What is bacterial vaginosis or gardnerella in women: causes of vaginal dysbiosis

Every year, doctors give every fifth expectant mother a rather unpredictable diagnosis: bacterial vaginosis. Women complain of pathological discharge and are very surprised when gynecologists discover this infection in them. Even more striking is the fact that bacterial vaginosis is the most common condition among pregnant women.

The fact is that under the influence of all the changes that occur in the female body during pregnancy, the bacterial balance in the vagina can be disrupted. Usually, the “balance” of the microflora is maintained by lactic acid bacteria, but in pregnant women their number decreases. Immunity decreases, and harmful pathogenic microbes develop in the vagina, which cause bacterial vaginosis.

The risk is that this infection can remain asymptomatic for years and only appear during pregnancy. And if the warning signs are not paid attention to and measures are not taken, the disease can lead to diseases of the pelvic organs and even premature birth or miscarriage. However, the connection between such complications and vaginosis has not yet been fully confirmed by scientists. There have been cases when women with vaginosis had an absolutely normal pregnancy, and the disease disappeared on its own over time.

Causes of bacterial vaginosis during pregnancy

Normally, the vagina is populated by 98% of lactobacilli. They control the balance of microflora and produce lactic acid, which maintains an acidic environment that is destructive to most pathogenic pathogens. Under the influence of certain factors, the number of lactobacilli may decrease. In this case, the acidity of the vaginal microecological system is disrupted. A decrease in lactobacilli causes the uncontrolled growth of a “minority” of harmful bacteria: gardnerella, bacteroides, mobilincus, peptococci, mycoplasma, streptococci. This is how bacterial vaginosis occurs.

It is difficult to determine exactly what exactly affects the microflora. Both internal and external factors can influence the reduction in the number of lactobacilli:

taking strong antibiotics, antimicrobials, antifungal and hormonal agents;
hormonal disruptions after abortion, childbirth, during puberty and irregularities in the menstrual cycle;
the use of antimicrobial products for intimate hygiene with triclosan, vaginal douching, as well as antiseptic solutions, soda;
use of combined oral contraception and IUDs;
the use of spermicides (they are included in vaginal suppositories and tablets);
allergic and endocrine diseases;
sudden climate changes, stress;
disturbance of intestinal microbial balance;
wearing synthetic tight underwear;
pregnancy, especially complicated;
neglect of basic hygiene rules.

Prevention

You can follow these guidelines to reduce your risk of developing vaginosis:

Minimize vaginal irritation . It's best not to use soap to clean the outside of your vagina, as even mild and unscented soap can cause irritation. Avoiding hot tubs is also a good idea. Cotton underwear can help prevent irritation.
Avoid douching . This procedure helps remove some of the "good" bacteria that protect the vagina from infection, increasing the risk of contracting bacterial vaginosis.
Use a condom with all sexual partners . This is the best way to prevent the spread of bacteria. It is also important to limit the number of sexual partners and get tested for STDs every six months.

Why is vaginosis dangerous during pregnancy?

During pregnancy, harmful microorganisms from the vagina can penetrate the internal genital area and infect the fetal membranes and placenta. Such “migration” leads to the development of severe complications: chorioamnionitis, inflammation and purulent melting of the membranes, their rupture and early rupture of amniotic fluid. This provokes premature birth.

The infection can “spread” to the child and can cause prolonged hypoxia and disruption of the normal functioning of the placenta and its vessels. Then the child is born weakened, with low body weight, with pneumonia, and diseases of the nervous system. In some cases, vaginosis causes miscarriage.

Information about the vaginal microflora

Bacterial vaginosis is considered one of the most common gynecological diseases today.

As you know, a woman’s vagina is populated by microorganisms, with lactobacilli accounting for approximately 95%. These are beneficial bacteria that support the normal functioning of the genital organs. For example, lactobacilli produce hydrogen peroxide, a substance with antiseptic and bactericidal properties. Another waste product of beneficial microorganisms is lactic acid, which creates an optimal pH level in the vagina for functioning and fertilization.

Approximately 2-5% of the microflora are opportunistic microorganisms. For example, different strains of staphylococci, streptococci, and gardnerella live in the vagina. Their number is strictly controlled by the immune system - normally, these bacteria are not capable of harming the body.

But sometimes, for one reason or another, there is an increased proliferation of opportunistic microflora, in particular Gardnerella (this bacterium, by the way, is considered a marker of vaginosis). The result of this process is the death of beneficial microorganisms. The vaginal microecosystem is disrupted, the pH changes, which creates ideal conditions for the proliferation of potentially dangerous fungi and bacteria. This is how vaginosis develops.

During pregnancy, the expectant mother's body undergoes a lot of changes. This primarily concerns changes in hormonal levels and weakened immunity. That is why pregnant women quite often face such a problem as bacterial vaginosis.

