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What is prescribed for pregnant women with thrush. Review of drugs used for the local treatment of thrush. What drugs can be used by pregnant women

Among the infectious and inflammatory diseases of the urogenital sphere of a woman, thrush or occupies the first place. During pregnancy, a physiological decrease in the immune status of a woman occurs, so the disease of thrush increases several times. Treating thrush during pregnancy is not an easy task, due to the limited choice of drugs used in the treatment of this disease.

Information about the disease

The causative agent of thrush is a yeast-like fungus of the genus Candina Albicans. It is present in small amounts in the vaginal secretion, where its abundance is controlled by the main flora of the vagina - lactobacilli. Under adverse conditions, as a result of the death of lactobacilli, a decrease in local immunity and the development of dysbacteriosis, the fungus begins to colonize the mucous membranes of the genitals.

Pregnancy is a special state in a woman's life, when everything that happens in the body concerns not only her, but also the unborn child. Therefore, even at the stage of pregnancy planning, it is necessary to treat diseases that can worsen during this period. Treatment of thrush during pregnancy should be carried out only with drugs prescribed by a doctor.

Factors that provoke the disease

The causes of thrush during pregnancy are diverse and are often laid before conception: taking antibiotics, hormonal drugs, oral contraceptives, weakened immunity, bad habits. Pregnancy is a trigger mechanism for testing the body for strength. It's all about the development of immunosuppression - the suppression of the immune system, which is formed in the body of a pregnant woman, so that there is no rejection of the embryo, half consisting of someone else's (male) genetic material.

  • If a woman becomes pregnant with chronic candidiasis, the disease will definitely manifest itself, since during pregnancy the hormonal background changes significantly, which affects the acidity of the vaginal secretion and creates favorable conditions for the reproduction of fungi.
  • Hormonal adjustment: the level of the hormone progesterone increases, which is responsible for maintaining pregnancy. Under its action, the vaginal mucosa changes, it loosens, swells, becomes more sensitive to pathogenic microorganisms.
  • Violation of the rules of intimate hygiene: vaginal douching, untimely change of pads, underwear made of synthetic fabrics, prolonged stay in a wet swimsuit, use of various gels with fragrances to wash the external genitalia.
  • Intestinal dysbacteriosis can cause candidal vaginitis, and chronic, not fully treated, thrush can go to the intestines.
  • A sharp change in climatic zones - during acclimatization, immunity decreases.
  • Inflammatory diseases of the genitals and pelvic organs of another etiology (including venereal diseases).
  • Frequent psychotraumatic stresses that negatively affect the nervous system.
  • Vaginal dysbiosis.
  • The predominance of easily digestible carbohydrates in the diet.
  • Endocrine diseases (diabetes mellitus, metabolic syndrome, obesity).
  • Deficiency of vitamins and microelements.

What are the symptoms of pregnancy

Any changes in the quality and quantity of vaginal discharge during pregnancy should be alarming. Normally, a healthy woman during this period has transparent, sometimes whitish, without a sharp smell of discharge. They do not irritate the skin in the perineal area and do not cause any discomfort to the woman.

The first signs of thrush in a pregnant woman are the formation of a milky color, thick discharge with lumps resembling cottage cheese. They are accompanied by severe itching, burning sensation in the genital area. When the urethral outlet is involved in the infectious process, urethritis develops, the symptom of which is pain during urination. Intimacy causes discomfort or even pain in a woman.

On examination, the gynecologist notes inflammation of the external genital organs (vulvitis) and the vagina (vaginitis). The mucosa of the large and small labia, the vagina is inflamed, hyperemic, edematous, covered with a white coating. When you try to remove the film, an eroded surface is exposed.

Treatment of candidiasis during pregnancy is a prerequisite for the normal course of pregnancy, fetal development and the absence of complications during childbirth.

Why it is necessary to treat candidiasis in pregnant women

Some women tend to view thrush as a harmless disease that brings only minor inconveniences. The question of whether it is worth treating thrush or whether treatment can be postponed for a while after the birth of a child is of interest to many pregnant women.

There are good reasons to treat candidiasis in pregnant women, among them:

  • Constant discomfort in the genital area, soreness during sex leads to excessive nervousness and a deterioration in the quality of life.
  • Lack of normal sexual relations often lead to conflicts in the family.
  • A negative effect on the fetus is the birth of a small, weakened child.
  • The risk of complications is premature birth.
  • Childbirth with symptoms of thrush will lead to infection of the baby with the development of fungal infections of the umbilical wound, mucous membranes of the oral cavity, eyes, larynx, skin, and lungs. In severe cases, at the birth of a child with immunodeficiency, candidal sepsis is possible with a fatal outcome.
  • Yeast colonies, penetrating the vaginal mucosa, loosen its walls, which become thin and less elastic. During childbirth, their rupture is possible.
  • The presence of a fungus in the birth canal increases the risk of inflammatory processes in the uterus, although the fungus itself is not involved in the disease. This is due to the suppression of local immunity by the fungus, and other microbes make their way into the uterus more easily.

Basic principles of treatment

In the treatment of thrush in pregnant women, systemic antifungal drugs are not used due to their toxicity.

Experimental data indicate fetal malformations when using the antimycotic agent introconazole during pregnancy in animals.

