How To Prevent Vaginal Infection During Pregnancy

Your private area is as delicate as other parts of your body, especially during pregnancy. The crazy hormonal changes in your body during this period also affects your body’s PH levels. This encourages the growth of bacteria, including in your private areas. As a result, many women would complain of vaginal infections during their pregnancy.

Vaginal Infection

Three of the common vaginal infections that pregnant women experience are as follows: yeast infection, bacterial vaginosis, and urinary tract infection. Though common, these infections are low risk and can easily be treated. The important thing, however, is that they need to be treated as soon as possible. If not, complications may arise which may put you and your baby’s health at risk.

We all know that prevention is better than treatment. To make sure that your private parts will remain healthy and infection-free, you need to include this in your routines. It’s a healthy habit that you should not break if you want to be free from infection, especially in your vaginal area.

Keep it clean and dry down there.

It is better to use plain water when washing your vagina. Soap and other cleansing agents may contain harmful chemicals that you wouldn’t want to get into your private parts. They can also kill the good bacteria that your intimate area needs to maintain a healthy balance.

Give your anal area that TLC it needs.

Your anal area needs the same protection as your vagina. Wipe from front to back so that no unnecessary bacteria may enter your intimate area. You also need to keep your anal area clean by washing it with water.

Drain out that excess semen through your pee.

Reduce the possibility of acquiring Urinary Tract Infection (UTI) when you do this. Unwanted may grow in your private area if you will neglect to pee after having sex.

Don’t let dirt seep through your lady-friend.

Some prefer dipping and relaxing in a tub to soak in a bubble bath for hours. This is not healthy, however. The ingredients in the bubble bath intended to remove dirt and bacteria from your skin will also kill the good bacteria that your intimate parts need. Sitting in the tub will also allow dirt that the bath removed from your body to go back and forth your vaginal area. If you really want to dip in the tub. Make sure that you are already done showering and cleaning your body, and have only clean water in the tub.

Wear cotton undies to let your vagina breathe.

Yeast will not propagate in dry and oxygen-rich places. Cotton undies are made of natural and breathable materials and will keep your vagina free from unnecessary bacteria.

Follow a healthy diet.

Every health expert will agree that pregnant women need all the nutrition that they can get from the food that they consume. You may have an aversion to some delicacies or foods during this period. Even then, it is necessary that you take only what your doctor advises you to include in your diet. That will also mean that you will be taking vitamin supplements to ensure that both you and your baby will receive all the essential nutrients that you need to have a healthy pregnancy.

Keep it dry all over.

Bacteria love moist areas. If you want to keep your private area to encourage bacterial growth, you have to make sure that you keep them dry. If you use pads, you also need to make sure that you change them regularly and at good intervals. Some even suggest that you don’t wear any underwear when you sleep at night.

Keep your body hydrated.

Toxins are constantly removed through perspiration, urination, and bowel movements. To help flush out bad bacteria from your body, including your private parts, make sure to stay hydrated. If you can drink more than 8 glasses a day, that will be better.

Give your body adequate rest.

Your body is providing for two. As such, it needs more rest for the whole system to function properly. Let your body have adequate rest. Meditate more as well so you won’t get stressed when you are not in a rest mode. Bacteria grow rapidly if you are stressed and you would not want it to happen, would you?

Engage in safe sex.

Don’t practice sex that will not be healthy for your baby. Only engage in the most natural forms of sex and never let any commercially made sex toys to pass through your private area. These materials may contain several components that may pose danger to your private parts. Enjoy safe sex and enjoy a healthy lady-friend even while you are pregnant.

If you enjoyed this article and you found this post helpful, it would be more meaningful if you will share it with other pregnant moms.

Fibroid during Pregnancy

A Fibroid or Fibroids are very often discovered in the womb (uterus) during a pelvic examination or more frequently during a routine ultrasound scan when a woman is pregnant. Medical research has shown that the most uterine fibroids do not grow or shrink during pregnancy. It has been found that about a third of fibroids may enlarge during the first three months (known medically as the first trimester) of pregnancy. Studies have shown that the vast majority of women with fibroids have an uncomplicated pregnancy and childbirth. However it has been found that some women do unfortunately have some problems due to their fibroids. It is known that uterine fibroids are linked to a greater rate of spontaneous miscarriage, placental abruption, early onset of childbirth (preterm labour), malpresentation of the baby (abnormal position of the baby e.g. breech baby), an abnormal or difficult childbirth( labour dystocia), need for caesarean section and bleeding after the baby is born (postpartum haemorrhage).

Fibroids (leiomyomas) are benign (non-cancerous) tumours or swellings made up of uterine smooth muscle which develop in the muscular wall of the womb. They are very common. By the time they are 35 years of age it is estimated that 40-60% of women will have at least one fibroid, and by the time they reach the age of 50 approximately 70-80% will have fibroids. The exact cause of fibroids is still unknown. Making the diagnosis of fibroids during pregnancy is neither simple nor straightforward.

