Colpitis during pregnancy
Content:
- What is colpitis?
- Causes of colpitis during pregnancy
- Colpitis symptoms during pregnancy
- Diagnosis of colpitis during pregnancy
- Colpitis treatment during pregnancy
- Danger of colpitis during pregnancy
- The consequences of colpitis for a child
Colpitis is a widespread gynecological disease. According to statistics, almost all women without exception suffered from this pathology at least once in their lives. Colpitis and pregnant women are not spared. Pregnancy increases the risk of developing colpitis and complicates the course of the disease, so it seems to many patients that it is simply impossible not to get sick, and it is very difficult to recover.
However, not everything is so scary, and you can get rid of colpitis even during pregnancy, it is important to strictly follow the treatment regimen and follow all the prescriptions of the attending specialist.
What is colpitis?
Colpitis (otherwise vaginitis) is a pathological inflammatory process that develops as a result of the multiplication of pathogenic or opportunistic microflora on the vaginal mucosa.
In the course of their life, bacteria release a huge amount of toxins and decay products. To remove harmful substances from the body, the glands located in the genital area begin to work more actively. For this reason, the patients have abundant discharge, which contains both the waste of the pathogenic microflora and the pathogens themselves.
Leucorrhoea irritates the external genitalia, therefore colpitis is often accompanied by vulvitis (inflammation of the vulva).
According to statistical information, pregnant women suffer from colpitis especially often. The incidence among expectant mothers reaches 75-80%. There appears to be no relationship between gestational age and the risk of developing the disease. Women can get sick at any time during pregnancy. However, the greatest danger to the fetus is the development of the pathological process in the third trimester (immediately before childbirth).
Causes of colpitis during pregnancy
The causes of colpitis during pregnancy are many. Paradoxically, pregnancy itself significantly increases the risk of developing the disease.
There are two explanations for this:
- Bearing a fetus is associated with a weakening of the protective functions of the body due to the natural suppression of immunity. In this way, nature implements the child's defense mechanism, which the mother's immune system can mistake for a dangerous antigen;
- Under natural conditions, the environment in the vagina is acidic. Thanks to this, the mucous membrane is reliably protected from the uncontrolled multiplication of pathogenic microorganisms. However, during the period of gestation, a restructuring of the hormonal background is observed: the pH of the mucous membrane changes, and the acidic environment becomes alkaline. Due to this, favorable internal conditions are formed for the reproduction of various pathogens: bacteria that cause venereal diseases, opportunistic microflora, yeast-like fungi of the genus Candida, etc.
There are also several factors that increase the risk of developing colpitis outside of pregnancy:
- Premature onset of sexual activity (14-16 years old);
- Long-term use of antibiotic drugs;
- Promiscuous sex;
- Wearing tight-fitting underwear made from unnatural (synthetic) materials;
- Wrong diet;
- Development of allergic reactions to linen, feminine hygiene products;
- Damage to the vaginal mucosa (mechanical, thermal or chemical);
- The presence of acute or chronic endocrine pathologies (hypo- or hyperthyroidism, diabetes mellitus, etc.);
- Violation of the norms and rules of intimate hygiene.
Colpitis symptoms during pregnancy
Symptoms are generally the same, and do not differ in special manifestations in pregnant women.
The clinical picture includes:
- Pronounced profuse discharge. They can be both transparent and white curdled. A significant amount of secretions falls on the external genital organs, causing them to be irritated and reddened;
- If you neglect the rules of personal hygiene, discharge, falling on the inner surface of the thighs, also causes irritation and redness of the skin;
- Itching of the skin and mucous membranes in the genital area;
- The mucous membrane of the vagina swells and takes on a bright red hue due to a pronounced immune response to an irritant. A dirty brown or whitish coating is deposited on the walls of the mucous membrane;
- The color of the discharge varies from greenish to yellowish, depending on the infectious agent. The discharge has an unpleasant odor.
In addition, colpitis is characterized by severe itching and burning, which manifests itself constantly or periodically. The intensity of sensations depends on the patient's activity: when walking, running, changing body position, physical activity, urination, a slight change in the diet, burning and itching sensations increase.
