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Is this thick sticky white discharge, CERVICAL MUCUS PLUG?

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Hi there! I'm 17 weeks, 3 days pregnant (first pregnancy!) and I am suddenly very anxious that I might be losing my cervical mucus plug. I was always concerned as to how my cervix would hold up in pregnancy since 6 years ago I had laser surgery performed for pre-cancerous changes to my cervix. (I was told however that the odds of that affecting my cervix where small - less than with a LEEP or something). Also, at 9 weeks pregnant, I had a cervical polyp that was bleeding removed. Lately I've been feeling lots of random pains in what feels like my cervix…or in the vagina somewhere! I have had lots of discharge throughout the pregnancy but today about a nickel sized amount worth of really thick, really stretchy, discharge came out that was like a light green/yellow. I decided to look up there with a mirror and saw that tons of it was just stuck there in the opening of my vagina. I tried to get it out but it is so sticky, like thick glue almost, I could barely get it out. It's gross. Ironically, I just saw my OBGYN today and told him my cervix had been getting pains and my discharge had increased but he said he wasn't concerned, which made me feel a lot better (although at that time the discharge was the same as it had been since basically the beginning of the pregnancy). It wasn't until his office closed later this afternoon that I discovered this new type of discharge that after a lot of googling I feel pretty certain is part of my mucus plug. I will attach a picture of a small amount, if that helps. In the picture it looks spread out only because I was checking the consistency. It's normal shape would have been a blob! Additional information: my doctor said that at my last visit he swabbed me for every type of infection so that's why he wasn't worried about the discharge. Also, my husband and I had sex last night and I began to get more pains after that - finally resulting in this possible loss of some of my mucus plug today. Should I be going to the ER or could this be just nothing to worry about? I will obviously call my doctor in the morning, but was hoping that maybe I could get an answer on here first in case this is urgent. I also wanted to add that I do/have been feeling a lot of pressure in my pelvic region/uterus for a number of days now. And I do get cramps. I did tell my OB this today during my appointment but he said that they were likely contractions which were common and not harmful at this stage. Thanks in advance for your help. I will be anxiously awaiting your response! 

Category: OBGYN

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Category: Infertility Specialist
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Hello
Thank you for your query at Doctorspring.com
I understand your anxiety, having had two procedures on the cervix and with the pains you are having.
However, please be reassured.
This is NORMAL cervical discharge.
DUring pregnancy the discharge thickens, is glue / blob like and there is lots of it , copious amounts.
You have not lost your mucous plug, because it is a dynamic process and mucus keeps getting secreted as it keeps getting washed out.
There is no need to go the ER unless you are having intolerable cramping .
You do need to address the off and on pains that you are having though, ask your doctor to consider starting progesterone for you.
Also, if sex makes you ache more , then best to refrain till you feel fine.
Regarding the mucus though, I have gone through the picture, and your history, and would like to reassure you again that there is no cause for concern.
Stop googling, stop worrying and relax.
Stress will harm you more than the innocent cervical discharge.
All the best
Please feel free to discuss further.


Patient replied :

Thank you so much for responding to me tonight, I really appreciate it! Now I can get some much needed rest and let go of some of the stress. You're a god send :) So you think it is ok even though it is not the same as the discharge I had leading up to this point? I could really stretch it between two fingers (suprisingly far) whereas I never noticed any elasticity like that with the discharge I've been getting all along. It's also a slight greenish/yellowish tinge, although I think my cervical mucus is/always has been like that. I promise to offically stop googling for the night. (I even got my husband googling this and he normally tells me not to!) haha We will both stop it now!
Good night and thanks again.


Thank you for the appreciation.
Yes, stop googling.
The discharge is quite normal in consistency too for pregnancy.
Do not worry and get some much needed rest.
Good night.
Regards


Patient replied :

Hello again!
So, I took your advice and asked my OBGYN about starting progesterone for my contractions/cramps and he agreed that it was a good idea. He prescribed me 100 mg of Prometrium - vaginally. He said to try it for a month and see if it makes a difference.
I think in terms of my concerns about my cervix, it's reassuring to be on it, however, I've also read a lot of negative things about it online as well. Have you ever heard of it causing heart defects, cleft palate or causing the child to be a hermaphrodite?? I was worried about this when I took it in my first trimester and googled it, but now taking it in my second trimester makes me once again worry about whether there may be are any potential risks. My doctor didn't think so. But what do you think?
I also carry some rare auto-antibodies called SSA. They are associated with Sjogren's which I seem to perhaps have a mild case of. Anyway, these auto-antibodies pose a small risk of causing congential heart block in the baby from weeks 18-25 (most commonly). I was told it's like a 3-5 percent chance. So, I'm getting the heart rate monitored every week from week 16-25. So far so good, but I know the highest risk is beginning next week! That's why I'm so anxious about everything I think. But anyway, that's also why I felt extra worried when I read today that prometrium has been linked to causing congenital heart defects. Your opinion would be greatly appreciated!
Thanks again Dr. Vazirani!


Hello again.
Thank you for the appreciation.
WIth Sjogren's syndrome, the risk of congenital heart block developing in the baby is less than 5 %, as right surmised by you.
Prometrium contains natural micronized progesterone.
This type of progesterone is least associated with congenital defects that you mention.
The effect is seen maximally with androgenized progesterone, Prometrium is completely safe, I can assure you.
Also at 18 weeks, the heart and other systems are almost fully functional.
In my opinion, please take the drug as prescribed, and do not worry about the side effects, as they are only anecdotal and not proved in humans.
Lots of pregnant women in my experience have gone on to use progesterone till term without any adverse effect.
Take care.
Regards


Patient replied :

Hello again! Just one more follow up question and then I will close this consultation...The mucus that I first inquired about never returned. I now have other types of cervical discharge that I think are from the progesterone suppositories. I put it in at night and then in the morning I always have a wetness, that sometimes leaks out a bit and runs down my leg. It's clear and it's not urine. Throughout the day I pee out chalky white stuff and there's lots of it it. If not for the progesterone I would think that I had a yeast infection although it's not itchy, just sometimes irritated. Anyway, I have been having quite a few contractions (braxton hicks), off and on. They don't hurt really. I can just feel my uterus/lower abdomen tighten for a few seconds, and then it subsides. Is it too early to be having braxton hicks contractions since I'm only nearing the end of my 19th week of pregnancy? (I will be 20 weeks on Monday). Should I be asking my doctor to further investigate this? I have an ultrasound on Monday and my next appointment with my OB is just over a week from that day. I'd told him before about them (I thought they were cramps and based on my description he told me they were actually contractions). He didn't seem ovelry concerned but I was just hoping for a second opinion. I remain worried about pre-term labor. Well, I am just always worried it seems!! Haha
Thanks for your guideance!
Krista


Hello Krista, good to hear from you again.
The discharge that you now mention is typical of the residue that comes out after using progesterone suppositories.
Regarding Braxton - Hicks contractions, they are commonly seen at the beginning of the third trimester, but occasionally might be felt from the second trimester onwards.
Apart from rigorously using the progesterone, there is nothing else to add on to the medication.
Just rest a lot, avoid vigorous sex and yes, drink plenty of water - that is very important.
Do not panic, but, on the other hand, do not ignore any ominous cramps, spotting or altered discharge.
Take care.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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