Therapy for thrush during pregnancy is selected from local agents - suppositories, creams, ointments, vaginal tablets that affect the pathogen - Candida fungus directly at the location. The decisive factor in favor of treatment with local drugs is that they are not absorbed into the blood, and, therefore, cannot get to the fetus and adversely affect it.

Fungicides for local action

These include a large group of modern drugs.

Pimafucin is a macrolide antibiotic with an active antifungal effect against Candida. The active substance natamycin destroys the cell membranes of fungi, thereby causing their death. In candles, it is applied intravaginally - 1 candle at night for 3-6 days. The drug is indicated for the treatment of candidiasis in pregnant women at any gestational age. After the disappearance of symptoms, you can not stop the course of therapy yourself.

Antifungol is an antimycotic drug based on clotrimazole. Approved for the treatment of vulvovaginal candidiasis in pregnant women. It is used in the form of vaginal tablets of 500 mg. A good effect is observed after a single application. At the same time for topical application Antifungol cream. Not prescribed in the first trimester.

Candibene. The active substance is clotrimazole. A vaginal tablet is inserted into the vagina 1 time per day. Course - 6 days. Contraindicated for use in the first three months of pregnancy.

Shortly before childbirth, a pregnant woman is prescribed a complex preparation - Terzhinan for sanitation of the birth canal from various types of infection.

Each of the components that make up the drug acts on different links of pathogenesis.

  • Ternidazole suppresses the simplest: trichomonas and chlamydia.
  • Neomycin sulfate is an antibiotic against a large number of pyogenic microbes.
  • Nystatin destroys fungi.
  • Prednisolone, being a glucocorticoid, reduces inflammation.

Since the drug contains an antibiotic that suppresses the beneficial microflora, therefore, after treatment with Terzhinan, the appointment of probiotics is indicated: Bifidumbacterin, Vagisan to normalize the vaginal microflora.

It is impossible to treat thrush during pregnancy with immunostimulants due to insufficient experience in their use and the lack of reliable data on the effect of this group of drugs on the fetus.

Treat candidiasis by prescribing complex vitamin preparations specially designed for pregnant women. Moreover, the needs for vitamins and mineral supplements in the body of the expectant mother are different depending on the period. You can’t drink vitamins more than prescribed, for the future - this is also a medicine and an excess can do more harm than a deficiency. You can completely do without synthetic vitamins, if you balance the diet for the main food ingredients: proteins, fats, carbohydrates and with sufficient consumption of vegetables and fruits.

Probiotic group

Probiotic preparations, relatively recently included in the treatment regimen for this disease, will help cure candidiasis during pregnancy. The essence of the technique lies in the ability of these drugs, and they mainly consist of live lactobacilli and bifidumbacteria, to settle on the vaginal mucosa and compete with pathogens, including fungi. In addition, they secrete substances that inhibit the growth and reproduction of pathogens. The big advantage of this group of drugs is their safety, the absence of contraindications and the ability to treat thrush in pregnant women at any time.

Vagisan. The live lactobacilli and lactic acid contained in it quickly bring the pH of the vaginal secretion to a normal level, which negatively affects the vital activity of fungi. Method of application: 1 suppository intravaginally at night for 6 days.

Lactonorm. Contains several types of acidophilic lactic bacteria. When it enters the vagina, it promotes the regeneration of the mucosa, improves metabolic processes, and normalizes the vaginal microbial composition.

For the successful treatment of thrush during pregnancy, it is important not only to adequately select medications, but also to correct nutrition, and observe the rules of personal hygiene.

Yeast's favorite breeding ground is a substrate high in glycogen, a carbohydrate made up of glucose. With increased consumption of foods that quickly turn into glucose in the body (sugar, sweets, chocolate, cookies, muffins), favorable conditions are created for an increase in the number of fungi. The conclusion is obvious - do not grow mushrooms in your own body. You should follow a diet with a restriction of sweet, fatty, fried foods.

Personal hygiene

  • Intimate hygiene is carried out twice a day. Do not use antibacterial soap for washing. This can complicate the course of an already existing vaginal dysbacteriosis. If a special gel or foam is used for hygiene, they should be free of fragrances, dyes, and have a pH value in the range of 4-5.
  • It is not advisable to take a bath, it is necessary to wash in the shower.
  • Wash the external genitalia from front to back, otherwise infection from the intestines into the vagina is possible.
  • Wear underwear made from natural fabrics, change twice a day. In addition to washing, iron with an iron heated to the highest possible temperature for this type of fabric.

Features of treatment at different times

It is an axiom that before treating thrush, it is necessary to make a correct diagnosis, because similar symptoms are observed in other genital diseases - chlamydia, trichomoniasis, mycoplasmosis. Therefore, it is reckless to try to diagnose and treat diseases of the genital organs during pregnancy on your own. You can muffle the symptoms of candidiasis, but it will not be possible to completely cure the disease.

Candidiasis during pregnancy tends to become chronic: periods of remission are replaced by frequent relapses. Each exacerbation with the onset of symptoms must be treated. You should not use the same drugs throughout pregnancy. A fungal infection can develop resistance to a particular drug.

A simple and affordable method for diagnosing and determining the sensitivity of fungi to fungicidal preparations is the sowing of biomaterial from the vagina on special media. It will be easier for the attending physician to choose an effective medicine for a pregnant woman, based on the results of the study.