If the patient neglects the rules of hygiene and does not undergo timely treatment for the disease, discharge from colpitis destroys the epithelial surface of the cervix and entails erosion. The manifestations of erosion are especially striking with mechanical action on the cervix (intercourse, hygiene procedures, gynecological examination) and include the release of blood clots and pain in the lower abdomen.
The main difference between the course of colpitis in pregnant women is intense pain in the lower abdomen (aching, dull and pulling in nature), radiating from the affected walls of the vagina and cervix to the thighs or lower back.
Example from practice: A woman came with the threat of termination of pregnancy with complaints of pulling pains in the lower abdomen and profuse yellowish spotting. Initial examination did not reveal characteristic changes. Erosion of the cervix was found, otherwise the picture corresponded to the normal course of pregnancy at this time (28 weeks). Only discharge with a characteristic unpleasant odor was observed. Was diagnosed with colpitis. The woman was sent by the treating specialist for conservation.
Most often during pregnancy (and outside of connection with it), colpitis is found, caused by opportunistic microflora - fungi of the genus Candida. This form of colpitis is characterized by a discharge of a thick, viscous texture of white color, which outwardly resembles cottage cheese. Thanks to this, candidal colpitis received a second name - "thrush". Discharge often has a pungent sour odor, reminiscent of yeast or mixed dough.
With candidal colpitis, the symptoms are even more pronounced, there is pain, burning and dryness of the vagina and urethra (since fungi often affect the mucous membrane of the urethra).
Despite the fact that infection by candida fungi is relatively harmless and causes only discomfort, over time, if untreated, it can be extended and involve the kidneys and bladder in the pathological process. This is already fraught with serious health consequences.
Diagnosis of colpitis during pregnancy
Only a practicing gynecologist can confirm the presence of colpitis. To establish the correct differential diagnosis, after collecting the anamnesis, a primary examination of the vagina and cervix using mirrors is performed.
The manifestation of signs of a pronounced inflammatory process is characteristic:
- Swelling and hyperemia of the mucous membranes;
- Cervical erosion;
- A large volume of transparent, greenish (yellowish) or white discharge of various consistency with a pronounced unpleasant odor.
In addition to the initial examination, laboratory tests are recommended:
- Collection of smears from the vagina and from the walls of the cervix for pathogenic and opportunistic microflora, fungi, leukocytes, etc.);
- Taking smears for cultures for venereal infections: chlamydia, ureaplasmosis, etc.;
- Biological (bacteriological) examination of smears. Sowing leucorrhoea from the vagina into nutrient media to determine the pathogen and its sensitivity to antibacterial drugs;
- Ultrasound examination of the uterus and fetus. It is carried out in order to identify the threat of termination of pregnancy, delayed fetal development, placental insufficiency;
- Colposcopy is performed according to indications.
Colpitis treatment during pregnancy
Regardless of the duration of pregnancy, colpitis must be eliminated without fail, so you should not hesitate to visit a doctor. The earlier the diagnosis is carried out and the treatment is prescribed, the higher the probability of timely cure and the birth of a healthy child.
The means of drug therapy are selected by the doctor, based on the "neglect" of the pathological process, the intensity of manifestations, the duration of pregnancy, the etiology of the disease and other factors.
Preparations for colpitis during pregnancy:
- Pimafucin. Effective for fungal infections of the skin and mucous membranes. During pregnancy, it is recommended to use vaginal suppositories, since local treatment is safest for the fetus. Drugs with a similar effect: Nystatin, Clotrimazole in the form of suppositories. The price for these drugs varies from 20 to 300 rubles;
- Terzhinan, Hexicon. Candles. Price - from 200 to 300 rubles. Method of application - 1 suppository before bedtime for 1-2 weeks;
- Metromicon Neo. Other trade names: Klion-D, Meratin-kombi, Neo-Penotran Forte. The drug is recommended for Trichomonas colpitis. Method of application: 1 candle a day for 10-14 days;
- Betadine. The use of Betadine is permissible only during the first trimester of pregnancy (up to 12 weeks), since the drug contains iodine in its composition, which can affect the development of the fetal endocrine system (in particular, the thyroid gland). Cost - from 170 to 350 rubles;
- Polygynax. The drug is ambiguous and is not always recommended by gynecologists, since pregnancy is indicated in the annotation as a contraindication to admission. However, at the end of pregnancy, just before childbirth, it is permissible to use Polygynax suppositories.
