Vaginal thrush and its management in pregnancy

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases

Background:

• Vaginal thrush, or vulvovaginal candidiasis, is a common fungal infection.
• Asymptomatic infections are frequent in pregnant individuals attending antenatal clinics.

Purpose of the Study:

• To determine the frequency of vaginal thrush in pregnant patients.
• To evaluate the efficacy of ketoconazole vaginal ovules for treating thrush.
• To assess the need for routine screening and optimal timing of treatment.

Main Methods:

• Diagnosis of vaginal thrush using phase-contrast microscopy and fungal culture.
• Treatment administered with a single vaginal ovule containing 400 mg ketoconazole nightly for three consecutive evenings.
• Follow-up assessment of treatment efficacy at 4 and 8 weeks post-treatment.

Main Results:

• Vaginal thrush was detected in 25% (25 out of 98) of the studied pregnant patients.
• Ketoconazole treatment resulted in the elimination of thrush in 92% (23 out of 25) of cases.
• Recurrence or re-infection was noted, emphasizing the need for careful consideration of treatment timing.

Conclusions:

• Routine screening for asymptomatic vaginal thrush in pregnancy may not be necessary.
• Ketoconazole vaginal ovules demonstrate high efficacy in treating vaginal thrush during pregnancy.
• Treatment is best administered in the third trimester unless symptoms necessitate earlier intervention, considering potential recurrence.