Vulvovaginal candidiasis (VVC) is a common fungal infection mostly caused by Candida albicans, that affects many pregnant women. The increased susceptibility of pregnant woman is related to hormonal changes, and decrease in cell-mediated immunity, and disturbed vaginal microbiota. If left untreated, VVC may lead to negative effects for both the mother and the fetus, including low birth weight, neonatal candidiasis, and premature labor. This review explores the pathogenesis, diagnostic advancements, treatment approaches and the role of probiotics managing VVC during pregnancy. The clinical presentation of VVC include pruritus, burning, leucorrhoea and dysuria, but asymptomatic colonization is also frequent. The proper diagnosis is important and is usually made by a clinical evaluation, along with laboratory testing including KOH microscopy, culture, and germ tube testing. Advanced diagnostic tools, such as rapid card tests and molecular methods like PCR, LAMP, and MALDI-TOF MS enhance pace and accuracy of diagnosis. Topical azoles, especially clotrimazole are preferred as first line in view of their safety in pregnancy. Systemic agents such as fluconazole are used cautiously depending on the gestational age and the severity of the presentation. Probiotic treatment with Lactobacillus may serve as an adjunctive antifungal therapy and may contribute to the restoration of vaginal microbiota, as well as a shortage of recurrence particularly in recurrent VVC in women. This review emphasizes the need for early diagnosis and multimodal management including anti-fungals and probiotics in order to achieve the best maternal and neonatal outcome. Further research is warranted to establish standardized guidelines for probiotic use during pregnancy in VVC management.
Vulvovaginal Candidiasis, Pregnancy, Candida albicans, Pathogenesis, Diagnosis, Antifungal Therapy, Probiotics, Antifungal Resistance
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