The Relationship between Bacterial Vaginosis and Pregnancy
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Bacterial vaginosis (BV) is a vaginal infection caused by an imbalance in bacteria, affecting one in eight women during pregnancy, making it a common condition.

This imbalance occurs when there’s a shortage of friendly bacteria, called lactobacilli, in the vagina. Lactobacilli, also called “good bacteria” like the ones promoting digestive well-being, create lactic acid, which keeps the environment mildly acidic. This acidity hinders the growth of other bacteria. In BV, the reduced lactobacilli lead to a less acidic vagina, allowing the proliferation of bacteria.

BV often causes abnormal discharge, although increased discharge is normal during pregnancy, so it’s essential not to assume BV solely based on discharge changes.

How do I know if I have Bacterial Vaginosis (BV)?

BV can be asymptomatic, with around half of affected women experiencing no symptoms. Detection sometimes occurs incidentally during other medical examinations. Routine screening for BV isn’t standard as it hasn’t proven beneficial for most women.

Symptoms, when present, include a thin white or grey discharge with an unpleasant odour, especially noticeable after sex. If you experience such symptoms, Book an Appointment with your doctor, who will test a vaginal discharge sample for BV or other infections. Results may be immediate or take up to a week.

How does BV impact pregnancy?

Bacterial Vaginosis is unlikely to affect pregnancy if asymptomatic. However, symptomatic cases require treatment to reduce complications, particularly for those with a history of pregnancy problems. Potential complications include premature labour, late miscarriage, and post-birth uterine infections.

While the link between Bacterial Vaginosis and pregnancy complications isn’t clear, certain sexual activities, such as oral sex or finger insertion, might be associated with BV. Although not an STD, women can transmit BV to female partners through sex.

Having BV increases susceptibility to STIs like chlamydia and HIV, and if you have HIV, there’s an elevated risk of transmitting it to your baby. We recommend screening and treating bacterial vaginosis for individuals experiencing symptoms. If left untreated, bacterial vaginosis can lead to complications and discomfort.

How is BV treated during pregnancy?

If diagnosed with BV during pregnancy, your doctor will prescribe antibiotics, either as tablets or a vaginal gel. Bacterial Vaginosis Treatment is essential for symptomatic cases or those with a history of premature birth.

Completing the whole antibiotic course is crucial, even if symptoms subside. Though safe in pregnancy, antibiotics may cause side effects. If symptoms persist, inform your doctor promptly. Antibiotics may lead to symptom recurrence, highlighting the importance of follow-up testing.

Alternative treatment involves introducing acidity to the vagina through a gel, promoting the growth of friendly bacteria and restoring bacterial balance. While effectiveness varies, it’s a viable option, available over the counter.

What Are the Complications of Bacterial Vaginosis (BV)?

When BV remains untreated, it can lead to significant complications and health risks. These include:

  • Complications during pregnancy: Pregnant women with BV face a higher likelihood of experiencing early delivery or having a baby with low birth weight. Moreover, they are at increased risk of contracting other infections following childbirth.
  • Increased susceptibility to sexually transmitted infections: BV raises the risk of acquiring sexually transmitted infections (STIs) such as herpes simplex virus, chlamydia, and HIV.
  • Development of pelvic inflammatory disease: BV may progress to pelvic inflammatory disease, an infection affecting women’s reproductive organs. This condition heightens the risk of infertility.
  • Elevated risk of post-surgical infections: BV increases the likelihood of developing infections after reproductive system surgeries such as hysterectomies, abortions, and cesarean deliveries.

How can I prevent BV?

Preventing BV is challenging due to unclear causes, but some strategies may reduce risk:

  • Use condoms, especially with new partners during pregnancy.
  • Quit smoking, which not only harms your baby but also increases BV risk.
  • Wash genitals with pH-neutral, unscented soap, avoiding douching or scented products that disrupt bacterial balance.
  • Ensure adequate vitamin D intake for immune health during pregnancy.

These practices may mitigate BV risk, providing a proactive approach to maintaining vaginal health.

Mahantesh Karoshi
Mahantesh Karoshi

I'm a Consultant Obstetrician & Gynaecologist and Women's Health Expert. I believe in educating my patients to contribute to achieving the best possible clinical and holistic outcomes. By taking this approach, I enable and empower my patients whilst addressing their issues and concerns. I run a private practice with an extremely high standard of professionalism. My patients are directly involved in their care and management in all stages. My approach to my patient's problems is built on dedication and passion, drawing on analytical thinking and my on-time honored reading, teaching medical professionals nationally and internationally.