OBJECTIVE
To evaluate the efficacy of a two-stage therapy in pregnant women with vulvovaginal candidiasis using the innovative drug Multi-Gyn FloraFem.
MATERIAL AND METHODS
We examined 66 pregnant women (aged 20 to 35 years) with a verified diagnosis of concomitant gestational pathology — vulvovaginal candidiasis. Verification of the diagnosis of concomitant gestational pathology at antenatal clinic was based on the characteristics of the patients’ complaints and the results of clinical and laboratory examination methods. The laboratory examination included pH-metry of the vaginal contents using colpotest, microscopic and bacteriological methods, real-time polymerase chain reaction using Femoflor 16 and Femoflor Screen test systems to examine bioassays from the female genital tract (vaginal fornix, cervical canal, urethra). This test was performed initially to verify the diagnosis and subsequently the following time parameters were used as a criterion for treatment efficacy 1) clinical examination, pH-metry, microscopic and bacteriological methods, which were performed one week after the cessation of treatment; 2) real-time polymerase chain reaction, 2 weeks after the application of all types of local dosage forms. Patients were divided into 2 clinical groups, according to management. The study group included 33 patients who were treated in two stages: stage I included local application of an antimycotic agent, and stage II included the administration of Multi-Gyn FloraFem. The drug was used once a day with 1 tube of one dose of gel before bedtime for 5 days. The comparison group included 33 pregnant women in whom the treatment of vulvovaginal candidiasis was limited to local prescription of antimycotics.
RESULTS
The data we obtained confirm the advisability of applying a second phase of treatment to patients with vulvovaginal candidiasis to both restore the vaginal biotope and prevent the recurrence and spread of vaginal yeast microorganisms (of the Candida spp.).
CONCLUSION
Inclusion of Multi-Gyn FloraFem in the treatment of vulvovaginal candidiasis (second-line therapy) and its continued use to prevent vulvovaginal candidiasis and bacterial vaginosis and to maintain the lactobacillus vaginal microflora helps to reduce a number of complications and adverse outcomes in the gestational period.