- McMiror. Designed for the local treatment of vulvovaginitis. Its active ingredient nifuratel has antibacterial, antifungal and antiprotozoal activity, and nystatin is added to enhance antifungal activity.
Instead of douching, preference should be given to irrigation of the external genital organs with medicinal herbs and medicinal baths. They effectively relieve inflammation, eliminate discomfort and itching (chamomile, St. John's wort, calendula, coltsfoot, etc.). The recommended course of treatment is from 7 to 14 days.
Danger of colpitis during pregnancy
During the period of gestation, the treatment of colpitis should be approached especially carefully. This pathology can be dangerous for both the mother and the unborn child:
- Further infection. Both bacteria and fungi are prone to upward damage to tissues and anatomical structures. Microorganisms can easily get into the bladder, uterus, kidneys, causing much more serious diseases;
- Tissue tears. The presence of "old" untreated colpitis can be dangerous for the mother's body, since the inflamed and edematous birth canal becomes prone to rupture. Even with the normal course of the birth process, significant damage can occur with the development of massive bleeding;
- The risk of termination of pregnancy. In the presence of colpitis, the risk of miscarriage increases by 20-40%;
- Purulent and necrotic processes after childbirth. Colpitis can cause the development of septic complications in the postpartum period: suppuration of sutures, the development of secondary infections, etc.;
- Formation of an inflammatory focus. With insufficient attention to the problem or illiterate, untimely treatment, colpitis can become chronic. Chronic illness can cause a lot of problems, is difficult to treat and gives frequent relapses with the risk of ascending infection and the development of severe complications;
- Endometritis. With an insufficient level of body resistance, infectious agents penetrate into the uterus, and, "settling" in the organ, contributes to the development of inflammation of its mucous membrane and erosion of the cervix;
- Inflammation of the appendages: ovaries and fallopian tubes. Some of the pathogenic microorganisms (mainly causative agents of venereal diseases: Trichomonas, gonococcus, etc.) are able to penetrate the internal genital organs and cause severe purulent inflammation;
- Infertility. It occurs relatively rarely with "running" colpitis. Adhesions in the uterus and fallopian tubes interfere with normal physiological fertilization and result in egg rejection. As a result, the patient is unable to become pregnant for a long time (there is a risk of complete infertility).
On the subject: 2 effective folk remedies for colpitis
The consequences of colpitis for a child
Colpitis can lead to the following phenomena hazardous to the fetus:
- Infection of amniotic fluid and placenta. Through the cervix and adjacent anatomical structures, the causative agent of colpitis can penetrate the placenta and infect the amniotic fluid in which the fetus is located. With a high degree of probability, this will entail chorioamnionitis and result in functional disorders in the fetus;
- The development of placental insufficiency. The invasion of microorganisms into the placenta causes a pronounced immune response and a decrease in organ function. As a result, the fetus does not receive enough nutrients and oxygen;
- Fetal infection. In severe cases, it can lead to intrauterine death.
Many causative agents of colpitis can cause infectious diseases in the fetus: pneumonia, pyoderma, etc. In addition, the risk of having a child with mental impairments, weakened immunity, etc., increases significantly.
Thus, colpitis is a dangerous inflammatory pathology, often of mixed etiology. The causative agent of the disease can be both pathogenic and opportunistic microflora. This disease is especially undesirable for pregnant women, since in this case there is a threat to the health of the mother and child. It should be noted that about half of all cases of colpitis during pregnancy are due to fungal infections.
The symptomatology of the pathology is typical; for an experienced gynecologist, diagnosis is not very difficult. Manifestations include redness and swelling of the vaginal mucosa, pain, itching and, mainly, profuse discharge. In some cases, general manifestations of intoxication can be observed. Depending on the individual characteristics of the mother's body, colpitis can occur without pronounced symptoms.
Treatment should be carried out in a timely manner and with drugs strictly recommended by the attending physician. Self-medication is unacceptable, because it can lead to harmful consequences for the child's body (many antifungal drugs are toxic).
It is not worth postponing a visit to a specialist at the first symptoms of colpitis during pregnancy, since a long pathological process leads to the development of a huge number of serious complications that are dangerous to the health and life of the mother and child.
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.
