Criteria for Diagnosis of Candida Vulvovaginitis in Pregnant Women

Abstract

In this prospective study of 303 pregnant women C. albicans was found in 50 patients (16.5 per cent) but only once was it isolated from the healthy vagina. The majority of isolates (84 per cent) were associated with signs of vaginitis or vulvovaginitis. In the remainder, isolation of the fungus was associated with discharge or other sign of morbidity. Discharge and irritation were not specifically associated with isolation of the thrush fungus, but 85 per cent of women with vaginitis during pregnancy had precipitins in their serum, or C. albicans in the vagina. Candida albicans was isolated from 23 of 28 women with vulvitis, and from 11 out of 16 women with vaginal plaques or a cheesy appearance of the vaginal epithelium.

Candida vaginitis

“…Carroll, Hurley and Stanley (1973) isolated C. albicans from 16-5 % of the pregnant population; the majority of the isolates in this double-blind prospective study (84%) were associated with signs of vaginitis or vulvo-vaginitis, giving an incidence of Candida vaginitis of 14%. C. albicans was, or had been isolated, from all women with both vaginitis and vulvitis, who complained of irritation and had discharge apparent to the clinical observer, and from all but one of those with vaginitis accompanied by symptoms.…”

“…It is likely that between 1/20 (Jennison, 1966) to 1/7 (Carroll et al, 1973) of women of child-bearing years suffer from Candida vaginitis, even ignoring the vexed and perplexing question of commensalism or transient carriage of the fungus in the vagina. This makes the disease one of considerable import to public health.…”

Candida vulvovaginitis in pregnancy

“…Accordingly, symptomatic VVC was observed in 60% to 90% of pregnant vaginal carriers [5,13,14]. Furthermore, recurrent attacks are also considered to be more common in pregnant women, with almost 50% of the symptomatic women suffering a second episode during the same pregnancy [15].…”

Fortnightly Review: Management of genital candidiasis

“…On the one hand, Carroll et al found that clinical signs of infection could be detected in all pregnant women from whom the fungus was isolated, even those without symptoms 4. On the other hand, numerous reports describe C albicans in vaginal swabs taken from women without symptoms or clinical signs of vulval or vaginal infection 3 5 6 7 8.…”