  • Treat during pregnancy, candidiasis begins no earlier than 12-13 weeks of gestation with the appointment of Pifamucin.
  • In the 2nd trimester, Clotrimazole can be used in suppositories. In addition to the main drug, a similar cream is used.
  • In the 3rd trimester - Terzhinan in the form of vaginal tablets.

7-10 days after treatment with antifungal drugs, testing is indicated to determine the microflora of the vaginal secretion. If there is not enough Candida fungus mycelium smear under microscopy, probiotics are prescribed to prevent relapse: Lactonorm, Acilac and others. The course is 7-10 days.

Treatment of thrush in pregnant women is long and not always successful. There are several reasons for this:

  • Incorrectly selected antifungal agent (use of drugs with low efficiency, but high toxicity).
  • Discontinuation of treatment after the withdrawal of symptoms (under-received course dose).
  • Some candidiasis is not caused by the fungus Candida Albicans, but by other species that are more resistant to fungicides.
  • The patient has diseases that cause a decrease in immunity - diabetes mellitus, anemia.

Vulvovaginal candidiasis during pregnancy must be treated without fail so that there are no complications and negative consequences for either the mother or the child.

Chances of getting pregnant with thrush

Biocenosis in the vagina is supported by normal microflora, which consists of 90% lactobacilli. The rest of the microbial community is represented by opportunistic bacteria. The name conditionally pathogenic means that in order to activate the pathogenic (disease-causing) properties of the microbe, special conditions must be created. For yeast Candida, favorable for its reproduction and development is a decrease in the vaginal secretion of lactobacilli that produce lactic acid. The acid-base balance shifts to the alkaline side, the number of lactobacilli, which inhibited the reproduction of fungi, decreases, and fungal colonies begin to massively populate the vaginal mucosa.

Thrush does not affect a woman's reproductive ability to conceive. But recurring unpleasant symptoms in the form of discharge, increased trauma to the vaginal wall during sex, do not contribute to active sexual relations. Some of the spermatozoa die in the vagina, and some lose their activity and cannot reach the egg. It is possible to get pregnant with thrush in women, but it should be remembered that during pregnancy, especially in the early stages, treatment will pose a threat to the health of the unborn child.

Sexual relations during the treatment of thrush should be interrupted due to the risk of microtrauma formation on the vaginal mucosa, as well as possible infection of the sexual partner.

Thrush (candidiasis, candidiasis) is an infectious and inflammatory disease caused by fungi of the genus Candida, most often Candida albicans. In pregnant women, thrush occurs 3-4 times more often than in non-pregnant women, in most cases affecting the mucous membranes of the genitourinary system, then they talk about genital or vulvovaginal candidiasis.

Pregnancy is a priori an immunodeficiency state, since the body "consciously" reduces immune defenses in order to avoid rejection of the fetus by the mother's body. Therefore, a woman during pregnancy is more susceptible to any infectious diseases, including thrush.

Causes of thrush during pregnancy:

Reduced immunity, the presence of chronic diseases (diabetes mellitus, diseases of the cardiovascular and respiratory systems, oncological pathology, HIV infection, and others);

Non-compliance with the rules of personal hygiene (insufficient hygiene is as harmful as too frequent washing, especially with soap, which destroys the natural protective microflora of the vaginal mucosa; wearing tight, synthetic underwear; using pads throughout the day without replacement);

Taking certain medications (glucocorticoid hormones, antibiotics, immunosuppressants);

Poor nutrition (an excess of sweet provokes a change in the composition of the vaginal secretion and provides a rich environment for the reproduction of the fungus).

During pregnancy, additional provoking factors appear:

Hormonal restructuring of the female body (the predominance of progesterone, which is responsible for maintaining pregnancy, causes specific changes in the mucous membrane of the genital organs, it becomes more loose, juicy and abundantly supplied with blood, and the acidity of the vaginal secretion also changes, it becomes higher, which prevents the growth of bacteria, but increases the risk of thrush);

Iron deficiency anemia (in pregnant women, this condition is observed in the vast majority, since iron intake during gestation is much higher than usual and food iron is not enough to make up for the deficiency) and hypovitaminosis;

Constipation and other intestinal dysfunctions (during pregnancy, constipation is a very common occurrence, which, however, is not the norm and leads to stagnation of feces, disruption of microflora and excessive reproduction of fungal colonies, which can also lead to vaginal candidiasis);

Chronic inflammatory diseases of the urogenital area, which are prone to exacerbation during pregnancy.

Symptoms of thrush during pregnancy

Acute candidiasis is a first-time disease that can be cured with timely treatment. However, the treatment of thrush often begins late, and the immunosuppression factor in the body of a pregnant woman also plays a role, and thrush acquires a chronic course with relapses, the frequency in all women is different, up to a continuous course, a chronic course is diagnosed if there are 4 or more episodes of recurrent candidal vaginitis within 1 of the year.

For acute and exacerbation of chronic candidiasis, the following signs are characteristic:

1) Allocations. The discharge from thrush is white or slightly yellowish, cheesy, thick, abundant or moderate, and has an unpleasant sour smell (yeast). Allocations can be in the form of plaque on the mucous membrane, thick creamy or separated by thick curdled lumps.

2) Itching and burning. Itching and burning of the vulva and vaginal mucosa can be of varying severity, sometimes characterized as unbearable and disrupting normal activity. A burning sensation in the vagina may occur at the end of urination. Sexual intercourse also provokes discomfort.

