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Thrush during pregnancy and lactation

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Definition of the disease

Thrush in pregnancy – the disease caused by yeast-like fungi Candida spp. (spp – different types). When anonymous surveys of women, nine out of ten of the respondents confirm the presence of vaginal thrush in different periods of life.

Vaginal thrush is not a sexually transmitted disease, but due to specific localization, often seen in conjunction with STD. Proven direct link vaginal yeast infection with the anatomical features of the female genital organs, regular cycles, potential pregnancy. The pathogenesis of thrush when breastfeeding is somewhat different, is the result of cracking of the nipples with abundant molokoobrazovanie. The value of candidiasis during pregnancy and lactation, their danger and the consequences – discussed topic in women's environment.


Dangerous during pregnancy a yeast infection?

From clinical practice of obstetricians and gynecologists, taken descriptions of the most important, for the body, the effects of thrush during pregnancy, namely:

  • Of PROM (premature rupture of membranes). The reasons are multiple, not fully understood. In some sources the root cause – inflammation of fetal membranes caused by pathogenic microflora, in combination with Candida. Mechanical and toxic irritation of the mucous membranes provokes inflammation of the cervix (cervicitis), violates the integrity of membranes. A result of the water simultaneously or fractional penetrate into the birth canal of a pregnant woman. Diagnosed earlier than 37 weeks gestation. The PROM is one of the causes of neonatal mortality due to sepsis, prematurity, underdeveloped lungs.

  • Candidal infection of the fetus. Fungi Candida spp. do not penetrate through the placental barrier, therefore, intrauterine infection of the fetus is practically impossible. Infection occurs when the movement of the fetus in generic ways. Diagnosed in the first days of life. In severe cases, causes sepsis and the systemic failure of organs of the newborn.

  • Thrush complicates the examination of the pregnant. Fungi Candida, in combination with chlamydia, Mycoplasma, other pathogens of genital infections cause inflammation, erosion, ectopia (pseudo) of the uterus and cervix. With colposcopic examination, the inflammation caused by yeast infection, falsely mistaken for dysplasia (presence of atypical, pre-cancerous cells) of the cervix.

  • Thrush – provocateur Allergy. Metabolites of fungi cause sensitization (hypersensitivity) is weakened by the pregnancy of the organism to various allergens.


Signs and symptoms of thrush during pregnancy

First, subjective feelings, to the attention of the diseased woman:

  • Itching, burning, discomfort at rest, during intercourse, urinating;

  • Swelling of the labia, scratching, rash, sleep disorder;

  • Discharge (RAID) on visible parts of the external genitalia;
  • Without carrying out regular hygiene mild smell of sour milk;
  • A yeast infection combined with bacterial vaginosis there is a rotten smell.

Of pregnant women indicates a combination of thrush with abundant vaginal discharge. During pregnancy vaginal discharge can be normal. Brightness, of discomfort depends on individual sensitivity. Hypersensitivity (allergist) pregnant to fungi accompanied by debilitating itching. The presence of subjective symptoms is not sufficient grounds for definitive diagnosis. The differential diagnosis of thrush is the traditional pattern: a medical history (interview), external and internal examination, instrumental and laboratory methods of examination.

History. Diagnostic value of the conversation with the patient, can be high, for example, when defining the social behavior of women (frequent change of sexual partners, unprotected sex), to identify conditions of pregnancy. In the survey, the doctor eliminates the symptoms: sexually transmitted diseases, diabetes, allergies, noninfectious inflammation of the genital organs, other abnormalities, accompanied by itching and other similar symptoms.

External and internal pelvic exam. Symptoms detect visually and with the help of vaginal mirrors. To the naked eye, in the region of the cervical canal, visible focal plaque cheesy, white or shades. Mucous membranes possible pockets pink color is evidenceerosion. Mucous discharge is colorless or white. Yellow or green mucus, purulent discharge – reason for differentiation of yeast infection from genital infections accompanied by purulent inflammation. Ulcers and fissures of the mucosa, not obligatory signs of thrush. Often they indicate a strong impact of infectious, allergic agents.

Microscopy of vaginal smear. A yeast infection is confirmed by microscopy, native (unpainted) and/or stained smears. In the field of view of the microscope shows a large number of the growing chain of the colonies of Candida (pseudogamy). Indicator of healthy vaginal flora is detected in the field of view of the microscope is not less than 95% of sticks Dederleyna. Wand Dederleyna is an Association of lactobacilli: L. acidophilus, L. casei, L. Fermentum, L. Cellobiosus. Flora of the vagina is considered healthy by detection of the sticks less than 95% on a small number of other facultative flora, including Candida, c isolated inclusions of red blood cells, white blood cells. Dangerous symptom is the presence of a large number of cells of pathogenic organisms and Candida on the background of low doderlein Bacillus.

