Can Vaginal Infections Increase Miscarriage Risk in Early Pregnancy?

What is the likelihood of miscarriage due to vaginal infections?

Hello, doctor.
I have heard that a vaginal infection can cause uterine contractions and bleeding.
If left untreated, could this lead to a miscarriage in the early stages of pregnancy? Or do the symptoms need to be quite severe to trigger such an outcome? Thank you.

fangke, 20~29 year old female. Ask Date: 2015/08/23

Dr. Lü Lizheng reply Obstetrics and Gynecology

Vaginal infections are not limited to just one type.
Among them, the most common is Candida (yeast) infection.
This type of infection is very prevalent, with estimates suggesting that about 80% of pregnant women have Candida in their vaginas.
Fortunately, Candida only resides on the surface of the vagina and does not enter the uterus, posing no risk of miscarriage.
Another, less common situation involves bacterial infections, which have the potential to invade the uterus, causing intrauterine infections and inflammation, and even leading to miscarriage.
Fortunately, a normal cervix is closed, which helps isolate bacteria.
Only a small number of pregnant women become infected.
It is recommended to maintain a dry and breathable vaginal environment and to avoid douching, which can help prevent vaginal bacterial infections.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/08/23

More Info

Vaginal infections during early pregnancy can indeed pose risks, including the potential for miscarriage, but the relationship is complex and depends on various factors. To understand this better, let's delve into the types of vaginal infections, their mechanisms, and their implications for pregnancy.

Firstly, it's important to recognize that there are different types of vaginal infections, with the most common being yeast infections (caused by Candida species) and bacterial vaginosis (BV). Yeast infections are prevalent among pregnant women, with estimates suggesting that up to 80% may experience them at some point. Fortunately, these infections typically remain localized to the vaginal area and do not usually ascend to the uterus, thus posing minimal risk for miscarriage.

On the other hand, bacterial vaginosis is a condition characterized by an imbalance of the normal bacterial flora in the vagina. It can lead to complications during pregnancy, particularly if left untreated. Research indicates that untreated bacterial vaginosis may be associated with an increased risk of preterm labor and delivery, which can indirectly contribute to miscarriage, especially in the early stages of pregnancy. The mechanism behind this is thought to involve the inflammatory response triggered by the infection, which can lead to uterine contractions and cervical changes.

In the context of early pregnancy, the risk of miscarriage due to vaginal infections is generally low, particularly if the infection is mild and treated promptly. However, if an infection is severe or left untreated, it can lead to complications that may increase the risk of miscarriage. For example, if a bacterial infection ascends to the uterus, it can cause chorioamnionitis (infection of the amniotic fluid and membranes), which is a serious condition that can lead to miscarriage or preterm birth.

Symptoms of vaginal infections can vary. Mild infections may not present significant symptoms, while more severe cases can cause discomfort, itching, unusual discharge, or odor. It is crucial for pregnant women to be vigilant about any changes in their vaginal health and to seek medical attention if they experience concerning symptoms.

In summary, while vaginal infections can potentially increase the risk of miscarriage, the extent of this risk largely depends on the type of infection, its severity, and the timeliness of treatment. Yeast infections are generally not a concern for miscarriage, while untreated bacterial vaginosis can pose risks. Pregnant women should maintain good vaginal health, seek treatment for infections promptly, and communicate openly with their healthcare providers about any concerns. Regular prenatal care is essential for monitoring and managing any potential complications during pregnancy.

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