3) Swelling and redness mucous membranes and skin of the external genital organs, reddish rashes may be observed. All of the above symptoms are aggravated by elevated body temperature, in the evening and during sleep (which often disturbs sleep), during walks (especially if you sweat), during water procedures.

Vulvovaginal candidiasis

Candidate carriers are possible - this is a condition when a fungus is found in a smear that does not multiply (there is no mycelium of the fungus in the smear), and there are no external symptoms of thrush. However, this condition during pregnancy is also treatable.

Diagnosis of thrush:

1) Clinical picture.
2) Anamnesis (finding out the facts of similar complaints in the past, especially if the treatment was not performed; concomitant diseases and risk factors).
3) Gynecological examination (examination of the external genital organs, examination in mirrors).
4) Microscopic method.

Microscopy of a correctly taken smear from the vagina is the main reliable method for diagnosing thrush. Microscopic examination of dry smears is usually performed in the laboratory, but sometimes native (fresh) smears are examined right at the doctor's appointment (if the doctor has the appropriate equipment and the doctor has the skills of microscopic diagnostics).

Cultural and molecular biological methods are not used in the primary diagnosis of this disease, because single Candida albicans can be observed in the vaginal microflora in a healthy woman.

Recently, microbiologists and gynecologists have been jointly re-examining a seemingly long-known pathology, but it turned out that now thrush can be caused not only by Candida albicans, but also by other fungi of the genus Candida. Many of them are typed (Candidatropicalis, Candidakrusei, Candidaparapsilous, Candidaglobrata), some do not yet have a separate name. Therefore, a group of fungi that cause thrush and are not related to Candidaalbicans are called Candidanon-albicans.

The cultural method can be used in chronic relapsing course of the disease, to determine the type of yeast-like fungi (especially to identify species that are not related to Candidaalbicans), when studying the effect of antifungal drugs, in atypical course of the disease (including with systemic manifestations of candidiasis), when other possible pathogens.

Thrush caused by Candidanon-albicans is unpleasant and dangerous because many of the usual drugs do not lead to a cure and the inflammatory process becomes chronic.

Treatment of thrush during pregnancy

Personal hygiene is the basis of thrush prevention and an important part of treatment. As we said above, the acidity of the vaginal secretion increases during pregnancy, which increases the risk of thrush, so during this period it is not recommended to use intimate hygiene products containing lactic acid (and in ordinary life this is welcome). It is recommended to use pure water, decoction of chamomile or calendula, intimate washing gels with a neutral pH. All of these funds are used externally, only for washing the external genitalia.

DO NOT DOUBLE! Such procedures wash out the microflora from the vagina and exacerbate the already impaired local immunity.

If the itching of the skin of the external genitalia is very pronounced, then you can prepare a weak solution of soda in warm water and wash it without ingesting it. Such manipulation will help relieve itching and burning and create a more alkaline environment. But for the mucous membranes, the effect will be too sharp.

Nutrition should be rational and this is a common truth. With excessive consumption of sugar in any form, especially in the form of carbonated sweet drinks and pastries (that is, in combination with yeast), drinks with yeast, a favorable environment is created for the reproduction of fungal colonies of thrush.

If you receive treatment even with the most modern drugs, but continue to eat cakes and other sweets, drink kvass and sweet soda, then the treatment will be much less effective, and the risk of relapse increases.

Excessively salty and spicy foods should also be excluded, as this leads to discomfort in the genital tract and during urination.

The basis of the diet is vegetables, fruits (exclude grapes, bananas and other too sweet fruits, give preference to seasonal fruits), cereals (with the exception of semolina), meat and fish.

Exclusion of the mechanical factor. For the duration of treatment, one should observe sexual rest, do not take a bath for a long time (preferably a shower), wear only underwear made from natural materials and exclude panties - thongs; change gaskets as often as possible.

Drug treatment of thrush.

During pregnancy, for the treatment of vulvovaginal candidiasis, as a rule, local drugs are used, which are practically not absorbed into the systemic circulation and therefore have little effect on the overall metabolism. And yet, only an obstetrician-gynecologist should be engaged in the selection of the drug, taking into account the data of all examinations and the clinical picture.

Systemic oral preparations (except pimafucin tablets) are used very rarely, as there is a significant risk to the fetus. The decision to prescribe a systemic antifungal drug must be carefully justified and the expected benefit to the mother must outweigh the risk to the fetus. Treatment varies by trimester, by the third trimester the organs and systems of the fetus are fully formed and a larger range of drugs is allowed. The most difficult period is the first trimester, as the choice of drugs is limited and the potential risk to the fetus cannot be ruled out.

Treatment of thrush in the first trimester of pregnancy

- Pimafucin (natamycin). Pimafucin suppositories are prescribed 1 suppository deep into the vagina at night for 3-6 days. With a persistent recurrent course of thrush, pimafucin tablets are added (1 tablet 4 times a day for 10 to 20 days). Data on toxic effects on the fetus have not been established.

- Zalain (sertoconazole). The drug is used when the benefit to the mother outweighs the risk to the fetus. One vaginal suppository is injected deep into the vagina at night once. If symptoms persist, re-introduction after 7 days is possible. Before using the drug, you should make a toilet of the external genital organs using neutral soap.

