PREGNANCY HEALTH, BELOW-THE-BUMP | by Jan Sheehan

Posted on Fri, Jun 7, 2013

Every pregnancy has its share of little discomforts and annoyances. And many of those discomforts are drips, spots, leaks and even gushes that take place below the bump. Mysterious discharges during pregnancy can be a simple inconvenience or a worrisome danger sign.

With all the things going on (and coming out!) down there, it’s easy to panic. So when should you worry and when should you relax? Health & Wellness speaks with two metro Denver obstetricians to decipher common pregnancy discharges and explain what’s normal and what’s not.

LEUKORRHEA

An increase in vaginal discharge is common in pregnancy and it’s completely normal. In fact, this discharge is so common that doctors have given it a name: leukorrhea. Some women will have profuse discharge, while others will just notice a little excess discharge. “Leukorrhea is caused by hormonal changes and increased internal blood flow, but it’s harmless,” says Dr. Maeve Felle, an obstetrician/gynecologist at Partners in Women’s Health, affiliated with Rose Medical Center in Denver. In fact, an increase in vaginal discharge can be a sign of a healthy pregnancy. “Discharge may be present throughout pregnancy, but many women notice an increase towards the end of their pregnancy,” Felle says. Expect the discharge to be thin, clear and mild smelling. It’s important to talk to your OB/GYN if you notice a change in its appearance or odor, Felle says.

INCONTINENCE

Most women experience at least some degree of urinary incontinence during pregnancy, which is the involuntary loss of urine. “Incontinence is most common during the end of pregnancy when your growing belly puts the most pressure on the bladder,” says Dr. Cindy Long, an obstetrician/gynecologist at The Women’s Health Group in Thornton. Urinary discharge can be annoying, messy and occasionally embarrassing, but it’s normal and (mostly) temporary. “You may notice a sudden gush when you change positions, sneeze, cough or laugh and then relative dryness,” says Long, who is on the staff of North Suburban Medical Center. Make sure that you are leaking urine rather than amniotic fluid, however. A quick smell test should confirm it – – urine smells of ammonia. Whatever you do, don’t stop drinking water in an effort to curtail incontinence, Long cautions. Dehydration can be dangerous during pregnancy, increasing the risk of preterm labor and miscarriage.

AMNIOTIC FLUID LEAKAGE

Amniotic fluid is the substance surrounding the fetus as it grows in the uterus. Leaking amniotic fluid can be a danger sign if it happens too early because it usually means you’re going into labor. “If you suspect you’re leaking amniotic fluid, it’s important to let your doctor know immediately so that you can be evaluated,” Felle says. It can sometimes be hard to tell if the leakage is amniotic fluid or urine. Long says that amniotic fluid has a mild odor similar to egg whites. She encourages her patients to put on a thick pad and walk around to help determine if they’re leaking amniotic fluid. “If the pad stays dry, it’s likely urine,” Long says. “If the pad is soaking wet, it’s probably amniotic fluid.” The only way to be sure, however, is an exam by a doctor.

YEAST INFECTION

Sometimes women experience a thick, cottage-cheese-like discharge during pregnancy. This is a sign of a yeast infection. “Although yeast infections have no negative effect on pregnancy, they can cause discomfort,” Felle says. Pregnant or not, you’ll experience the same symptoms: Itching, redness and irritation of the vagina lips and sometimes burning during urination. “The best treatment may be over-the-counter medications, but it’s important to let your doctor know if you suspect a yeast infection so she can decide on the most appropriate treatment,” Felle says. If left untreated, yeast infections can pass to your baby’s mouth during delivery, causing thrush.

SPOTTING

Spotting – discharge with a small amount of blood that may be brown, pink or dark red – can be normal during pregnancy, and there’s a reason it happens. “When you’re pregnant, the blood flow to the cervix is much greater and the delicate cells inside the cervix travel to the outside of the cervix, which makes it more fragile and likely to leak small amounts of blood,” Long says. “That means a relative light stimulus, like a pelvic exam or intercourse, can easily trigger spotting.” About 20 percent of women have some spotting during the first 12 weeks of pregnancy, and it’s usually no cause for alarm.

BLEEDING

Your first thought at the sight of blood heavier than spotting may be miscarriage, but don’t assume you’re losing the baby. Miscarriage is characterized by bright red blood with cramping pains, Felle says. Painless bleeding is probably due to another cause, including a possible pregnancy complication, such as abnormal location of the placenta. Call your OB/GYN for an evaluation. In fact, it’s important to talk to your doctor anytime there is a change in normal pregnancy discharge or if you’re worried. “I want my patient to call me if she has concerns,” Felle says. “My job is to answer her questions and give her the information she needs.”

PREGNANCY DISCHARGE DO’S AND DON’TS

DON’T:

• Use tampons because they can introduce new germs into the vagina
• Douche as this can interrupt the normal balance of good and bad bacteria and lead to a vaginal infection
• Assume you have a yeast infection and treat it yourself without consulting your OB/GYN

DO:

• Wear panty liners if it makes you feel more comfortable
• Try Kegel exercises to help control incontinence
• Notify your provider of any worrisome changes

Tags: Cindy Long MD, healthy pregnancy, North Suburban Medical Center, Rose Medical Center