Chadwick’s sign is present in 60% of pregnant women in the third trimester, but it can also be observed in children and adult females. This sign appears when there is an accumulation of fluid in the vagina because of pregnancy or urinary retention. It is present when this vaginal fluid becomes greenish-yellow or brown, with a particular odor that strongly resembles fecal matter.
The characteristics of Chadwick’s sign are:
In pregnancy, cervical effacement and dilation occur as a natural process of labor, accompanied by rupture of fetal membranes. This way, free hemoglobin from red blood cells can pass through and cause vaginal fluid to turn greenish-yellow because it has a strong affinity for oxygen and iron that remains inside the red blood cells. However, Chadwick’s sign does not mean that you will have an emergent induction. These signs refer to changes in the cervix and vagina, which does not mean that you will begin labor in a few hours.
Another characteristic of Chadwick’s sign is the bad vaginal odor that appears when fluid mixes with amniotic fluid or cervical mucus. Fluid with this characteristic color and foul smell indicates fungal infections such as candidiasis. This infection can be transmitted by sexual intercourse with an infected partner to whom it has not been treated.
The appearance of mucous or pus discharge from the vagina:
Normally, about 1-4 cm3 thick mucus containing bacteria accompanies fluid during pregnancy to prevent the growth of microorganisms in the genital tract. Sometimes, the vaginal discharge is accompanied by pus. This can be caused by bacterial vaginosis as a result of an imbalance between vaginal lactobacilli and other microorganisms such as Gardnerella vaginalis, Mycoplasma hominis, Ureaplasma urealyticum and Bacteroides species.
Accumulation of fluid in the vagina:
As previously mentioned, Chadwick’s sign refers to the accumulation of fluid in the vagina because it makes its expulsion difficult due to thickness. This accumulation can be observed when there are no contractions or fetal head descent that facilitate cervical dilation and effacement.
It is difficult to express the vaginal fluid:
Normally, it is easy to express vaginal fluid from the opening of the vagina by placing a finger inside and pulling it. When this sign appears, you should not try to expel the fluid if it does not come out easily because there may be a risk that part of the placenta comes out as well. In case of expulsion from the cervical canal, the placenta may remain inside causing serious infection. It is recommended that you immediately consult your doctor or midwife in these cases even if you have Chadwick’s signature.
Chadwick’s sign is not an indication of the beginning of early labor, neither mean that you will begin inducing childbirth. These signs are related to changes in the cervix and vagina, which do not mean that it will be easy to express vaginal fluid because it may come out easily. If you have these signs, you should consult your healthcare team as soon as possible because they may indicate a vaginal infection such as candidiasis.