Candinorm. Candinorm intravaginal gel is applied once a day at night for 1 to 3 days. The gel is available in individual tubes, the contents of one tube should be injected deep into the vagina at a time. Candinorm intravaginal gel (6 ml) should be combined with candinorm external hygiene gel (30 ml). Gel for intimate hygiene is applied 1-2 times a day, washing with warm water from front to back, can also be used by a partner. The drug is positioned as safe at any stage of pregnancy.

Viferon. It is used in the complex treatment of recurrent candidiasis, starting from the first trimester. Viferon 500 thousand units is applied 2 times a day rectally for 5-10 days. Compatible with all antifungal drugs.

- Betadine (Povidone-Iodine, Iodoxide, Iodovidone, Iodosept). These are suppositories containing an iodine compound, used 1 suppository 1-2 times a day for 7-14 days, if necessary, the course is extended as directed by a doctor. In the II and III trimesters, these drugs are not used.

Treatment of thrush in the second trimester of pregnancy

Polygynax. The drug is used strictly from the second trimester, is available in the form of capsules. Capsules are injected one at a time deep into the vagina, moistened with water. Course 6 - 12 days.

Terzhinan. Available in the form of vaginal tablets, used at night, 1 tablet deep into the vagina, moistened with water. The course is from 6 to 20 days, selected individually.

Clotrimazole. Clotrimazole comes in the form of vaginal tablets and is very affordable. Apply 1 vaginal tablet at night for 6 days. The tablet must be inserted deep into the vagina, moistened with water.

Livarol. Livarol suppositories are used 1 suppository per day (preferably at night) for 10 days. This drug is remarkable in that it has proven efficacy against Candidanon-albicans and a low rate of recurrence of thrush.

- Gino-pevaril (econazole). Available in the form of suppositories with a dosage of 50 mg and 150 mg.
Gino - Pevaril 50 mg 1 suppository at bedtime for 14 days.
Gino - Pevaril 150 mg 1 suppository at bedtime for 3 days. In case of relapse, the course is repeated after 1 week.

Treatment of thrush in the third trimester of pregnancy

In the third trimester, all of the above drugs are used (except for iodine preparations), and a solution of boric acid in glycerin is also used (borax in glycerin, sodium tetraborate 20%). It is used for abundant accumulations of mycelium of the fungus on the walls of the vagina, recurrent course. Sanitation of the genital tract is performed with a swab dipped in a glycerin solution of borax for 1 to 3 days, sometimes longer. Sodium tetraborate is not an independent type of treatment and will not get rid of thrush, but will significantly reduce the fungal mass and cleanse the mucous membranes so that the drug prescribed further acts more efficiently.

Additional medical treatment for thrush

- multivitamins for pregnant women (elevitpronatal, vitrumprenatal, femibionnatalkea I or II, depending on the duration of pregnancy);

Preparations of pre- and probiotics (linex, hilak-forte, bifiform, maxilac) to normalize the function of the intestine, which is one of the breeding sites for thrush fungi.

To obtain a lasting effect, the partner should also be treated. The partner should be treated by a urologist or andrologist. Men, as a rule, are prescribed external creams and gels, with inefficiency, systemic drugs are used.

Complications of thrush during pregnancy

Complications for the mother

Complicated childbirth. The inflamed walls of the vagina lose their elasticity, become loose and vulnerable, therefore, the likelihood of ruptures in childbirth increases and the healing of sutures worsens, the risk of bleeding during childbirth and the early postpartum period increases.

Complicated course of the postoperative period after caesarean section. The postoperative period may be complicated by difficult healing of sutures, failure of the scar on the uterus.

Attachment of another flora. A mixed infection is always treated more difficult and longer than a monoinfection. The addition of bacterial vaginosis may lead to the appointment of more drugs and increases the risk of toxic effects on the fetus.

Complications and consequences of thrush for the fetus

- Delayed growth and development of the fetus. A chronic inflammatory process leads to fetal growth retardation, impaired placental blood flow.

Intrauterine infection of the fetus. Candidiasis in the mother is dangerous for the spread of infection to the fetus. After birth, fungal plaque on the gums (candidiasis stomatitis), skin infection (vesiculopustulosis) is found. The most extreme manifestation of intrauterine infection is candidal sepsis.

- The threat of abortion. Recurrent itching causes sleep disturbance, anxiety, which can affect the tone of the uterus.

- The threat of premature birth due to premature rupture of amniotic fluid. Untreated thrush can lead to damage to the membranes and their premature rupture with leakage of amniotic fluid.

Forecast

With timely treatment, candidiasis is treatable and does not provoke complications. With regular monitoring, control over the cure, you can be sure that your baby is safe. However, neglected cases of such a “harmless” and banal infection as thrush can provoke many of the above complications.

When thinking about planning a pregnancy, you should definitely visit a gynecologist and exclude microflora disorders, infections and other risk factors. Having been treated before pregnancy, you will significantly protect both yourself and the unborn baby. If thrush overtook you during pregnancy, then you should immediately go to your gynecologist, the sooner you start treatment, the more effective the result. Look after yourself and be healthy!

Obstetrician-gynecologist Petrova A.V.

Thrush or candidiasis is a disease caused by a pathological increase in the number of fungi of the genus Candida in the body. In gynecology, this is vaginal candidiasis. Thrush during pregnancy often occurs due to a decrease in immunity.

