The negative influence of Trichomonas vaginalis on pregnancy and treatment strategies

Trichomonas vaginalis (TV) is a parasite that invades the urogenital tract, causing numerous pathologies. Two main genotypes can be distinguished, which differ in their response to treatment. Trichomoniasis is the second most prevalent curable sexually transmitted infection worldwide, with an estimated annual incidence ranging from 170 to 256 million cases, including approximately 25 million cases among pregnant women. This patient group is highly susceptible due to hormonal changes occurring during pregnancy. A rise in estrogen concentration causes a change in the pH of vaginal secretions, and increased epithelial exfoliation favors parasite colonization. In addition to causing pelvic inflammatory disease (PID), infertility, and cervical cancer, TV infection may also contribute to low birth weight, preterm rupture of membranes (PROM), and preterm birth (PTB). Moreover, TV is a risk factor for HIV infection. The treatment of trichomoniasis in pregnant women remains a subject of debate. Although the WHO recommends metronidazole, its use is often substituted due to concerns regarding its transplacental transport and the potential for TV resistance. This paper aims to analyze the available literature concerning the diagnosis, symptoms, complications, and treatment of Trichomonas vaginalis invasion during pregnancy.