Sowing of clinical material. The method has a high diagnostic value. Candida are simple and plated on selective nutrient medium. Cultivated at a temperature of 30 to 37o C and pH 6.0-68. Using different laboratory methods, it is possible to differentiate:

  • the Candida from bacteria, protozoa;
  • species composition of fungi inhabiting the vagina;
  • pathogenic and saprophytic forms of Candida;

Another important characteristic of pathogenicity of yeast infection is to determine the field of view of the microscope, the number of colony-forming cells in clinical material milliliter (CFU/ml). Method is used for the differentiation of pathological development of yeast infection from harmless carriage of fungi. Considered to be:

  • asymptomatic carriage of Candida, a value less than 104 CFU/ml;

  • clinical course of thrush, the value of more than 104 CFU/ml.

For detail of the pathogenesis and interdependence of thrush to other injuries of the body, using immunological, allergic study of a biological sample in laboratory animals.

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Causes of thrush in pregnancy

Yeast-like fungi can, for a long time harmless, to coexist in Association with beneficial bacteria of the body. Fungal growth is constrained mainly by natural antagonists, lactic acid bacteria. Under certain conditions Candida begins to grow rapidly, causing mechanical and toxic effects on the body.

For pathogenic development of thrush, it is necessary that the body came as:

  • depression of lactobacilli, the other beneficial flora of the intestine, vagina;
  • hormonal disorders of the organism under the influence of internal (diseases of the organs of internal secretion, or physiological hormonal changes in the female body) or external causes (long-term use of hormonal drugs);
  • damage to natural barriers (cracks, erosion, waterlogged mucous membranes), disorders of the immune cooperation (infections, medications – immunomodulators);
  • hypersensitivity of the body to metabolites of fungi.

A yeast infection in pregnant women occurs on the background of hormonal changes, followed by morphological and physiological changes in the body. The most significant changes in the body of pregnant women, indicating their increased predisposition to vaginal thrush:

  • Under the influence of progesterone, the increased friability of the mucous membranes of genital tract. In combination with other factors, it greatly facilitates the adhesion (sticking) of colonies of fungi on the mucous membranes of the birth canal;
  • The increase in total circulating blood volume of up to 40% drop in the number of proteins in the blood up to 7 g/l provokes a tendency of pregnant women with edema. Humidity mucous membranes, with swelling, in combination with other factors, a favorable factor for the growth of Candida;

  • The increase in the erythrocyte sedimentation rate (ESR) of 50mm/h and above, accompanied by pregnancy anemia and deficiency of vitamin b12 (cyanocobalamin). Vitamins – are important regulators of metabolism. In particular vitamin b12 is essential for maintaining the beneficial microflora of the vagina and intestines.

  • Increasing the level of female sex hormones involved in the synthesis of glycogen, lowers the threshold of renal filtration, produces glucosuria (sugar in urine) during pregnancy. Sugar in urine is one of the most important private causes of thrush.
  • Metabolic acidosis. Even in normal pregnancy, under increasing thoracic breathing, possible effects of weak metabolic acidosis. Some sources described a stimulating effect of metabolic acidosis on Candide.
  • Whenpregnancy sebaceous and sweat glands are functioning in emergency mode. High humidity in the folds of the body stimulates the growth of Candida.

Thrush on the breast and nipple during lactation

Breastfeeding is an important factor of full feeding, emotional interaction between mother and child. Sadly if you have problems lactating gland. One of them is breast thrush. It manifests itself as a consequence of vaginal thrush, the result of abrasions of the skin of the breast. Treated by traditional methods (drying out) and drugs (antimykotika). The doctor in charge of the postnatal period, can prescribed drugs of other pharmacological groups. More threatening pathology – mastitis or inflammation of the mammary gland. Causes of mastitis (milk stasis, non-infectious and infectious agents). Sometimes thrush on the nipple is called the provocateur mastitis.

Signs of yeast infection breast

A yeast infection of the breast occurs after the occurrence of diaper rash and engorgement of the breast. Causes of diaper rash – a close, tight underwear, excessive sweating. Engorgement (hardening of the breast) is a result of the overflow of the milk glands. Without Express breast milk delicate skin the nipple cracks, the breast skin becomes shiny, the nipple is stretched flat state. On the diaper rash or cracks possible colonization of Candida. Damage felt pain at rest and during feeding. On your nipples and in areas of diaper rash plaque white. open the gates of Candida infection in the mammary gland. Soreness provoke the failure of women from breastfeeding or pumping. The result is stasis (stop) maximize, then Candida and other agents that initiate the pathogenesis of mastitis.

