Management of Vulvovaginal Candidiasis in Pregnancy

Q4 Medicine
Jessica Levina, D. Ocviyanti, Robiatul Adawiyah
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引用次数: 0

Abstract

Pregnancy is a risk factor for vulvovaginal candidiasis (VVC). The most common cause of VVC in pregnancy is Candida albicans. During pregnancy, physiological changes occur, such as increased levels of estrogen, lower vaginal pH, increased production of vaginal mucosal glycogen and immunological changes so that Candida colonization in the vagina increases. Increased colonization can be symptomatic or asymptomatic. When symptoms and signs of vulvar pruritus, pain, swelling, redness, burning, dyspareunia, dysuria, vulvar edema, fissures, excoriation and vaginal discharge are found, it is necessary to perform microscopic examination and/or fungal culture to establish the diagnosis of VVC. Topical intravaginal antifungal therapy such as clotrimazole and nystatin, are the recommended treatment for VVC in pregnancy that has been shown its safety. Treatment with oral antifungal is not recommended because of the risk of causing congenital abnormalities in the fetus. Prophylactic administration in the last trimester of pregnancy in asymptomatic VVC cases provides good pregnancy and neonatal outcomes but is still being debated. In severe, prolonged or recurrent cases of VVC, other co-infections may be sought which may also need to be managed. Administration of probiotics for VVC therapy still requires further research.
妊娠期外阴阴道念珠菌病的处理方法
怀孕是外阴阴道念珠菌病(VVC)的一个危险因素。妊娠期外阴阴道念珠菌病最常见的病因是白色念珠菌。妊娠期间会发生生理变化,如雌激素水平升高、阴道pH值降低、阴道粘膜糖原分泌增加以及免疫学变化,从而导致念珠菌在阴道内的定植增加。定植的增加可能是无症状的,也可能是无症状的。当发现外阴瘙痒、疼痛、肿胀、发红、灼热、排尿困难、排尿困难、外阴水肿、裂口、糜烂和阴道分泌物等症状和体征时,有必要进行显微镜检查和/或真菌培养,以确定 VVC 的诊断。阴道内局部抗真菌治疗,如克霉唑和奈司他丁,是治疗妊娠期外阴阴道炎的推荐疗法,其安全性已得到证实。不建议使用口服抗真菌药物治疗,因为有可能导致胎儿先天畸形。对于无症状的 VVC 病例,在妊娠的最后三个月进行预防性用药可获得良好的妊娠和新生儿预后,但目前仍有争议。对于病情严重、病程较长或反复发作的 VVC 病例,可能还需要治疗其他合并感染。使用益生菌治疗 VVC 仍需进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Indonesian Journal of Obstetrics and Gynecology
Indonesian Journal of Obstetrics and Gynecology Medicine-Pathology and Forensic Medicine
CiteScore
0.10
自引率
0.00%
发文量
0
审稿时长
24 weeks
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