Research has shown that only 42% of fibroid greater than 5cm (labelled as large) and 12% of smaller fibroids (measuring 3-5 cm) can be felt and diagnosed on pelvic examination. Surprisingly, making the diagnosis using ultrasound is also difficult. This is mainly because of the difficulty of distinguishing fibroids from the normal thickening of the lining of the womb (myometrium). It is therefore thought likely by specialists that the frequency of fibroids during pregnancy is actually underestimated.

There is an increasing trend in the Western world for pregnancy to be delayed until women are older. Research has shown that the incidence of uterine fibroids in older women who are having medical treatment for infertility is approximately 12-25%.

Even though they are becoming more common, the exact nature and reasons for leiomyomas causing infertility and problems when a woman is pregnant are not fully understood.

Medical evidence from ultrasound studies which monitored the size of fibroids during pregnancy has shown that most fibroids (60-78%) did not change in size significantly throughout pregnancy. The volume of fibroids was monitored prospectively. Some fibroids did grow (22-32%) and increased in volume and most of this growth took place in the first three months of pregnancy. In particular most growth occurred during the first 10 weeks of pregnancy and it is interesting to note that very little growth took place during the last 6 months of pregnancy (i.e. during the second and third trimesters).

The vast majority of fibroids cause no symptoms. A well described, but rare complication of fibroids is known as “red degeneration”. This is most likely to happen to a pedunculated subserosal fibroid. Red degeneration causes severe localised abdominal pain. Fibroids can also cause pain simply due to their size and larger fibroids (those greater than 5cm) are those that most often cause pain, usually during the second and third trimesters of pregnancy. In fact pain is the most common complication of fibroids during pregnancy.

A study investigated the frequency of red degeneration in fibroids during pregnancy using ultrasound scans. It was found that 9% of fibroids had ultrasound evidence (showed a heterogeneous echogenic pattern or cystic change) of red degeneration. The women were asked about their symptoms and about 70% of these women had experienced severe abdominal pain compared with about 12% of women whose ultrasound scans showed no sign of red degeneration in their fibroids.

Why does red degeneration cause pain?

There are three medical hypotheses which have been proposed to explain why red degeneration of a fibroid causes severe pain.

The first theory is that the rapid speed of growth of the fibroid causes the tissue in the middle of the fibroid to outgrow its blood supply resulting in death of the tissue (known as infarction).

The second theory is that the growing uterus disrupts the blood supply to the fibroid by kinking the blood vessels in some way (there is thought to be a change in the architecture of the blood vessels).  This happens even if the fibroid does not grow.

The third theory is that the pain is due to prostaglandin chemicals produced by damage of the cells in the fibroid. This theory is supported by the fact that NSAIDS drugs (such as ibuprofen or diclofenac) which work by inhibiting prostaglandin quickly and effectively control the pain.

Effect of Fibroids on Pregnancy Outcome

It has been found that between 10% and 30% of women with fibroids have problems or complications during their pregnancy. However, medical specialists have criticised the way that some of these studies have been carried out. (They have commented that there have been problems such as: selection bias, small and differing characteristics of the populations studied, low occurrence of adverse outcomes, varying inclusion criteria and inadequate confounding variables.) The studies carried out so far have found varying and inconsistent correlations between fibroids and the frequency of complications in pregnancy. More research into fibroids during pregnancy needs to be carried out.

It is not known yet precisely how fibroids cause complications in pregnancy. It is hypothesised that mechanical obstruction or impaired distensibility (stretchability) of the uterus may explain some of the problems caused by fibroids.

Early Pregnancy

Miscarriage

It is known that the frequency of spontaneous miscarriage is increased in pregnant women who have fibroids. One study found that the rate of miscarriage in women with fibroids was 14% compared with 7% in women without fibroids. Research has found that the size of a fibroid does not affect the risk of miscarriage, but that the number of fibroids may do. Multiple fibroids increase the risk of miscarriage (miscarriage rate found to be 23%) compared with a single fibroid (miscarriage rate was 8%). It is also thought that the position of the fibroid in the uterus is important. Early spontaneous miscarriage happens more often when the fibroids are in the main body of the uterus when compared with fibroids being in the lower segment of the uterus or those fibroids which are intramural or submucosal. It is not known exactly how fibroids cause miscarriage. Possible mechanisms include: increased irritability of the uterus, mechanical compression by the fibroid and/or damage to the blood supply to the growing placenta or foetus.

Bleeding in early pregnancy

The risk of bleeding during early pregnancy is affected by the location of the fibroid in the womb. If the placenta has implanted close to where the fibroid is then the risk of bleeding is increased significantly to 60% from a risk of 9% if there is no contact between the fibroid and the placenta.

