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Gardnerella in pregnancy

Gardnerella in pregnancy


'Gardnerella vaginalis' or 'Haemophilus' is a bacterial infection of the vagina that can behave in a similar way to the fungal infection 'candida' or thrush.

How does gardnerella occur?

Gardnerella is very commonly experienced during pregnancy as well as in the weeks following the birth of the baby. This is because of slight changes in the woman's vaginal acidity (or pH) and the extra physical demands of pregnancy and new parenting. The normal, healthy bacteria that live in a woman's vagina are called 'Lactobacilli'. Lactobacilli need an 'acidic' environment to survive. However, the bacteria that causes gardnerella, requires a more 'alkaline' environment to thrive.

An infection of the vagina is medically referred to as 'vaginosis'. Another baterium that can be involved in vaginosis as well as gardnerella is 'mycoplasma hominis'.

The gardnerella bacteria are often found in the vagina in small quantities. This is normal and does not cause any physical signs and does not require any treatment. A gardnerella infection usually only causes problems when the acidity of the vagina changes to allow the bacteria to multiply and 'overgrow'.

Symptoms of gardnerella

The symptoms of a gardnerella infection can include a heavy, watery vaginal discharge that can have a strong, fishy odour. The discharge may look greyish or green in colour (or be brown or yellowish). There is usually little, or no vaginal irritation felt with gardnerella, but a few women will find that they do feel some itching.

Conditions that can encourage an alkaline environment in the vagina and promote the growth of gardnerella can include:

  • Pregnancy (great!)
  • Stress, not sleeping well, a poor diet, and possibly zinc and iron deficiencies.
  • Hot weather and wearing synthetic underwear, gym leggings, tights or stockings.
  • Vaginal deodorants and powders. (These should be avoided during pregnancy anyway.)
  • Douching or washing out the vagina (this should also be avoided).
  • Wearing plastic backed panty liners or sanitary pads continuously and prolonged bleeding (the twi things that normally happen after the birth).
Some women will experience gardnerella on and off on a regular basis. Many will use natural methods to keep the infection under control, only using antibiotics when the gardnerella becomes severe. (This is usually when the discharge becomes quite heavy and smelly.) You may want to use condoms during sexual intercourse while treating gardnerella, as semen is very alkaline. Your partner may also need treatments as they may reinfect you after treatment with medications.

Up to 20 percent of pregnant women, if tested, will show some presence of gardnerella in their vaginas, but only a few women will actually need treatment. Some caregivers like to treat gardnerella routinely in all pregnant women if a test shows that it is present. This approach is thought to stem from the belief that vaginal infections can occasionally lead to premature labour. However, research studies to date are inconclusive. There only may be some benefit for women who have had a previous premature labour. Gardnerella should not affect the baby if present during a vaginal birth.

Treating gardnerella

The routine treatment of all women with gardnerella without symptoms is not generally recommended. It is possible for gardnerella to return again after treatment. Therefore multiple courses of antibiotics may be used over a period of time. Most infections of gardnerella will go away without medical treatments.

Gardnerella can occasionally cause an infection of the uterus for the woman after the birth. Again, antibiotic treatment is usually only recommended if you are noticing symptoms (lower abdominal pain, fever, heavier bleeding after the birth). If the symptoms are mild and the woman feels well, you may still choose to take the 'wait and see' approach before taking any antibiotics.

There are some approaches that women will use to help them deal with their gardnerella infection. If you are concerned about any unusual vaginal discharge you should seek the advice of your caregiver.

Lifestyle choices

Some women will try strategies aimed at encouraging an acidic environment in the vagina in the hope of reducing the chances of needing to treat their gardnerella with antibiotics, or to stop it returning soon after treatment. These can include:

  • Eating well, resting and drinking plenty of fluids. Some women will eat fresh garlic or garlic capsules, take vitamin C or zinc to boost their immune system and help the body to fight the gardnerella naturally. (Check with your caregiver.)
  • Avoiding vigorously cleansing the vagina with lots of perfumed soaps. The normal vaginal discharge naturally cleanses the vagina and is needed to keep the acidity balanced. Some women will use plain water, unscented soaps or sorbelene and glycerine cream as cleanser alternatives.
  • Dealing with stress. Deep breathing, meditation and relaxation exercises can be helpful. Some women will organise time off work or mothering, have a massage, rest or look at strategies to take the pressure off.
  • Wearing cotton under wear (or none at times if you can and feel comfortable with this). Avoiding tight leggings, stockings etc. for long periods. Changing your clothes detergent to a non-scented brand. Women who experience gardnerella after their birth will often try just sitting on a folded towel at times to have a break from wearing plastic-backed sanitary pads.
  • Being aware that semen can aggravate gardnerella. A man's semen is very alkaline and can encourage the growth of gardnerella. You may like to try using condoms until it has cleared.

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