Oral and vulvovaginal changes in pregnancy.
Physiologic alterations of the oral and vulvovaginal mucosal surfaces result from the profound hormonal and immunologic changes of gestation. High estrogen levels are responsible for the vascular changes noted on mucosal surfaces. Gingival hyperemia and edema, gingivitis and pyogenic granuloma are the most common alterations of the oral mucosa during gestation. Physiologic changes of the vulvovaginal area are mainly of vascular nature, and include among others varicose veins. The oral and vulvovaginal mucosal surfaces can be affected by diseases that can worsen or develop in pregnancy. Oral lesions are encountered in a large spectrum of diseases including aphthosis, pemphigus vulgaris, systemic lupus, and Behçet disease. Pregnancy dermatoses such as impetigo herpetiformis and gestational pemphigoid can exceptionally affect the oral mucosa. Infections of the vulvovaginal region by Candida species, Trichomononas vaginalis, human papilloma virus, and herpes simplex virus have been associated with fetal risks. The dermatologist, obstetric medicine physician, and neonatologist should be familiar with the above physiologic changes as well as maternal/fetal risks relevant to disease affecting these mucosal surfaces during gestation.
Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: ramos.e.silva@dermato.med.br.
Marcia
M
Ramos-E-Silva
Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Natalia Regina
NR
Martins
Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
George
G
Kroumpouzos
D004967:Estrogens / Q000097:blood; D005260:Female; D006801:Humans; D009059:Mouth Diseases / Q000097:blood* / Q000209:etiology; D009061:Mouth Mucosa / Q000473:pathology / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011251:Pregnancy Complications, Infectious / Q000382:microbiology; D011374:Progesterone / Q000097:blood; D012871:Skin Diseases / Q000097:blood* / Q000209:etiology; D014623:Vaginal Diseases / Q000382:microbiology*; D014845:Vulvar Diseases / Q000382:microbiology*
D004967:Estrogens; D011374:Progesterone