Yeast Infections During Pregnancy

by David Eschenbach, MD, William Ledger, MD, FACOG and Benson Horowitz, MD

Yeast infections are a common problem for women and some say pregnancy increases your risk. Many women feel they know enough about the condition to take care of it themselves, but for pregnant women, self-diagnosis is a no-no. Tune in as experts discuss why pregnant women are considered more prone to yeast infections and why a doctor's visit is a must.

Yeast infections are a common problem for women, and many think they know enough about the condition to treat it themselves. But most doctors agree that self-diagnosis isn't always a good idea. And for pregnant women...it's out of the question.

BENSON HOROWITZ, MD: Pregnant women should never self-treat. We worry about drugs in pregnancy, and no drug of any kind, topical or otherwise, should be taken by a pregnant woman without the consent of her provider.

DAVID ESCHENBACH, MD: We're naturally cautious about pregnant women and the medication we give them, just simply because not only do we have an adult but we got a developing fetus here to be concerned about.

ANNOUNCER: some experts think yeast infections are more common during pregnancy, making the condition an important factor in prenatal care.

DAVID ESCHENBACH, MD: What people often ask is why are yeast infections more common in pregnancy and the simple answer: We don't know. But we think pregnancy has an impact on reducing the immune system to the point where it allows the organism to grow and cause symptoms more readily.

ANNOUNCER: Others believe that pregnancy does not increase the risk of infection, but still stress that pregnant women who are infected should approach treatment with caution.

WILLIAM LEDGER, MD, FACOG: I think that the risk of the individual woman getting a yeast infection is probably based upon her local immune system and how it works. And if she is a woman that has a pretty good immune system against yeast, it probably doesn't matter whether she's pregnant or not or whether she takes antibiotics, she's not going to have a problem.

The concerns of the treatment of a yeast infection in a pregnant woman and a non-pregnant woman are much different except for the fetus. I think that you don't want to give anything to the pregnant woman that might be a problem for the fetus.

ANNOUNCER: Diflucan, an oral medication that is absorbed through the bloodstream, is one drug that may pose a risk to the fetus.

WILLIAM LEDGER, MD, FACOG: Diflucan is an excellent oral drug against vaginal yeast infections, but I don't think it should be used in pregnant women. I think there are some case reports that suggest that there could be problems with it for the baby. I don't think it's ever been confirmed by large studies, but I think there's enough concern that I don't like to use it during pregnancy.

DAVID ESCHENBACH, MD: Diflucan could possibly cause some teratogenic issues with the baby, it could possibly affect the mother's liver. And although it's been used a lot, we're more concerned about the safety of that drug than we are with the other preparations that are used vaginally.

ANNOUNCER: Vaginal treatments are topical drugs, which are applied directly to the site of infection. That means the active chemicals may be less likely to put the fetus in danger.

WILLIAM LEDGER, MD, FACOG: You have Monistat and Terazol, Gyne-Lotrimin, and the old Mycostatin or nystatin vaginal tablets, which are, I think are all effective, among others.

ANNOUNCER: In fact, the only concern with topical medications is that some of them may pose a risk to the fetus in the first trimester. So some doctors prefer to use milder treatments until later in the pregnancy.

BENSON HOROWITZ, MD: A yeast infection early in the pregnancy is a problem. We only have several treatments for that. We can use gentian violet early in a pregnancy safely, and we can use Mycostatin early in a pregnancy. However, Mycostatin is a very old drug and does not have a very high success rate.

ANNOUNCER: At any time in the pregnancy, treatment should be completed as quickly as possible, to reduce the risk of exposure to the fetus, however small it may be.