Bartholin cysts are a common gynecological condition during pregnancy. The Bartholin glands are small, pea-sized structures located on each side of the vaginal opening. Their primary function is to produce a lubricating fluid that helps maintain vaginal moisture and aids in sexual lubrication.
What Are Bartholin Cysts in Pregnancy?
Bartholin cysts form when the duct of one of these glands becomes blocked, leading to fluid buildup. This blockage can occur due to various reasons, including thickened mucus, inflammation, or infection. The cyst typically presents as a firm, round lump near the vaginal opening, ranging in size from a pea to a golf ball.
Pregnant individuals may be more susceptible to Bartholin cysts due to increased genital blood flow and hormonal changes, which alter mucus consistency. Small cysts are often painless, but larger ones can cause discomfort or pain, especially during walking, sitting, or sexual intercourse. If infected, the cyst can become a painful abscess, characterized by severe pain, redness, warmth, and swelling. A fever may also indicate a more significant infection.
Treatment Approaches During Pregnancy
Consulting a healthcare provider is important for diagnosis and management. Initial treatment often involves conservative measures, such as warm compresses and sitz baths. Soaking the affected area in warm water several times a day can help reduce pain and promote natural drainage. Good hygiene also helps prevent infection.
For larger or infected cysts, medical interventions may be necessary. Incision and drainage (I&D) is a common procedure where a small cut is made to drain fluid or pus. A catheter, such as a Word catheter, may be inserted for several weeks to ensure complete drainage and prevent recurrence.
Marsupialization, another surgical option, involves opening the cyst and stitching its edges to create a permanent drainage pouch, often considered for recurrent cysts. If an infection is present, antibiotics may be prescribed, with specific choices like clindamycin for pregnant individuals, especially if penicillin allergy is a concern. Treatment decisions are carefully made to ensure the safety and well-being of both the pregnant individual and the fetus.
Potential Effects on Pregnancy and Birth
A simple Bartholin cyst does not pose a direct risk to the baby. These cysts are external to reproductive organs and do not affect the uterus, ovaries, or fallopian tubes, having no impact on fetal development. Most Bartholin cysts do not interfere with vaginal delivery.
However, a very large cyst or an infected abscess might require specific management during labor. While the incidence of Bartholin gland abscesses during pregnancy is low (around 0.13%), proper management leads to favorable maternal and neonatal outcomes. In rare instances, a large or severely infected cyst could influence the mode of delivery or necessitate drainage prior to childbirth to prevent complications. Recurrence is possible, with rates varying by treatment method, but with appropriate medical care, most cases are managed without adverse effects on pregnancy or birth outcomes.