Is vaginal discharge a natural or pathological problem in pregnant women
associated with adverse pregnancy outcomes?: A cross-sectional study
Abstract
Objective: To differentiate between normal and pathological vaginal
discharge (PVD) in pregnant women and to identify causes of and adverse
pregnancy outcomes associated with PVD. Design: A cross-sectional study.
Setting: Outpatient antenatal clinics. Population / Sample: Pregnant
women, Convenience sample (N=85). Methods: Data were collected through
history, clinical examination and laboratory investigations. Data
analysed by frequencies, descriptive statistics and Chi-Squared tests.
Main outcome measures: Vaginal discharge (VD), age, gestation, parity
and adverse pregnancy outcomes. Results: Women’s mean age was 27.4
(±4.67) years. Majority of women were 26-31 years old (40%), 28-35
weeks pregnant (34%) and primigravida (41%). Of 89% (n=76) women with
VD, 32% (n=24) had normal VD and 68% (n=52) PVD. Normal VD was watery
(100%) and odourless (96%) while PVD was yellowish curd like (33%)
and foul smelling (52%). PVD was significantly associated with
bacterial vaginosis (P < 0.0001), candidiasis (P = 0.005) and
trichomoniasis (P = 0.018). A higher proportion of women with PVD
reported irritation (P < 0.0001), pain (P < 0.0001),
uterine contractions (P < 0.0001), premature membrane rupture
(P < 0.0001), abortion (P < 0.042), pre-term
delivery (P < 0.0001) and post-partum endometritis (P
< 0.0001). PVD was also associated with low birth weight (P
< 0.0001), low Apgar score at birth (P < 0.0001),
respiratory distress syndrome (P < 0.0001), intensive neonatal
care hospitalisation (P = 0.001) and early neonatal death (P = 0.002).
Conclusions: Vaginal discharge in pregnancy requires early investigation
to avoid any adverse fetomaternal outcomes associated with pathological
vaginal discharge.