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Advice for treating VVC during pregnancy

Updated: 2020-11-27


Vulvovaginal candidiasis (VVC), also known as candidal vaginitis, is a common opportunistic mucosal infection caused by Candida spp.

About 75 percent of women have had at least one episode of candidal vaginitis in their lifetime, and 45 percent have experienced two or more episodes. The detection rate among pregnant women is about 10 percent. Its main symptoms are vulvar itching and a painful burning sensation. Some patients will have increased vaginal discharge that has curd-like texture similar to tofu residue.

When pregnant women suffer from the disease, they often worry about the impact of medication on the fetus and choose to put up with it. But, in addition to vulvar and vaginal discomfort, vaginitis during pregnancy can also cause a series of hazards such as fetal intrauterine infection, premature rupture of membranes (PROM) and premature delivery. Therefore, attention should be paid to the disease, and timely treatment should be given.

1. Treatment principles

(1) Actively eliminate etiological factors.

(2) Standardized use of antifungal drugs, the first episode and visit to the doctors are critical periods for standardized treatment.

(3) Sexual partners do not need routine treatment; sexual partners of recurrent vulvovaginal candidiasis (RVVC) patients should be examined at the same time and treated if necessary.

(4) No need for routine vaginal cleaning.

(5) Sexual activity should be avoided in the acute phase, or condoms should be used during sexual intercourse.

(6) Simultaneous treatment of other sexually transmitted diseases (STD).

(7) Personalized treatment.

2. Treatment drug selection

(1) For pregnant women, a seven-day regimen of topical azoles (e.g., miconazole, clotrimazole vaginal preparations) is recommended.

(2) Pregnant women should avoid oral antifungal drugs, such as fluconazole, itraconazole, etc.

(3) Intravaginal boric acid preparations should also be avoided during the first four months of pregnancy.

3. Notice

(1) Women in early pregnancy should weigh the pros and cons and use drugs with caution.

(2) Long-course regimens are more effective than short-course regimens.

(3) Recommendation: apply small dose, long-course regimen, and use microecological agents if necessary.

The clinical pharmacy of Chongqing Health Center for Women and Children (CQHCWC) mainly provides counseling and guidance services for medication during pregnancy and lactation.

Consultation hours: 8:00 am – 12:00 noon weekdays

Location: B area, 1st floor, CQHCWC clinic building