In a healthy body, Candida is also present. But its quantity does not cause negative manifestations. When the organism is weakened, a favorable environment arises for the pathogenic microorganism and it begins to multiply intensively. As a result, symptoms of the disease appear.

Thrush during pregnancy is a frequent occurrence, because it is during this period that a woman's body is weakened.

What to treat?

If thrush is diagnosed during pregnancy, only a doctor prescribes, based on the danger of drugs for the mother and baby.

Doctors prescribe women in this position most often topical drugs:

  • ointments and creams;
  • vaginal during pregnancy;
  • sprays;
  • bath solutions.

The drug and its form are selected only by the doctor, based on the severity of the disease. So, how to treat thrush during pregnancy? The following medicines are suitable:

  • Pimafucin;
  • Polygynax;
  • Livarol.

At home

It is possible to cure thrush during pregnancy and. Some folk methods are effective and are allowed during pregnancy. However, again, you can not self-medicate. This must be agreed with the attending physician. And it is even better to supplement the prescribed medical treatment with traditional medicine.

Pregnant women should not douche. All solutions and decoctions should be used only for washing, irrigation, baths.

The following methods are suitable:

  • Chamomile decoction. It has anti-inflammatory and antiseptic action, quickly relieves itching of the external genital tract, redness and burning. To use, you need to take 1 tablespoon of the plant, pour a glass of boiling water and bring to a boil, filter, cool.
  • A solution of baking soda. Soda is alkaline, and therefore well neutralizes the acidic environment of the vaginal mucosa affected by the fungus. To prepare, you need to dissolve 1 tablespoon of baking soda in a liter of water.
  • A blend of chamomile, oak bark, marigold and lavender. Herbs are taken in equal proportions and brewed with boiling water. The infusion relieves itching and inflammation, microcracks of the affected mucosa heal well.
  • Plan pregnancy only after a complete cure for thrush, if it was before.
  • Before conception, pass all the necessary tests.
  • Proper nutrition is required, all the necessary substances, vitamins and trace elements must be present in the diet.
  • Underwear made of natural fabrics should be worn, it should not be tight.
  • Take antibiotics only as directed by your doctor.
  • After the onset of conception, it is better to use condoms during sexual relations.
  • It is important to observe personal hygiene, intimate organs should always be clean and dry.

On the video about therapy for candidiasis

The most common cause of curdled discharge from a woman's genital tract is thrush during pregnancy. If not to say that it is the main one.

This pathological condition has a different, medical, name - candidal colpitis, or vaginitis. In other words, candidiasis. Thrush emphasizes clinical manifestations.

During pregnancy, candidiasis is the second most common pathological process associated with infectious agents.

The first place is occupied by bacterial vaginosis, i.e. violation of the normal vaginal biocenosis towards the predominance of anaerobic microorganisms.

According to statistics, thrush occurs in 75% of pregnant women, and the recurrence of infection occurs in 50%.

The numbers are pretty impressive. You should know whether the disease affects pregnancy and what are the means to protect yourself from the development of candidiasis.

Causes and factors of occurrence

Thrush is caused by yeast-like fungi of the genus Candida, which are opportunistic pathogens. What does this mean?

Normally, candidal fungus "lives" in the genital tract of women, but in the case of a normal state of immunity, it does not cause the development of a pathological process (the disease does not develop).

It is only a slight decrease in immunity, as the uncontrolled reproduction of fungal cells begins.

This is exactly what happens during pregnancy.

The gestational period is characterized by the fact that physiological suppression of immunity occurs in order to ensure normal growth and development of the fetus.

However, sometimes the process can be very pronounced, so there is an activation of conditionally pathogenic microflora.

The main factors that further reduce immunity:

  • concomitant infectious diseases;
  • autoimmune disorders in the body of women;
  • obstetric complications;
  • hormonal imbalance;
  • taking immunosuppressants, for example, glucocorticosteroids, etc.

Several types of fungi of the genus Candida have been identified, which can be the cause of the inflammatory process in the genital tract of women.

The fact should be taken into account before starting treatment for thrush in a pregnant woman, because. Not all fungi are equally sensitive to antimycotic drugs.

Also an important fact in the development of candidal vaginitis is the lack of lactobacilli that produce hydrogen peroxide. And it has a detrimental effect on candida, blocking their activity.

Symptoms during pregnancy

The main localization of candidal lesions in any trimester is the vaginal mucosa.

However, candida can also occur in other places: damage to the mucous membrane of the mouth, gastrointestinal tract, and skin.

We should dwell in more detail on vaginal candidiasis: thrush of the vagina and external genitalia.

Clinical manifestations (symptoms) in this case are:

  • the appearance of curdled discharge in large quantities;
  • itching and discomfort in the vagina;
  • redness and swelling of the genitals.

The signs lead to the appearance of irritability and nervousness, and the condition can be dangerous for the child.

Danger

Many women do not always realize how dangerous thrush is during pregnancy.

It should be borne in mind: an infectious lesion of the genital tract poses a real threat to the fetus, because. candida can penetrate into the fetoplacental complex.

In the worst case scenario, there is a risk of intrauterine infection with all the ensuing consequences (developmental anomalies, fetal growth retardation, intrauterine hypoxia, etc.).

After birth, the baby may develop oral candidiasis and diaper dermatitis. The conditions develop during the first year of life.

