During prenatal care, it is common for many women to complain of vulvovaginitis, which are infectious diseases that affect the female genital region. Among these, candidiasis, bacterial vaginosis, and trichomoniasis stand out. Scientific research on vulvovaginitis aims to determine whether treatment during pregnancy is effective at preventing preterm birth and other risks to the mother and baby. Now learn about the case of trichomoniasis, classified as an STI – sexually transmitted infection1.

What is Trichomoniasis?

Trichomoniasis is an infection caused by a protozoan, which is a parasitic microorganism called Trichomonas vaginalis. It can inhabit the cervix, vagina, and/or urethra, and its main form of transmission is through sex2.

The problem is that the disease can be asymptomatic, meaning it may not present symptoms. However, some characteristic symptoms may appear, such as, mainly, yellowish-green vaginal discharge. Diagnosis is made by a gynecologist, based on the result of the mucus exam collected from the vagina.

Signs and Symptoms

Symptoms may be absent in up to half of cases of trichomoniasis, which makes the disease harder to identify. But when a woman does have symptoms, the following are commonly reported:

  • Irritation in the genital area and perineum;
  • Pain or burning sensation when urinating;
  • Pain or discomfort during intercourse;
  • Itching in the genital area;
  • Discharge that is yellowish-green, frothy, and has a bad odor.

Risk Factors for Developing Trichomoniasis

Since trichomoniasis is transmitted through sexual contact, there are several risk factors possibly related to the sexual life of patients who show symptoms. Among the most common, we can mention:

  • Having unprotected sex with several different partners;
  • Not using barrier contraceptive methods (such as condoms), which protect the body against sexually transmitted infections and not just pregnancy;
  • Having a previous history of STIs.

Do Men Know They’re Infected with Trichomoniasis?

Unfortunately, there’s no way to know without tests if your partner is infected and can transmit trichomoniasis to you. Most men do not notice any changes when they are infected; only a small percentage of them have urethritis (inflammation of the urethra).

This leads to many refusing to go to the doctor and to even get treatment, which contributes to spreading the disease further among women.

Treatment Methods

For treating trichomoniasis during pregnancy, doctors usually prescribe a single-dose oral imidazole medication called metronidazole. It is also used to treat other vulvovaginitis conditions, such as bacterial vaginosis, at different dosages.

However, in high-risk pregnancies, the use of metronidazole may not be recommended and requires caution – especially in the second trimester. Some studies have already linked the incidence of the disease in the second trimester of pregnancy with more than a threefold increase in the likelihood of the child later being diagnosed as mentally disabled.

Another key point is that the sexual partner should also be treated at the same time to prevent the disease from recurring. Trichomoniasis treatment has used this method for many years and is successful in 90% of cases.

The opposite cases are rare, but resistance to this allopathic therapy may be resolved with higher doses of the drug or by substituting with other imidazole medications. It’s worth noting that in cases of unsuccessful treatment, the main causes are not medication failure, but mainly untreated partners and treatment carried out incompletely.

Consequences of Trichomoniasis in Pregnancy

Trichomoniasis during pregnancy has an incidence of around 3 to 5%. Therefore, this sexually transmitted infection (STI) is considered to have a high prevalence. When it occurs in a woman during pregnancy, it can be a risk factor for intellectual deficits in her child, according to several studies. In addition, it can cause respiratory tract infection in newborns3.

A study in North Carolina showed that women with trichomoniasis during pregnancy have a significantly greater chance of having a child with low intellectual development (HR index 1.28).

However, researchers describe this situation when it is associated with “premature rupture of membranes” (when the amniotic sac breaks), with preterm birth and low birth weight. These conditions and the disease can be prevented, but once infected with trichomoniasis, treatment does not reduce the risks of preterm delivery.

In any case, treatment is recommended for pregnant women with symptoms of trichomoniasis at any stage of pregnancy. For those who are asymptomatic, the decision on what to do should be considered on a case-by-case basis.

See Also: Discharge During Pregnancy – What is or Isn’t Normal?

Photo: epaaeiz