Discussion:

Normal vs pathological vaginal discharge

Vaginal discharge is common during pregnancy and it is important to differentiate between natural (physiological) discharge and pathological discharge. In this study, we characterised normal (physiological) and pathological vaginal discharge and identified risk factors and adverse maternal and neonatal outcomes associated with pathological vaginal discharge. We found normal pathological vaginal discharge in three and seven of ten pregnant women. The former type of vaginal discharge was not a serious nuisance in terms of colour, quantity and odour while the later type of vaginal discharge was a serious issue not only in regards to these parameters5 but also in terms of associated adverse impacts on the mother, pregnancy and neonates.

Common causes of pathological vaginal discharge

Out findings revealed statistically significant associations between pathological vaginal discharge and common vaginal infections i.e. bacterial vaginosis, vaginal candidiasis and trichomoniasis vaginalis,21,22 which are commonly found in pregnant women with low education, underprivileged social and economic status and poor hygiene.6 Most of women participants of our study were recruited during antenatal appointments in the outpatient obstetrics and gynaecology clinics, which are mostly attended by poor families in Pakistan. In addition, the literacy in female is also low (52%) in the country, which is even lower in rural areas (40.5%).23 These factors may have contributed in the higher prevalence of pathological vaginal discharge in our sample. Thus, our study shows that pathogenic organisms such as BV, VVC and TV are the major risk factors of pathological vaginal discharge in pregnant women.24 Thus, these infections need proper investigation and appropriate treatment.
We did not find any statistically significant differences in the preponderance of normal and pathological vaginal discharge based on the women’s age, gestation period and parity.25