High Risk Pregnancy
High Risk Pregnancy
-pregnant with a concurrent medical disease
-with pregnancy related complication
-presence of external factor that jeopardizes the health of the mother, the fetus, or both
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Candidiasis (Moniliasis)
INCIDENCE:
• 75% of women will have at least 1 episode of VVC with 40-45% having 2 or more episodes
ETIOLOGIC AGENT: • Candida albicans, Candida glabrata
MODE OF TRANSMISSION normal flora of the skin & vagina not considered as sexually transmitted
RISK FACTOR for Candida overgrowth -pregnancy -use of OCPs -prolonged antibiotic use -Diabetes -Iron deficiency anemia -use of immunosuppresants/ immunologically deficient (e.g. HIV infection)
SIGNS & SYMPTOMS: • -severe itching, soreness &/or burning discomfort in the vagina & vulva • -dysuria & dyspareunia
PHYSICAL EXAMINATION • -thick cream cheese-like vaginal discharge • -vagina appears red & irritated
LABORATORY DIAGNOSIS • -Direct microscopy (10% KOH) ➡ mycelia (long thread-like fibers) & psudeohyphae, budding of yeast • -(+) growth on vaginal yeast culture •
TREATMENT
• -local - Clotrimazole 1% cream 5g intravaginally x 7 days or • -Clotrimazole 100 mg vaginal tablet x 7days • -Miconazole 2% cream 5 g intravaginally x 7 days • -Miconazole 100 mg vaginal suppository, 1 supp. x 7 days or • -Nystatin 100,000 units vaginal tablet x 14 days
Trichomoniasis • -one of the more common sexually transmitted diseases • accounts for 1/4 of vaginitis cases • -ETIOLOGIC AGENT: Trichomonas vaginalis • -a pear shaped single-cell protozoan • -can withstand fairly extreme changes in the vaginal environment • -may infect the vagina, urethra & paraurethral glands • -grows best under anaerobic condition at pH >/= 5
-pregnant with a concurrent medical disease
-with pregnancy related complication
-presence of external factor that jeopardizes the health of the mother, the fetus, or both
[pic]
Candidiasis (Moniliasis)
INCIDENCE:
• 75% of women will have at least 1 episode of VVC with 40-45% having 2 or more episodes
ETIOLOGIC AGENT: • Candida albicans, Candida glabrata
MODE OF TRANSMISSION normal flora of the skin & vagina not considered as sexually transmitted
RISK FACTOR for Candida overgrowth -pregnancy -use of OCPs -prolonged antibiotic use -Diabetes -Iron deficiency anemia -use of immunosuppresants/ immunologically deficient (e.g. HIV infection)
SIGNS & SYMPTOMS: • -severe itching, soreness &/or burning discomfort in the vagina & vulva • -dysuria & dyspareunia
PHYSICAL EXAMINATION • -thick cream cheese-like vaginal discharge • -vagina appears red & irritated
LABORATORY DIAGNOSIS • -Direct microscopy (10% KOH) ➡ mycelia (long thread-like fibers) & psudeohyphae, budding of yeast • -(+) growth on vaginal yeast culture •
TREATMENT
• -local - Clotrimazole 1% cream 5g intravaginally x 7 days or • -Clotrimazole 100 mg vaginal tablet x 7days • -Miconazole 2% cream 5 g intravaginally x 7 days • -Miconazole 100 mg vaginal suppository, 1 supp. x 7 days or • -Nystatin 100,000 units vaginal tablet x 14 days
Trichomoniasis • -one of the more common sexually transmitted diseases • accounts for 1/4 of vaginitis cases • -ETIOLOGIC AGENT: Trichomonas vaginalis • -a pear shaped single-cell protozoan • -can withstand fairly extreme changes in the vaginal environment • -may infect the vagina, urethra & paraurethral glands • -grows best under anaerobic condition at pH >/= 5