Trichomoniasis in Pregnancy: Treatment Options and Risks to the Fetus - Obstetrics and Gynecology

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Pregnant women infected with trichomoniasis?


Hello Dr.
Tsao,
I am currently six weeks pregnant and have been diagnosed with a trichomonas infection from a Pap smear.
The doctor prescribed Metronidazole for seven days, to be taken twice a day at 500 mg each time, and mentioned that the treatment is expected to last for two weeks.
I would like to know if this treatment will affect the fetus.
Are there any alternative treatment options? Currently, my only symptom is an increase in yellow discharge.
If left untreated, will it have any impact on the remainder of my pregnancy or delivery? Thank you.

Xiao Chai, 30~39 year old female. Ask Date: 2018/04/18

Dr. Cao Guotao reply Obstetrics and Gynecology


Hello, it generally does not have an impact.
If left untreated, it will not significantly affect future pregnancies or childbirth.
Wishing you good health.

Reply Date: 2018/04/18

More Info


Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. In pregnant women, it is crucial to address this infection promptly due to potential risks to both the mother and the fetus. The treatment of choice for trichomoniasis during pregnancy is metronidazole, which is generally considered safe when used appropriately.

In your case, you have been prescribed metronidazole at a dosage of 500 mg twice daily for seven days, which is a standard treatment regimen for trichomoniasis. Research indicates that metronidazole is classified as a Category B medication by the FDA, meaning that animal reproduction studies have not shown a risk to the fetus, and there are no adequate and well-controlled studies in pregnant women. Therefore, the benefits of treating trichomoniasis with metronidazole during pregnancy usually outweigh the potential risks.

It is important to complete the full course of treatment as prescribed by your physician to ensure that the infection is fully eradicated. Untreated trichomoniasis can lead to complications such as premature rupture of membranes, preterm labor, and low birth weight. Additionally, there is a risk of transmitting the infection to the newborn during delivery, which can lead to further complications.

As for alternative treatment options, metronidazole remains the most effective and recommended treatment for trichomoniasis in pregnant women. Other medications, such as tinidazole, are also effective but are less commonly used during pregnancy due to limited safety data. It is essential to consult your healthcare provider before considering any alternative treatments.

If you choose not to treat the infection, you may face several risks during your pregnancy. These include the potential for increased vaginal discharge, which you are already experiencing, and the risk of complications mentioned earlier. Therefore, it is highly advisable to follow through with the treatment plan provided by your healthcare provider.

In addition to medication, consider implementing preventive measures to reduce the risk of reinfection. This includes practicing safe sex, such as using condoms, and ensuring that your partner is also treated for trichomoniasis to prevent reinfection. Regular follow-up appointments with your healthcare provider are essential to monitor your condition and ensure the health of both you and your baby.

In summary, the prescribed treatment of metronidazole for trichomoniasis during pregnancy is safe and effective. It is crucial to complete the treatment to avoid complications associated with untreated infections. Always communicate openly with your healthcare provider about any concerns or symptoms you may experience during your pregnancy. Your health and the health of your baby are of utmost importance, and timely treatment can help ensure a healthy pregnancy outcome.

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