About 30% of all pregnant women are affected by antepartal vaginal yeast contamination. During the past 40 years this incidence has remained unchanged throughout the world. Due to the close contact of the baby with the contaminated area during parturition, yeasts are transmitted to the skin surface of the newborn. Yeasts are still demonstrable in more than 10% of all newborn on the 5th day of life. All newborn presenting yeast contamination on the 7th day of life are likely to develop a clinically manifest thrush by the end of the 2nd week of life. If the yeast contamination is acquired at a later stage, the risk of infection is much lower. Extensive mycological examinations of the newborn nursing staff and of the environment of newborn have not indicated any causal relationship to contamination. The yeast reservoir of the maternal vagina may therefore, in the majority of cases, be regarded as the cause of perinatal thrush which affects about 13% of all newborn by the 4th week of life. A prophylaxis of neonatal thrush should thus be carried out before parturition. Both the incidence of vaginal and neonatal yeast contamination can be reduced by more than 60% by a general mycological examination of all pregnant women between the 34th and 36th week of pregnancy and treatment of a possible yeast contamination with a local antifungal.
Zusammenfassung: Der präpartale vaginale Hefebefall bei Schwangeren zeigte in früheren Jahren eine gleichbleibende Häufigkeit von ca. 30 Prozent. 1972 wurde in der Rheinischen Landesfrauenklinik eine Kontamination von 27,6 Prozent ermittelt. In den seither vergangenen zehn Jahren haben diagnostische Methoden in der gynäkologischen Praxis erheblich Boden gewonnen, die Forderung nach einer antepartalen vaginalen Hefebeseitigung ist den Frauenärzten intensiv nahegebracht worden. Die jetzt vorgelegte Untersuchung erbrachte eine Senkung der allgemeinen vaginalen Hefekontamination auf 21,4 Prozent. Die unterschiedliche Betrachtung der Kollektive Deutsche/Ausländerinnen zeigt, daß die Kontaminationsrate bei Ausländerinnen mit 28,8 Prozent unverändert ist. Die Ursache darf in einer mangelnden Therapiecompliance dieser Patientengruppe gesehen werden. Im Kollektiv der deutschen Frauen wurde die Kontaminationsrate auf 17,7 Prozent gesenkt. Dies entspricht einer relativen Senkung der Hefebefallsrate von 1972 um 35,9 Prozent. Eine weitere Senkung dürfte durch Verbesserung der Untersuchungsqualität ante partum und weiterer konsequenter Forderungen nach Sanierung der mütterlichen Geburtswege erreicht werden. Summary: In recent years, the antenatal vaginal yeast contamination has to be known to be about 30 per cent. In 1972, the contamination in the Rheinische Landesfrauenklinik Wuppertal was found to be 27.6 per cent. In the recent ten years, diagnostic methods of gynecologic practitioners have been improved considerably. The demand for an elimination of the antenatal vaginal yeasts was repeated intensively. This study shows a diminution of the common antenatal vaginal yeast contamination to 21.4 per cent. The selective view of the different collectives of German and foreign women, however, shows an unchanged contamination rate of the foreign women. The reason is seen in an restricted compliance for therapy of this group of patients. In the German collective, the contamination rate is reduced to 17.7 per cent, which is equivalent to a relative reduction of the vaginal yeast contamination of 1972 to 35.9 per cent. A further diminution should be possible by a better quality of the investigations ante partum and a further consequent demand for sanitation of the mother's birth‐channel.
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