Why does it worsen during pregnancy?
Under the influence of estrogens, more glycogen accumulates in the cells of the vaginal mucosa - this is a breeding ground for both beneficial lactobacilli and fungi. At the same time, the body physiologically reduces some of the immune reactions so as not to reject the child, and the local mucosal defense weakens. Often the trigger factor is a course of antibiotics that destroys lactobacilli. Additionally, gestational diabetes plays a role, in which there is more glucose in the secretions, as well as tight synthetic underwear and panty liners, which create a warm, moist environment.
- Increased levels of estrogen and glycogen in the mucosa
- Physiological decrease in local immunity
- Taking antibiotics
- Gestational diabetes mellitus
- Synthetic underwear and permanent pads
- Douching that disrupts microflora
Symptoms
The main symptom is itching, sometimes painful, intensifying in the evening, after a shower and during sleep. The discharge is thick, white, looks like cottage cheese, usually without a pungent odor. The mucous membrane turns red and swells, there is a burning sensation when urinating and pain during intimacy. It is important to understand that the normal clear or whitish discharge increases during pregnancy and is not a disease in itself. It is alarming when itching, changes in color, consistency or odor are added.
- Itching and burning in the vagina and vulva area
- Thick cheesy discharge
- Redness and swelling of the mucous membrane
- Burning sensation when urinating
- Pain during intimacy
- Increased itching in warm weather and at night
Examination: what is important to exclude
Itching and discharge are not only caused by mushrooms. Similar complaints occur with bacterial vaginosis with a characteristic fishy odor, with trichomoniasis with foamy greenish discharge, with aerobic vaginitis. Therefore, during pregnancy, you should not buy suppositories based on advertising: the doctor takes a smear of the flora and, if necessary, prescribes PCR or culture to determine the type of fungi and their sensitivity. This is especially important for repeated episodes when conventional medications no longer help. Additionally, blood glucose levels are checked.
- Inspection in the mirrors
- Flora smear and microscopy
- PCR for candida
- Sowing with determination of the type of fungi in case of relapses
- Rule out bacterial vaginosis and trichomoniasis
- Blood glucose monitoring
Treatment during pregnancy
Thrush in pregnant women is treated mainly locally: with suppositories, vaginal tablets and creams approved for a specific period. The course is usually longer than outside pregnancy, because short regimens cause more relapses. Systemic antifungal drugs in tablets are usually not prescribed during pregnancy, especially in the first trimester. The partner is treated only if he has complaints. Douching, soda solutions and folk remedies are not recommended: they disrupt the microflora and can increase inflammation. All appointments are made by the doctor.
- Local antifungal suppositories and creams
- Longer course than outside pregnancy
- Systemic drugs - only in exceptional cases
- Treating your partner if they have symptoms
- Avoiding douching and self-medication
- Follow-up examination after the course
Impact on the child and prevention
In the vast majority of cases, candidiasis is safe for a child in the uterus: fungi do not penetrate the placenta. The main point of treatment before childbirth is to reduce the likelihood of infection of the baby during passage through the birth canal, when a newborn may develop thrush in the mouth. Therefore, before childbirth, sanitation is carried out as prescribed by the doctor. For prevention, simple measures are enough: cotton underwear, avoidance of panty liners unless necessary, limiting sweets, glucose control and taking probiotics during antibiotic courses on the advice of a doctor.
- Fungi do not penetrate the placenta
- Possible infection of the child during childbirth
- Sanitation before childbirth as prescribed by a doctor
- Cotton underwear and breathable clothing
- Limiting sweets and glucose control
- Refusal of douching and aggressive gels
