Vaginal Candidiasis (Vaginal Thrush)
What is vaginal candidiasis infection? Is it common in pregnancy?
Vaginal candidiasis is a fungal infection of the vagina. It is also known as thrush. Thrush is usually caused by a fungus called candida albicans. This fungus commonly lives in the intestines of healthy adults and about 1/3 of women have it in their vagina. The problem occurs when there is overgrowth of this fungus compared to other microorganisms in your vagina. It is relatively common during pregnancy due to several factors. During pregnancy, there is an increased in a type of sugar (glycogen) in the cells lining the vagina which promotes excessive growth of this fungus leading to thrush. In addition, you may develop thrush after given a course of antibiotics for other reasons. This is because the good bacterias which protects the lining of your vagina against infections may be killed by the antibiotics and hence increase your risk of infections.
What are the symptoms associated vaginal candidiasis?
- Thick creamy whitish (cottage-cheese like) vagina discharge which is commonly associated with itchiness to your genital area.
- Bladder infection symptoms such as burning sensation during urination or frequent passing out of urine.
How is the diagnosis of vaginal candidiasis made?
Usually your doctor will suspect thrush from your symptoms of thick whitish discharge and itchiness. However, there are a lot of causes of vaginal discharge in pregnancy. In order, to accurately diagnose thrush, your doctor may need to do an internal examination and take a swab (using a cotton-like swab) from vagina. This specimen will be sent to the lab to be examined under the miscroscope and culture to confirm that it is thrush.
Could infection with vaginal candidiasis be transmitted to my baby?
No, it would not hurt your developing baby by causing any abnormalities or infection in the womb. However, if you have thrush during labour, there is a small chance that your baby may catch it when he passes through the vagina. This could lead to oral thrush in your baby causing small white patches to develop in his mouth affecting breast feeding requiring treatment. It usually isn’t a serious condition.
What is the treatment for vaginal candidiasis during pregnancy?Your doctor will prescribe some medication to apply to your genital area or vaginal pessaries to be inserted into your vagina. Common treatment includes Canestan or Nystatin pessaries. Quite often, this will give quick relief to your discomfort and itchiness. Please consult your doctor first and do not buy over the counter medication to treat yourself. Oral fungal medication may not be safe during pregnancy.
What else could I do if I have vaginal candidiasis?
- Where cotton panties.
- Avoid tight pants or other synthetic material such as nylon panties.
- Avoid long hot baths or perfumed bubble bath.
Should my partner be also treated if I have vaginal candidiasis?
Your partner does not need to be treated if you have vaginal candidiasis.
What is the cause for recurrent vaginal candidiasis?
Vaginal candidiasis or thrush could come and go during pregnancy. However, if you persistently have recurrent thrush, your doctor may want to screen you for diabetes in pregnancy. In addition, you may be infected with a certain strain of fungus other than candida albicans which could be resistant to the normal fungal medications which is prescribed.
Recent studies on the use of lactobacillus probiotics in recurrent vaginal candidiasis has shown promising results. However, more studies should be taken to determine the type of lactobacillus, dosage, optimal route and vehicle of administration.
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REFERENCES:
1. Chong PP, Lee YL, Tan BC et al. Genetic relatedness of Candida strains isolated from women with vaginal candidiasis in Malaysia. J Med Microbiol. 2003; 52:657-66.
2. Chong PP, Abdul Hadi SR, Lee YL et al. Genotyping and drug reistance profile of Candida spp. in recurrent and one-off vaginitis, and high association of non-albicans species with non-pregnant status. Infect Genet Evol. 2007;7(4):449-56.
3. Hilton E, Isenberg HD, Alperstein P. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis.Ann Intern Med. 1992; 116(5): 353-7.
4. Abad CL, Safdar N. The role of lactobacillus probiotics in the treatment or prevention of urogenital infections — a systemic review. J Chemother. 2009; 21(3); 243-52.
