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.