Evaluation of Vaginal Complaints During Pregnancy: the Approach to Diagnosis

Vaginal discharge during pregnancy is commonly accompanied by pruritus, malodor, dysuria, or dyspareunia. Almost half of pregnant women are estimated to present with such symptoms. Differential diagnosis is diverse and includes entities that are specific to pregnancy, some of which may pose a hazard to maternal and fetal outcomes. Accurate diagnosis is essential and requires a detailed medical history combined with a thorough genital examination, measurement of vaginal pH, and a microscopic evaluation of vaginal secretions (wet mount). This review will present the approach to diagnosing vaginal complaints during pregnancy, together with the criteria and techniques for diagnosing each of the etiologies.