What to Do About Mycoplasma Infection During Pregnancy

Over a decade ago, mycoplasma screening was considered a standard part of prenatal care, especially during preconception planning or early pregnancy. However, in recent years, routine testing for mycoplasma has been de-emphasized in many clinical guidelines. This shift is based on growing evidence that the presence of mycoplasma—commonly found in the cervical and vaginal areas of pregnant women—does not necessarily indicate an infection or pose a threat to pregnancy when no symptoms are present.

Understanding Mycoplasma in Pregnancy

Mycoplasma refers to a group of bacteria that naturally reside in the urogenital tract of many healthy individuals, including pregnant women. In the absence of symptoms such as abnormal discharge, itching, or irritation, their presence is generally considered part of the normal microbial flora. Research shows that asymptomatic colonization does not increase the risk of adverse pregnancy outcomes like preterm birth, low birth weight, or miscarriage.

When Should You Be Concerned?

If you begin to experience symptoms like increased vaginal discharge, discomfort, burning, or persistent itching of the vulva, it may indicate an overgrowth or active infection. In such cases, a positive mycoplasma culture from a lab test should not be ignored. While mycoplasma itself isn't always harmful, its presence alongside symptoms could point to an imbalance in your vaginal microbiome or a coexisting infection that requires medical attention.

Next Steps: Diagnosis and Treatment

Seek prompt medical evaluation if you're experiencing any troubling symptoms during pregnancy. Your healthcare provider may perform a pelvic exam and order specific tests, including nucleic acid amplification tests (NAATs) or bacterial cultures, to confirm the presence of pathogenic strains like Mycoplasma hominis or Ureaplasma urealyticum.

Treatment typically involves a course of pregnancy-safe antibiotics, such as azithromycin or erythromycin, carefully selected to protect both maternal and fetal health. It's crucial to complete the full treatment regimen and follow up with your doctor to ensure the infection has cleared.

Prevention and Vaginal Health Tips

Maintaining a healthy vaginal environment can help prevent symptomatic infections. Avoid douching, use mild, unscented soaps, wear breathable cotton underwear, and practice safe sex. If recurrent issues occur, your partner may also need evaluation and treatment to prevent reinfection.

While mycoplasma is no longer routinely screened for in pregnancy, staying informed and proactive about your reproductive health ensures a safer, healthier journey toward motherhood. Always consult your OB-GYN before starting or stopping any treatment during pregnancy.