Vulvo vaginal candidiasis (VVC) usually is caused by C.
albicans but can occasionally be caused by other Candida sp. or
yeasts as C. glabrata, C. tropicalis, C. krusei and C.
parapsilosis.
Vaginal candidiasis is common during
pregnancy.
According to Center for Disease
control (CDC) an estimated 10-15% of women will have one episodes of
Vaginal candidiasis
in pregnancy.
According to CDC 2015 Sexually Transmitted Diseases
Treatment Guidelines only topical azole therapies, applied for 7
days, are recommended for use among pregnant women.
But, in cases of recurrence or severe symptoms or when
topical treatment has failed oral fluconazole is often used despite of limited
safety information available.
According to a recent study published in Journal of American
Medical Association (JAMA) on January 5, 2016, a link is found between the use of
oral Fluconozole in pregnancy and the risk of spontaneous abortion or still
birth down the lane.
This is a nation wide register based cohort
study by Danish researcher spanning 17 years and studying 1,405,663 pregnancies.
The pregnancies were matched on other
confounding factors!
Of 3315 women who took oral
fluconazole during the 7th through 22nd weeks of gestation, 147 had a
spontaneous abortion. In contrast, of 13,246 matched controls (pregnant women
with no fluconazole exposure), 563 had spontaneous abortions, a difference that
translated into a hazard ratio (HR) of 1.48.
An increasing trend towards
stillbirth was also seen in women who took oral fluconazole, when comparing
with unexposed matched controls or unexposed unmatched pregnant women, but
these differences were not statistically significant, reported the researcher
from the Department of Epidemiology Research at
Statens Serum Institut in Copenhagen,
Denmark.
A higher association was noted as
the dose increased from the routine dose of 150 milligrams.
So it means that scientists concluded that women in this
Danish study who used the drug during the first six months of pregnancy were
almost 50 percent more likely than nonusers to have a miscarriage.
While this study does not establish a cause- effect
relationship, but it does warrant larger studies, more research and a caution
to physician and patient about the use of oral fluconozole in pregnancy.
Dr Scott Sullivan, a member of the ethics committee at the
American Congress of Obstetricians and Gynecologists, said the new study
doesn't prove any miscarriage risk from fluconazole, 'it just means we need
more data, more studies'.
The researcher also urged patients in being caution taking
fluconozole while pregnant as it is freely available over the counter.
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