VAGINAL DISCHARGE

Learning objectives

1. Define the term vaginal discharges

2. Differentiate between normal and abnormal vaginal discharges
3. Define and describe the characteristics and functions of leucorrhoea, show,
liquor amnii, lochia and its types, and menstrual flow.
4. Describe the characteristics of abnormal vaginal discharge.
Definition

These are secretions seen per vagina.

They are of two types, that is, normal and abnormal.

Normal vaginal discharge

1. Leucorrhoea

This is the normal discharge and keeps on changing depending on the menstrual
cycle. It is produced by adult women in reproductive age by Doderlien bacilli.

Characteristics

 Should be minimal and moderate in amount

 Should not be offensive
 Should not be itching or irritating
 Should be acidic in reaction
 It is usually whitish, clear or creamy in colour and changes according to the
menstrual cycle. It is egg white and elastic around ovulation and should be
clear after peak days.
Functions

 It keeps the vagina moist and warm

2. Show

It is a bloody mucoid discharge from the vagina which appears when a woman is in
her first stage of labour.

Characteristics
  Should not be much in amount
 Should not be offensive
 Should not be irritating
3. Liquor amnii/ amniotic fluid

It is a clear straw coloured fluid found in the amniotic membrane in the uterus, in
which the foetus grows.

Characteristics

 It ranges between 1000-1500ml in amount

 It is clear if not infected
 It pours out during labour which aids in lubrication of birth canal during
child birth.
 It consists of 99% water, mineral salts, urea from urine passed by the foetus.
 It is alkaline in reaction
 It sometimes contains meconeum especially in obstructed labour
Functions of amniotic fluid

 Protects the fetus

 Free movement of the fetus
 Regulates fetal temperature
 Protects fetal limbs from sticking together
 Contains nutrients which nourishes the fetus
Abnormalities associated with amniotic fluid

 Oligohydromnous-inadequate amniotic fluid between 300-500mls

 Polyhydromnous-excess amniotic fluid between 2000-3000mls
 Offensive amniotic fluid-due to infections
 Blue amniotic fluid-due to drugs
 Brown amniotic fluid-due to fetal death
 Meconeum stained-due to fetal distress

4. Lochia

 This appears after delivery of the baby (puerperium)

  The amount varies in different women and is more in quantity than that of
menstrual flow.
 Its odour is heavy and unpleasant but not offensive
 It has an alkaline reaction
Types of lochia

 Rubra (red). Present during the first 3 days. It consists of blood, sheds of
deciduas and pieces of chorion, liquor amniivernixcaseosa and meconeum
may be present. Appears red owing to the presence of erythrocytes
 Serosa(pink). Present from 4th to9th day. The discharge becomes paler and
pinkish in colour, containing less blood and more serum, leucocytes(WBC)
and bacteria.
 Alba(white or clear). Present from 10th to 15th day. The discharge becomes
paler, it is yellowish white in colour and contains cervical mucus, bacteria
and debris from the healing process of the uterus and the vagina.
5. Menstrual flow

It should be about 60-180mls of blood. This flow consists of blood from the
endometrium, endometrial tissue, +- unfertilized ovum and secretions from the
endometrium.

Characteristics of menstrual flow

 It should not clot

 It should not be offensive
 It should be dark red

ABNORMAL VAGINAL DISCHARGES

These are discharges which are caused by sexually transmitted infections of the
female reproductive system and require treatment.
These discharges are pathological other than physiological.

Characteristics of abnormal vaginal discharges

Colour

 Whitish creamy or curdy milky discharge- usually due to fungal infection of

the vulva and vagina like candidiasis
 Greenish yellow discharge- is a common feature of trichomonasvaginalis
 Purulent yellow discharge-usually due to gonococcal infections.
Odour

 Any offensive discharge should be investigated and the cause treated

Amount

 Increased amount that tint the nicker is abnormal and should be investigated
and treated.
Irritant

 Any discharge that may cause irritation and results into inflammation is
abnormal and should be investigated and treated.
Assignment: explain any 8 causes of abnormal vaginal discharge