QuestionSBA
QuestionChoice
This history is suggestive of thrush, given the pruritis and yellow-white discharge with an acidic vaginal pH. In a pregnant woman, oral fluconazole is contraindicated and so a clotrimazole pessary is the recommended option.
10035052
a
Clotrimazole pessary
QuestionChoice
This would be used to treat a Chlamydia trachomatis infection, which would present with dysuria and discharge, typically with no itching. It is also contraindicated in pregnancy as it is teratogenic.
10035054
c
Oral doxycycline
QuestionChoice
This would be a first-line option in a non-pregnant patient but is contraindicated in pregnancy.
10035053
b
Oral fluconazole
QuestionChoice
This would be used to treat a Neisseria gonorrhoea infection, which would present with dysuria and purulent discharge, typically with no itching.
10035055
d
IM ceftriaxone
QuestionChoice
This is used to treat bacterial vaginosis, which causes an alkaline vaginal pH.
10035056
e
Oral metronidazole
Concept
Chapter
2693
6123
Genital candidiasis
Topic
163
Genitourinary medicine
19414
Clotrimazole pessaries are commonly used to treat vaginal candidiasis during pregnancy, as they effectively target the fungal infection while being considered safe for use in the second and third trimesters.
A 32-year-old pregnant female complains of vulval itching and a yellow/white discharge. She is sexually active with one partner and is in a monogamous relationship.

Her vaginal pH is found to be <4.5.

Given the likely diagnosis, what is the most appropriate treatment?
a