How to detect

Diagnosis of candidiasis is based on the correct assessment of the clinical picture that occurs during the development of thrush. Symptoms are quite specific, it is difficult to confuse them.

However, confirmation of the diagnosis requires additional research methods.

They will eliminate cases of overdiagnosis and avoid unreasonable prescribing of drugs - pills and other drugs, which is especially important during pregnancy.

Therefore, the following diagnostic tests are indicated:

  • examination of a Gram smear under a microscope;
  • cultural method;
  • polymerase chain reaction;
  • serological examination with the identification of various classes of immunoglobulins.

However, it is necessary to evaluate the data obtained in a complex, because candida are conditionally pathogenic microorganisms.

The diagnosis of "thrush" is made only in the presence of clinical signs in combination with laboratory detection of candida.

If there are no clinical symptoms, and laboratory tests reveal yeast-like fungi, then there is no need to treat.

How to treat

Treatment of vaginal candidiasis in pregnant women should be prescribed only by a doctor. It doesn't matter what trimester you're talking about.

You should not self-medicate, because. it may be harmful to the fetus. After all, many antifungal drugs are contraindicated during pregnancy, causing the risk of various deviations in the fetus.

As a rule, they begin to treat with drugs intended for local use.

  • Candles from thrush

Will minimize the risk of systemic side effects of oral antifungal drugs.

For example, candles Zalain, Livarol

Be sure to take into account the duration of pregnancy: after all, thrush in the early stages requires special attention in relation to which medicine can be prescribed.

Really heal. The main thing is to pay attention to the signs and symptoms in a timely manner, and to eliminate various causes in advance.

Candles are injected into the vagina once, twice, depending on the half-life of the drug.

The drugs may differ in the duration of treatment. For example, Zalaina is enough to introduce once.

Going to the doctor, especially in the last weeks, is a tedious task for the expectant mother.

But having noticed the symptoms of the disease, it is still necessary to be treated. It is worth consulting, but you can treat it at home. If the doctor prescribes a medicine - whether it be pills, drugs, suppositories - go through the entire course.

Folk advice will also help get rid of thrush during pregnancy: follow not only the medication regimen, proper nutrition, etc., but also exclude the causes of the disease in any trimester:

  • Underwear should be made of cotton (synthetic materials prevent oxygen from reaching the skin, being one of the causes).
  • It is better to exclude douching, or use it less often (so as not to disturb the healthy microflora of the vagina in any case).
  • Do you use lubricants during sex? Replace with other products (for example, water-soluble).

Some folk remedies can be used at home, and without any risk:

  • Drink plenty of fluids - compotes, cranberry fruit drinks;
  • Carry out hygiene procedures 2-3 times a day with plain and clean water.
  • You can also treat by washing with solutions - oak bark, saline
  • Baths will also help - from calendula or: water, iodine, soda (1 liter, 1 tsp, 1 tbsp, respectively). Spend in such a bath should be 20 minutes.

It is important to keep in mind: folk methods, although effective, are, unfortunately, short-lived.

Prevention: how to prevent disease

The health of a woman and a child depends to a large extent on compliance with all sorts of rules and regulations, it is important to maintain immunity, for example.

Remember, thrush can be avoided. And it will not be necessary to treat her by taking various pills, drugs that can be harmful to the child.

It is worth taking care of prevention only at the very beginning.

In the 1st trimester, sour-milk yogurts, lingonberries, grapefruit juice and the like are suitable.

The main preventive measures:

  • timely rehabilitation of the genital tract;
  • strengthening immunity by non-specific methods (first of all - proper nutrition);
  • the use of lactic acid products in sufficient quantities, tk. they contain lactobacilli;
  • compliance with the rules of personal hygiene.

Pregnancy is a special time in the life of every woman. During this period, many changes occur in the body, some of which, unfortunately, create favorable conditions for a disease such as candidiasis. When carrying a child, it is impossible to get sick, and it is undesirable to use many drugs, so the question of how to get rid of thrush during pregnancy is particularly relevant.

Clinical manifestations of the disease

Candidiasis is caused by a fungal microorganism belonging to the genus Candida, which is normally present in almost all women. With a decrease in immunity and local protective properties of the body, yeast-like fungi begin to actively multiply, displacing the beneficial microflora and thereby leading to the development of the disease.

Thrush during pregnancy proceeds similarly to the disease in non-pregnant women, patients are concerned about:

  • Itching and swelling of the skin in the perineum.
  • Hyperemia of the labia and vaginal mucosa.
  • Burning in the vagina, in the external genitalia.
  • Profuse yellow-white discharge with a characteristic sour smell.
  • Discomfort during urination.

You can't self-diagnose thrush based on symptoms alone. If unpleasant manifestations or discomfort occur, it is necessary to consult a doctor who, based on the examination data and the results of a smear on the flora, will select an effective and safe treatment for the mother and the unborn baby.

Reasons for the development of thrush

Candidiasis is the most common companion of pregnancy, which occurs due to hormonal and immune changes that occur in a woman's body. The following factors lead to the appearance of thrush:

  1. Hormonal changes necessary for the normal course of pregnancy. When carrying a child, the content of gestagens in the woman's blood increases, which leads to the active growth of the fungal flora.
  2. Decreased general immunity. In the fair sex, a physiological decrease in immune defenses is observed, which is necessary in order to avoid miscarriage.
  3. Diseases that often accompany pregnancy (anemia, diabetes, thyroid pathology).
  4. Irrational and frequent use of antibacterial agents.
  5. Chronic inflammatory processes occurring in the vagina.