Bacterial vaginosis. Symptoms

According to statistics, in about half of women, bacterial vaginosis is asymptomatic. This makes timely detection of infection and its treatment difficult. You should be concerned if you notice the following symptoms:

sticky and viscous copious discharge of white, sometimes gray color. If the disease continues for more than one month, the discharge may acquire a yellow and green tint;
sour, fish-like odor of discharge, which intensifies after sexual intercourse, in particular after contact with sperm;
itching, mainly in the evening and at night, worsening after sexual intercourse or after taking a hot bath;
pain when urinating;
pain during sexual intercourse;
pain in the lower abdomen in the absence of any other inflammatory processes in the pelvic organs and hypertonicity of the uterus.

If you experience these symptoms, consult your doctor immediately! Your gynecologist will take a smear test to check for bacterial vaginosis or other infection and then prescribe appropriate treatment.

In some cases, pregnant women diagnosed with vaginosis still give birth to a healthy baby. It happens that the disease in expectant mothers goes away on its own. But there's another side to the coin: vaginosis makes you more susceptible to sexually transmitted infections. You can “catch” the immunodeficiency virus, chlamydia or gonorrhea.

Effective diagnostic measures

How to identify bacterial vaginosis? Gynecology offers the following diagnostic scheme.

To begin with, a conversation is held, an anamnesis is drawn up, the doctor is interested in the presence of certain symptoms in the patient.
Next, a standard inspection is carried out. During the procedure, the specialist may notice abundant, thick white discharge (sometimes with a grayish tint) with an unpleasant fishy odor on the walls of the vagina. But there are no traces of inflammation, in particular swelling of the mucous membrane and redness - the surface of the vagina has a normal pink tint.
It is important to determine the acidity of the vagina. To measure pH, a special strip is used, which is immersed in the area of the posterior vaginal fornix. Anaerobic vaginosis is accompanied by an increase in this indicator to 4.5 and higher.
A vaginal smear is required. During laboratory testing, a specialist can detect the presence of so-called key cells, which are epithelial cells with bacteria attached to them. The number of lactobacilli is reduced. Bacterial culture allows you to determine the type of pathogenic microorganisms and detect the presence of gardnerella.

Treatment with folk remedies

What should a woman who is diagnosed with bacterial vaginosis do? It is possible to treat such an ailment during pregnancy with folk remedies, but only with the permission of a doctor. As a rule, experts recommend douching using decoctions of medicinal herbs.

To prepare the medicine, you need to take a tablespoon of a mixture of chamomile flowers and plantain herb (the components are mixed in equal quantities) and pour a liter of boiling water over them. Cover the container and let it brew for an hour. Use the solution for morning and evening douching.
A tablespoon of bird cherry is poured into 400 ml of cold water. The mixture should be brought to a boil, then kept on low heat for another 15-20 minutes. The broth is infused and filtered. Douching is carried out once a day for a week.
Some traditional healers recommend using tampons soaked in sea buckthorn oil or aloe juice. The medicine must be taken at night.

Naturally, the procedure must be carried out with extreme caution. You should not use any home remedies without first consulting a gynecologist. By the way, such events are sometimes recommended to be carried out before the 20th week, because during this period the use of antibacterial drugs is contraindicated.

If during treatment you notice any deterioration, you should immediately stop home therapy and see a doctor - during pregnancy you should follow all precautions.

If not treated?

Lack of timely diagnosis and treatment can cause serious pregnancy complications, including:

Chorioamnionitis is inflammation of the amniotic sac. The pathological process can provoke partial or complete rupture of the membranes, which leads to termination of pregnancy or premature birth.
Penetration of bacteria into the fetal fluid and infection of the fetus. The consequences of infection can be fetal death or serious impairment of the child’s physical and/or mental development.
The development of other infectious inflammations of the female reproductive system.

The drug "Terzhinan" and features of its use

Quite often, gynecologists prescribe Terzhinan suppositories to their patients during pregnancy. Reviews indicate that this drug really helps. Therefore, it is worth understanding its composition.

The medicine has a lot of useful properties and has a complex effect on the body due to the presence of the following components in its formula:

ternidazole is a substance that inhibits the vital activity of anaerobic microflora, in particular gardnerella;
neomycin sulfate, which is a broad-spectrum antibacterial substance;
nystatin is a component with antifungal properties, active against fungi of the genus Candida;
prednisolone is a glucocorticoid that helps eliminate inflammation, relieve pain, swelling and discomfort.

This medicine ensures the integrity of the vaginal mucosa and maintains normal acidity. As a rule, patients are recommended to use one suppository per day. The duration of therapy is 10 days, although in some cases the gynecologist may decide to extend treatment to 20 days.

Are Terzhinan suppositories safe during pregnancy? Reviews from doctors indicate that the medicine can indeed be used even during pregnancy, but only in strictly defined doses and under constant supervision. Unauthorized use of the drug is strictly prohibited.

Is it possible to get pregnant

Bacterial vaginosis and vaginitis are not the direct cause of unsuccessful conception. However, the combination of pregnancy and vaginosis/vaginitis several times increases the likelihood of spontaneous abortion in the early stages and the development of premature birth (35-38 weeks).

The course of pregnancy is complicated. There is a high probability of infection of the membranes and the appearance of chorioamnionitis. This is what leads to premature birth, as infected membranes become thin and easily “torn.”

During childbirth, the baby becomes infected. A woman with vaginitis increases the risk of postpartum complications (mastitis, endometritis, etc.).