Causes of yeast infection during pregnancy

Causes of yeast infection during pregnancy are similar to the reasons for vaginal thrush. An imbalance of the normal intestinal flora after antibiotic therapy, reducing the overall resistance in the postpartum period, abrupt cessation of estrogen production by the placenta, the violation of the integrity of the natural skin cover. Specific cause lactation thrush is an incorrect application of the baby when feeding, provoking cracking of the teat skin. Candida – the most likely causes of persistently recurring after cure, mastitis.

For thrush can I breastfeed?

Neonatologists have noticed a yeast infection is not always transmitted to the baby. Described cases of yeast infection only in the mother or the child, especially when the hidden course of the disease. However, the fungi found in the oral cavity of the infant, the identical fungi – causative agents of other candidiasis. Therefore, detailed advice on breastfeeding, for thrush of the breast can give the doctor overseeing the health ofnewborn and mom. In the case of acute pain it is reasonable to refuse feeding from the affected breast. Milk during treatment is decanted, the feeding is not used.

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Yeast infection treatment during pregnancy

The most difficult and dangerous period for the treatment of thrush during pregnancy is 1st trimester. During this period, the fetus is actively growing and developing. In the formation of organs and systems of the unborn child the medication to pregnant women is contraindicated.

In the first weeks of pregnancy the occurrence of yeast infection - a rare phenomenon. With increasing period, the risk increases. For the treatment of pregnant women during 2-3 trimester there is a sufficient number of effective drugs. There are candles, which with caution can be taken at any time, however, complete recovery from yeast infection almost impossible. There are cases when doctors have to observe the course of the disease throughout pregnancy.

Drugs for the treatment of thrush trimesters of pregnancy:

Trimester

Drug name / Application

1 trimester

Betadine and Pimafucin - 6 times for a single candle on a night;

2 trimester

Gino-Peveril, Pimafucin, Betadine - for 6 candles;

Clotrimazole - 7 candles;

Gynofort - 1 applicator;

3 trimester

Gino-Peveril, Pimafucin, Betadine - for 6 candles;

Clotrimazole - 7 candles;

Gynofort - 1 applicator;

Features of treatment of thrush in the period of carrying a child

  • For the treatment of thrush during pregnancy is permissible to use means of local treatment. In the 2nd and 3rd trimester, the pills is only possible with the permission of the doctor.
  • Douching during pregnancy is not recommended, especially if you plan to use aggressive means. Douching is strictly prohibited with the use of manganese, baking soda and chlorhexidine.
  • Are considered the safest candles Pimafutsin. Use is permissible in the 1st trimester,after birth, during breastfeeding.
  • Treatment is important to get to the end. Even if after using 2-3 candles symptoms of thrush is gone, treatment continues.
  • Burning and discomfort at the beginning of the treatment course should not be cause for rejection of the use of candles. This is a temporary discomfort.
  • If during pregnancy was spotted at least one symptom of a yeast infection, before birth must undergo a course of treatment.
  • Treatment is recommended to place a sex partner, even if he has no symptoms and complaints.
  • With antibiotic treatment during pregnancy drugs for yeast infection use as a prophylactic.
  • After treatment, no later than two weeks is seeding from the vagina, it is necessary to control the condition.

    • Ignoring medical recommendations and failure (termination) of treatment can lead to serious health problems of the child. Very often goes untreated a yeast infection of the mother transmitted to the baby and is manifested already during the first weeks after birth. The lesion most often exposed to the oral cavity of a child.

    Candles thrush pregnancy

    The emergence and development of yeast infection during pregnancy is most often associated with weakening of the immune system. Many drugs women are in the position contraindicated.

    There are those whose safety is not yet proven, and it's always a risk to the health of the unborn baby and the mother.

    In our days range of pharmacy offers a fairly wide range of antifungal drugs that are widely used in gynecology.

    In pregnancy, the choice of means need to trust the doctor, because of the available variety of candles from yeast allowed for pregnant a little:

    • Candle Pribaturin and Pimafucin.
    • Macmiror complex (the active substance Nystatin and Nifuratel).

    14-15 weeks of pregnancy are assigned:

    • Nystatin

    • Clotrimazole

    • Gino-Pevaryl

    • tool Drill

    • Pimafucin

    • Gynofort (cream).

    These drugs require careful application, they are used in cases where the health risk to mothers is higher than for the unborn child.

    Sometimes prescribed to pregnant Terginan. In the instructions to the drug is indicated possible side effects. In Terginan composition contains prednisolone (hormonal drug). It can be used for treatment, but not before the second trimester and only if the potential benefit to a pregnantwomen.