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Abstract

Vaginal Candida colonisation and vaginal candidosis in pregnancy

At least 30% of pregnant women are vaginally colonised by yeasts, which are in more than 90% Candida albicans. During the vaginal delivery were 70–85% of the neonates colonised by these Candida species of their mother. Thus the colonisation rate is – depending on the frequence of caesarean sections – 22% to 24% of all newborns. Although those newborns are healthy and mature, more than 90% of them develop clinical signs of oral thrush and/or napkin dermatitis during the first year of life with a climax of at least 10% within the 2nd to the 4th week.

Prematures (and ill mature newborns) are at risk to develop in relation to their grade of maturity/birth weight a systemic candidosis, which is 10% for prematures beyond 1000 g. In contrast to the vertical transmission in mature babies, the Candida septicaemia in prematures is predominantly nosocomial.

An antimycotic vaginal prophylaxis during the last weeks of pregnancy is recommended for uncomplicated pregnancies and reduces the frequence of oral thrush and napkin dermatitis significantly.

Prematures in intensive care units should riskadapted be protected from a Candida septicaemia by local and/or oral antimycotics.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2015; 11(2): 122–138

Keywords
Vagina, Candida, pregnancy, neonatal candidosis

Werner Mendling
Deutsches Zentrum für Infektionen in Gynäkologie und Geburtshilfe,
Wuppertal
Reviewer: Udo B. Hoyme, Eisenach,
und Hanspeter Vogt, Langenthal, Schweiz

Mendling W. Vaginale ... Gynakol Geburtsmed Gynakol Endokrinol 2015; 11(2): 122–138 publiziert 31.07.2015 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2015 ISSN 1614-8533