In addition, predisposing factors for thrush include an imbalance of vitamins and a violation of the ratio of trace elements, nutrient deficiencies due to changes in taste preferences during pregnancy, frequent colds and diseases of the gastrointestinal tract.

The danger of thrush during pregnancy

Do not neglect your own health and ignore the symptoms of candidiasis, especially during the difficult period of bearing a child. Thrush is an insidious disease that threatens with many complications for a pregnant woman. Among them are:

  • Increased risk of spontaneous miscarriage. This is due to itching, burning in the genitals, leading to irritability and anxiety of the woman and, as a result, to an increase in the tone of the uterus.
  • Complications during childbirth. Chronic inflammation causes thickening of the vaginal walls, which contributes to the frequent occurrence of ruptures during natural childbirth.

In addition, thrush can provoke the appearance of other inflammatory diseases of the genital tract and organs of the excretory system.

Harm to the baby

In addition to the fact that candidiasis causes complications during gestation and childbirth, it negatively affects the health of the unborn baby. Acute and chronic thrush during pregnancy can cause:

  • I will delay the development of the fetus.
  • Congenital malformations in a child.
  • Infection of the baby with various bacteria and viruses, due to a decrease in maternal immunity during the development of the inflammatory process.
  • Death of a newborn due to fungal sepsis.

The harm from the disease far exceeds the possible harm from taking antifungal drugs. That is why the question "How to get rid of thrush during pregnancy?" should be resolved as soon as possible, but only with the participation of a gynecologist who can select the appropriate drugs. You should not use folk remedies instead of modern medicines, since the result of home treatment will not be so effective.

Diagnosis of thrush

Before starting therapy, it is necessary to establish an accurate diagnosis. To determine candidiasis, the doctor uses a visual examination and a smear on the flora. In doubtful cases, additional analysis may be required - cultural. It consists in sowing vaginal secretions on special nutrient media and further monitoring the growth of colonies of microorganisms.

The PCR method is considered the most accurate, which will help diagnose thrush even with its chronic form in the inactive phase. After establishing the correct diagnosis through laboratory tests, the specialist will select an effective therapy and determine the appropriate dosage of the drug.

Treatment of candidiasis in the first trimester

Gynecologists recommend using suppositories for thrush during pregnancy, since they act locally and are not absorbed into the systemic circulation, affecting the child. Among the most effective, as well as safe for the health of the mother and baby, such funds as Pimafucin and Hexicon are distinguished. Their tasks:

  • Reducing the amount of fungal flora in the genital tract.
  • Elimination of unpleasant manifestations of thrush.
  • Normalization of the healthy microflora of the vagina of a pregnant woman.
  • Preservation of the health of the unborn child.

It is important to remember that both partners should be treated for candidiasis at the same time in order to prevent re-infection.

Therapy in the second half of pregnancy

During the second and third periods of gestation, the fetus is protected from the harmful effects of various drugs by the placenta. At this time, medications do not have such a strong effect on the health of the child. A gynecologist may prescribe Pimafucin, Betadine and Clotrimazole. Despite the protective properties of the placenta, it is preferable to prescribe drugs in the form of vaginal suppositories.

In complicated cases, the doctor may prescribe systemic drugs (Nystatin), taking into account the sensitivity of the fungal flora, the characteristics of the woman's body and the course of pregnancy.

Prohibited for use are drugs of general action - Fluconazole and Flukostat, since they have significant harm to the formation of the fetal body.

Features of the treatment of thrush

During the passage of therapy for candidiasis, it is necessary to follow a number of simple rules that will contribute to a speedy and successful recovery. Treatment with antifungal suppositories lasts an average of 7 days, during which it is necessary:

  1. Carefully conduct personal hygiene.
  2. Regularly change pads, wear underwear made from natural materials.
  3. Avoid sexual intercourse during treatment.
  4. Limit physical activity, exposure to the sun.
  5. Observe proper nutrition - exclude fatty, fried, spicy foods from the diet.

In order to prevent the recurrence of the disease (after the completion of the main treatment), the doctor may recommend the use of drugs to normalize the vaginal microflora - Bifidumbacterin, Laktogel.

Getting rid of candidiasis at home

Many pregnant women, fearing to harm the baby, use folk remedies instead of medicines. You should not replace modern drugs with homemade recipes, since properly selected therapy does not harm the child, but contributes to a complete successful cure for thrush.

Among the folk remedies are widely popular:

  • Warm salt baths. For their preparation, it is necessary to dissolve in 1 liter of warm boiled water 2 tbsp. l. baking soda and add 5-10 drops of iodine. The resulting solution is poured into a shallow basin, in which you need to sit for 10 minutes. For treatment, you must complete a course of 5 procedures.
  • Mix in equal proportions the dried herb of sage, medicinal chamomile and calendula. Brew 3 tbsp. l. the resulting mixture with 500 ml of boiling water and wash with the resulting solution. This decoction will help reduce itching, irritation and other unpleasant manifestations of candidiasis.

It is important to remember that folk methods are designed to reduce the negative manifestations of thrush, but do not cure the disease. In order to get rid of fungal inflammation of the vagina, it is necessary to consult a doctor in a timely manner and carefully follow the treatment recommended by him.