Can vaginal candidiasis and exogenous prostaglandins (PG) increase the risk of vaginal lacerations during delivery?

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Last updated: April 25, 2025View editorial policy

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From the Guidelines

Vaginal yeast infections and exogenous prostaglandins can increase the risk of vaginal tears during delivery, and their management is crucial to minimize this risk. The use of exogenous prostaglandins, such as misoprostol, for labor induction has been associated with an increased risk of uterine hyperstimulation and potentially more rapid or intense contractions, which may increase the risk of vaginal tears 1. Vaginal yeast infections, on the other hand, can cause inflammation and decreased elasticity of vaginal tissues, making them more susceptible to tearing during delivery.

Key Considerations

  • Vaginal yeast infections should be treated before delivery to minimize the risk of vaginal tears, typically with topical antifungal medications like clotrimazole or miconazole, which are safe during pregnancy.
  • Exogenous prostaglandins, such as misoprostol, should be used with caution and under close monitoring to avoid uterine hyperstimulation and minimize the risk of vaginal tears.
  • The dosage and timing of misoprostol administration are critical, with lower dosages (25 µg every three to six hours) being effective for cervical ripening and induction of labor, while minimizing the risk of complications 1.
  • Continuous monitoring of fetal heart rate and uterine activity is essential when using exogenous prostaglandins, such as misoprostol, to induce labor 1.

Clinical Implications

  • Healthcare providers should carefully assess the risks and benefits of using exogenous prostaglandins for labor induction, particularly in women with a history of vaginal yeast infections or other risk factors for vaginal tears.
  • Close monitoring of labor progression and adjustment of medication dosages as needed can help minimize the risk of vaginal tears associated with exogenous prostaglandins.
  • Treatment of vaginal yeast infections before delivery and careful management of labor induction with exogenous prostaglandins can help reduce the risk of vaginal tears and improve outcomes for mothers and babies.

From the Research

Vaginal Yeast and Exogenous Prostaglandins

  • There is no direct evidence in the provided studies to suggest that vaginal yeast and exogenous prostaglandins increase the risk for vaginal tears at the time of delivery 2, 3, 4, 5, 6.
  • The studies primarily focus on the treatment and management of vaginal yeast infections, bacterial vaginosis, and other vaginal infections, rather than their impact on vaginal tears during delivery.
  • None of the studies mention the use of exogenous prostaglandins in relation to vaginal yeast infections or vaginal tears during delivery.
  • The available evidence does not provide a clear answer to the question, and further research would be needed to determine the potential relationship between vaginal yeast, exogenous prostaglandins, and vaginal tears during delivery.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

New Antifungals for Vulvovaginal Candidiasis: What Is Their Role?

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023

Research

Vaginal infections update.

Journal of midwifery & women's health, 2012

Research

Treatment of vaginal candidiasis: orally or vaginally?

Journal of the American Academy of Dermatology, 1990

Research

The effect of antifungal treatment on the vaginal flora of women with vulvo-vaginal yeast infection with or without bacterial vaginosis.

European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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