Bartholinitis During Pregnancy - Causes, Symptoms And Treatment Of Bartholinitis During Pregnancy

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Causes and symptoms of bartholinitis during pregnancy

The dangerous disease bartholinitis is a special process of serious inflammation of a large gland, which is located in a woman on the eve of the vagina. As a rule, such inflammation of the Bartholin gland is unilateral. In most cases, caused by infections such as gonococcus, staphylococcus, Trichomonas and E. coli, which can be extremely dangerous during pregnancy.

The penetration of any infection through an important excretory duct of the gland always leads to serious blockage and a false abscess. Often, such inflammations turn into the parenchyma, when all the fluid released is purulent. In this case, the formation of a true abscess is diagnosed. In extremely rare cases, dangerous suppuration may not be observed at all, but the gland will be dense and enlarged. After a certain period of time, the disease will resume only with serious complications.

The release of purulent contents, in other words, self-opening of the abscess, significantly improves the well-being of a particular patient. But during pregnancy, this can have serious consequences. Without treatment, a relapse of this disease is not excluded, as well as the risk of bartholinitis becoming a dangerous chronic form. The presence of any genital infections during pregnancy in almost all cases has an extremely adverse effect on the fetus itself.

In some cases, the protective mechanisms existing in the body of the expectant mother do not help at all. Infection of the baby can occur in a hematogenous way directly through the blood inside the womb. Infected blood first enters the placenta, and then through it and into the umbilical cord, after which the fetus is infected. A serious infection of the fetus with gonococcus or Trichomonas is considered dangerous, since inevitable changes can begin in the formation of the organs and systems of the child themselves.

As a rule, only infection in the period from 5 days to 13 weeks from the moment of conception leads to fetal death. During this period, any pathogenic microflora is detrimental to the child. If, with bartholinitis, the expectant mother does not go to the doctor, then serious complications of pregnancy with various vaginal infections are not excluded. With each patient individually, the doctor raises the question of terminating a pregnancy or treating a woman.

The causes of bartholinitis

It has been proven that the factors that provoke the development of bartholinitis can be a wide variety of microorganisms that penetrate the tissues of the bartholin gland under certain conditions. The disease develops in the case of penetration of various microorganisms into the gland located on the eve of the vagina through the excretory duct. The duct always opens only on the inner surface of the labia minora.

Usually, all causative agents of infection - microbes enter the gland immediately from the urethra or vagina. Urethritis and colpitis can be harbingers of bartholinitis. Very rarely, the cause of bartholinitis is infection directly through the blood. The most dangerous pathogens include microbes such as chlamydia, staphylococcus, streptococcus, gonococcus, Escherichia coli and Trichomonas. The most difficult and dangerous course of this disease often develops due to a typical gonorrheal pathogen.

There are also other provoking factors. Bartholinitis can occur due to hypothermia of the body, neglect of the basic rules of personal hygiene, stress, weakened immunity, vitamin deficiencies, sexual intercourse during severe monthly bleeding, promiscuous sexual intercourse with a large number of men, sexually transmitted diseases, as well as complications after abortions and various uterine surgical procedures.

Bartholinitis symptoms

According to the clinical course of the disease, the following types are mainly distinguished - acute and chronic. Usually, with acute bartholinitis, there is always general malaise, an increase in body temperature, weakness of the body, the presence of swelling in any area of the external genital organs.

For the development of the disease, favorable conditions are violations of the outflow of the secretion of the gland, which is usually observed due to the narrowing of the excretory duct. Discomfort and soreness in the genital area and severe suppuration with typical glandular abscess formation should also be noted.

In various cases, the chronic course of bartholinitis occurs without pronounced main symptoms. However, with exacerbations during hypothermia of the female body, during menstruation or after illness, typical chronic bartholinitis becomes painful. At the same time, the patients begin to be greatly disturbed by small pains of the labia, discomfort during intercourse and even rather unpleasant sensations when walking.

In the absence of the necessary treatment, chronic bartholinitis passes into the formation of a cyst, and inflammations have repeated repetition. Some pregnant patients try to squeeze out such an abscess on their own. Such a procedure at home can be extremely dangerous for both the woman and the fetus. Even a spontaneous breakthrough of an abscess does not guarantee its complete emptying, therefore, modern surgical intervention is necessary.

Bartholinitis treatment

Correct diagnosis of the presented disease allows therapy to be carried out without delay. It should be noted that the ability of the Bartholin gland to penetrate modern antibacterial drugs is rather poor, as a rule, the complete cure of dangerous bartholinitis in pregnant women is gradual, the disease directly depends on the stage of the disease.

In acute bartholinitis, it is recommended to stay in bed, to abstain from sexual activity for a long time, and in case of severe pain, you can put ice on a specific inflamed area. Antibiotic therapy includes groups of drugs such as cephalosporin, penicillin, fluoroquinolones and imidazoles.

Anti-inflammatory therapy is based on treating the inflamed area with a special ointment (for example, Vishnevsky), as well as applying small tampons with ichthyol ointment or levomecol. You can use solutions with chlorhexidine or miramistin. However, only a doctor should prescribe treatment, who will accurately determine the stage of the disease. Often, due to the rapid progression in pregnant women, standard surgical intervention is used.

Marsupialization and extirpation are used to treat the cyst of the Bartholin gland. Marsupialization is the surgical opening of a cyst capsule that is filled with pus using a conventional linear incision. In this case, the edges of the capsule are always sutured to the very edges of the skin wound. This allows the required outer opening to be formed. In the future, a drainage tube or catheter is quickly introduced through it to create an artificial duct of the gland, as well as the obligatory outflow of the contents of the cyst.

After carrying out such a procedure, a significant narrowing of the typical external opening usually occurs and the formation of a new excretory duct is mandatory. Another method - extirpation is always performed if a relapse of the disease occurs. In this case, when performing the required longitudinal incision of the labia minora, the gland is easily separated with a scalpel, and then removed. After removal, interrupted sutures are applied to the wounds, using catgut thread.

After surgery, a pregnant woman should refrain from sexual intercourse until the disease is completely cured. If necessary, the doctor will prescribe physical and magnetic therapy, as well as modern ultraviolet radiation.

A disease such as bartholinitis is always easier to prevent than to treat surgically. Therefore, every expectant mother must, before conception, cure all possible infectious diseases, as well as candidiasis, in order to prevent unnecessary risks and spontaneous abortion.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".