Many women have no symptoms of BV, but their practitioner may diagnose it at the time of a vaginal examination by checking the pH of the vaginal secretions or by looking at the discharge under the microscope. Up until just a few years ago, OB practitioners were fairly relaxed about BV and only treated it if the woman had symptoms. But recent research has shown that BV increases the chances of premature birth and premature rupture of the membranes, so the current practice is to treat it if diagnosed and to specifically test for it if a woman is already at high risk of having a premature birth. Trichomonas Trichomonas (often referred to as trich, pronounced trick) is a sexually transmitted parasite that can infect the vagina. Oftentimes no symptoms are present, although some women will notice a discharge, irritation, or odor. While the parasite itself does not travel up into the uterus or affect the baby in any way, this infection changes the pH balance of the vagina and can lead to bacterial vaginosis, which may pose some risk to the pregnancy. After a doctor diagnoses Trichomonas (usually after viewing vaginal secretions under a microscope), the infection can be treated with oral metronidazole after the first trimester. The woman's sexual partner(s) should also get treated, and anyone with trich should be tested for other sexually transmitted infections.
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