Late Pregnancy

Preterm labour and preterm premature rupture of membranes

Uterine fibroids increase the risk of premature labour and childbirth. The risk of preterm labour when fibroids are present is 16% in contrast with a risk of 8% when no fibroids are present. The rate of preterm delivery is 16% in contrast with a risk of 11% when there are no fibroids present.

Having multiple fibroids and having fibroids that are in direct contact with the placenta have been shown to be independent risk factors for premature onset of labour.

It is interesting that fibroids are not an independent risk factor for preterm premature rupture of the membranes (PPROM) of the amniotic sac around the baby. In fact recent research has suggested that fibroids may actually decrease the risk of PPROM.

Placental abruption

Data from medical studies suggests that placental abruption is three times as common in those women who have fibroids during pregnancy. Independent risk factors for placental abruption are: submucosal fibroids, retroplacental fibroids and fibroids with a volume of >200 cm3

A study which looked retrospectively found that placental abruption occurred in 57% of women who had retroplacental fibroids, in contrast with 2.5% of women who had fibroids in other areas of their womb. It is thought that one way that fibroids make placental abruption more likely is that there is reduced blood flow to the fibroid and the surrounding uterine tissue. This then leads to reduced blood flow (partial ischemia) and decidual necrosis in the tissue of the placenta over the underlying leiomyoma.

Placenta praevia

Only 2 research papers have been published about the relationship between placenta praevia and fibroids. They both indicated that the rate of placenta praevia is doubled even when adjustments were made for previous surgical procedures such as myomectomy and caesarean section.

Foetal abnormalities (anomalies) and foetal growth retardation

Medical research has found that the growth of the baby is not affected by the existence of uterine fibroids. Studies have suggested that women with fibroids were slightly at greater risk of having a baby whose growth had been slowed, these studies were not adjusted for gestational age of the foetus or the age of the mother, and these studies have been criticised by specialists in this area.

A large fibroid or fibroids can rarely press on and distort the cavity of the uterus and may then lead to a foetal abnormality.

The congenital abnormalities that have been shown to occur with large submucosal fibroids include: torticollis ( an abnormal twisting of the neck), dolichocephaly (lateral compression of the baby’s skull) and limb reduction defects.

Labour and Delivery

Malpresentation, caesarean section and labour dystocia

The rate of malpresentation of the foetus in women with fibroids is 13% in contrast with a rate of 4.5% in women with no fibroids. Independent risk factors for malpresentation are multiple fibroids, large fibroids and fibroids in the lower uterine segment.

Many medical studies have found that having a uterine fibroid increases the risk of caesarean section. A systematic review discovered that having fibroids increased the rate of caesarean section by a factor of 3.7 (from 13.3% – no fibroid to 48.8% – fibroids present). This is partly due to an increase in labour dystocia. Predisposing factors for caesarean section are: multiple fibroids, foetal malpresentation, large fibroids, submucosal fibroids and leiomyomas in the lower uterine segment.

However, obstetricians usually advise that the presence of uterine fibroids is not a contra-indication to a trial of labour.

Postpartum haemorrhage

Medical evidence and studies have provided conflicting data about the rate of postpartum haemorrhage (bleeding), however pooled cumulative figures have suggested that the rate of haemorrhage following childbirth is greater in those women who have uterine fibroids (risk – 2.5%) when compared with women with no fibroids (risk – 1.4%).

A fibroid may distort the architecture of the womb and also interfere with contractions of the uterine muscle (myometrium) leading to loss of muscle strength (atony) of the uterus and postpartum haemorrhage. These factors may also explain why fibroids increase the rate of hysterectomy in the weeks following childbirth (during the puerperium).

Retained placenta

A medical study has shown that the rate of retained placenta of the uterus is more frequent in those women who had a fibroid, but only if it was located in the lower segment of the womb. But pooled cumulative data has suggested that the risk of having retained placenta is more frequent in all women with leiomyomas regardless of the position of the fibroid (1.4% – fibroid present – compared with 0.6%- no fibroid present).

Uterine rupture following myomectomy

This is complication is extremely rare. One study looked at 120 women who had a baby at term having had a previous abdominal myomectomy (in which the uterine cavity was not entered) and there were no cases of uterine rupture. It is uncertain whether the same is true with laparoscopic myomectomy. Researchers report that there are many case reports of uterine rupture occurring during childbirth in women who had previously had a laparoscopic myomectomy. Recent research has shown that uterine ruptures take place before the start of labour at the site of the previous myomectomy carried out by laparoscope. Fortunately the risk of uterine rupture following laparoscopic myomectomy is reported to be low at 0.5% to 1%.

Fibroid in Pregnancy

What is a fibroid?

A uterine fibroid is a benign, firm, usually roundish, swelling (tumour) that develops within the muscular wall of the uterus (womb).

