Candidiasis in pregnancy

Category Gynecology | December 12, 2017 00:14

The concept of "candidiasis" combines a group of diseases, the causative agent of which are yeast-like fungi of the genus Candida. The clinical manifestations of these diseases are diverse.

Quite often candidiasis( sometimes called candidiasis) occurs as a drug disease as a result of "superinfection with microbes that are not sensitive to the Chemopreparation that have multiplied in the body under the influence of the latter."To such chemo drugs are primarily antibiotics and especially those that have a wide range of action( biomycin, levomycetin, terramycin, etc.).By suppressing bacterial antagonists and bacteria that form vitamins, antibiotics create favorable conditions for the multiplication of fungi and the activation of their pathogenic properties.

Despite the fact that in everyday practice "thrush" of the genitals during pregnancy is often found, the literature data on the disease of this etiology in pregnant women is very limited. The most common candidiasis vulva and vagina( vulvitis,
vulvovaginitis).This is especially common in women with diabetes, gonorrhea and trichomoniasis. It should also take into account the frequent candidosis in men. If pregnant women have complaints of pain, itching and burning sensation in the vagina, one should keep in mind the possibility of a fungal disease. The pregnancy itself contributes to the development of genital candidiasis.

Studies conducted at the Institute of Obstetrics and Gynecology of the Academy of Medical Sciences showed that the widely held opinion about the carriage of Candida fungi on a healthy vaginal mucosa in pregnant women is not correct. The incidence rate of vaginal yeast-like fungi of this genus in pregnant women without the presence of colpitis appeared to be 5%, and in the group of pregnant women suffering from colpitis 79%.This gives grounds for considering the presence of fungi on the vaginal mucosa in pregnant women as a sign of a pathological process. Mycological examination of aseptically taken urine in patients with candidal colpitis LD Yartseva and A. Dolgopolskaya in 50% of the patients examined had candidiasis. According to the materials of these authors, in women with candidal colpitis, pregnancy is often complicated by miscarriage( 13.5%) and polyhydramnios( 10.4%).In addition, these patients often had a low-grade fever without established cause( 16%), recurrent pyelitis or chronic pyelonephritis( 19.2%) and pruritus( 24%).Perinatal mortality has been slightly increased. Yu. V. Gulkevich( 1962) cites the data of AN Serzhanina, according to which 7 candida were found in 7 infants of 58 fatalities during the first day of extrauterine life in the lungs. One of these children had Candidiasis of the lungs, esophagus and intestines in combination with aspiration of amniotic fluid. The author believes that the infection occurred in utero, most likely intranatal. In the remaining 6 newborns, candidias, according to the author, did not play an etiological role, but aggravated the course of pneumonia caused by other pathogens. Yu. V. Gulkevich, on the basis of literature data, classifies Candida, along with staphylococci and Escherichia coli, among the most frequent pathogens of intranatal fetopathies. The case of C. albicans infection of the placenta and fetus is reported by Albarracin, Paterson and Haust.

The candidiasis of amnion and amniotic fluid is reported by Galton and Benirschke. Latent candidiasis in pregnant women describes Boys. Flamm, Kovac and Kunz, in an experiment on white mice, proved the possibility of infection of the fungus with Candida albicans by the hematogenous route, through the mother's blood.

The problem of candidiasis in obstetrics requires further study. For the treatment of vulvovaginitis, washing with 2% borax solution, 10% sodium bicarbonate solution, Lugol solution, 0.1-0.25% copper sulfate solution, lubrication with 10% bugoglycerin is recommended. Inside, nystatin is used. Effective treatment of levorin, administered with candida colpitis in the vagina in the form of globules. Simultaneously, it is necessary to eliminate the pathology that contributes to the emergence of candidiasis.

More on therapy in the article Treatment of Candidiasis