A fibroid can vary in size from being as tiny as a pea to as large as a melon. Fibroids are very common. The figures quoted vary, but it is estimated that between 25 per cent and 80 per cent of women have a fibroid or fibroids if you look very carefully. In a typical case a woman will have several fibroids present within her uterus and these will usually be of varying sizes.

Fibroid tumours are benign (they are not cancerous and do not spread to other parts of the body). They usually cause no symptoms at all and are often present without a woman knowing that she has them. If they become larger then they are more likely to result in symptoms or problems such as pain or discomfort. If fibroids enlarge and distort the endometrium (lining of the womb) then they cause heavy periods.

Having a fibroid during pregnancy and the potential problems it can cause.

Gynaecologists in the past used to be concerned that a fibroid may grow quickly due to the rising oestrogen levels in pregnancy and cause major problems. Recent medical research has shown that most fibroids do not actually become larger during pregnancy, and those that do often return to their pre-pregnancy size afterwards.

However, there are several ways that a fibroid may affect a pregnancy.

A uterine fibroid can cause uncomfortable feelings of discomfort, pressure, heaviness or even pain if they grow larger and press on surrounding organs or pelvic structures. A fibroid may lead to sharp pain in the lower back (lumbar region) and legs if there is pressure on a nerve.

A rare complication of a fibroid during pregnancy is a problem known medically as red degeneration. If red degeneration occurs there is haemorrhage within the centre of the fibroid. This usually happens in the middle trimester (three months) of pregnancy and is thought to result from the leiomyoma (fibroid tumour) growing rapidly and outgrowing its blood supply. Red degeneration can be very painful, usually requires treatment with strong painkillers, but nearly always settles down without causing serious problems or needing specific treatment.

With regard to falling pregnant, fibroids are thought to account for about two to three per cent of all infertility problems. If a fibroid or fibroids develop just under the endometrium (surface lining of the uterus) this may affect the way in which a fertilised egg attaches or implants in the endometrium of the womb.

A fibroid therefore, may cause recurrent early miscarriage, which is often so early that a woman is not even aware that she has been pregnant.  More rarely a fibroid may obstruct the canal of the cervix or the opening of the fallopian tubes into the womb. Sometimes later in pregnancy, fibroids may also disrupt the normal development and growth of the uterus, leading to premature labour and childbirth. Extremely rarely, fibroids may lead to a miscarriage before 23 weeks of pregnancy.

The most frequent problem with fibroids in pregnancy is that they can lead to slightly early labour and delivery of the baby two to three weeks early, which is of very little threat to the baby.

Rarely a fibroid can develop and enlarge in the lower part of the uterus and lead to cause partial blockage of the birth canal. If this happens, then a caesarean section operation is usually necessary to deliver the baby.

When a woman who is having infertility problems is discovered have uterine fibroids, they may be treated and removed they are sufficiently large, to try and increase the likelihood of conception. Gynaecologists usually advice that small fibroids are best left untreated.

Medical research has indicated that if there is cause found for the fertility problem, treating and removing the fibroids increases the chance of falling pregnant by about 40% to 80%.

Fibroid Pregnancy

Fibroids are very common. It is estimated that between 25 and 80% of all women have uterine fibroids. Therefore many women who are pregnant will have a fibroid or fibroids. Many women who are trying to fall pregnant will have fibroids. It is easy to diagnose fibroids with ultrasound scanning, and most pregnant women have one or more ultrasound examinations. Before the advent of ultrasound scanning many women who were pregnant did not know that they had fibroids. Nowadays many women are diagnosed with fibroids during pregnancy.

If you have been diagnosed with a fibroid that is causing no symptoms and want to fall pregnant, then it is usually safe to continue to try to conceive. I would advise that you discuss your fibroid with your family doctor or gynaecologist if you are trying to fall pregnant. If you want to start a family or try to fall pregnant it is sensible to discuss this with your GP or gynaecologist anyway. This is because pre-conception counselling can improve the chances of having a healthy baby.

Uterine fibroids usually grow during pregnancy. Some fibroids will stay the same size and some may even shrink during pregnancy. If you are pregnant and a fibroid is diagnosed, it is quite likely that it has been present for some time, many months or even many years.

If you are having difficulty falling pregnant or if you have had recurrent miscarriages, then investigation is important. Gynaecologists recommend that a couple, without risk factors for infertility, that has been trying to conceive for a year or more, should have tests for infertility.

If a couple is known to have factors that make infertility more likely, then most doctors will advise that a gynaecology opinion is sought after 6 months of trying to conceive. The most common reason for earlier assessment is if the woman is 35 years old or older. Other factors include a woman having irregular periods or a man who has a history of chemotherapy.

If you are known to have fibroid or fibroid symptoms then it is advisable to seek investigation after 6 months of trying to conceive.