[Clinical aspects of the issue "pregnancy complicated by syphilis"]

Syphilis is a disease with many social, cultural and ethico-moral implications. During the course of pregnancy it may lead to serious fetal disorders and eventually to its intrauterine death. With timely diagnosis, contemporary treatment is uttermost effective.

Analysis of the frequency of syphilis among pregnant women, undergone treatment in the Quarantine Isolation Sector (QIS) with the Clinic "High risk pregnancy", at the University Multifunctional Hospital for Active Treatment (UMBAL) - Pleven Ltd., for a 5 year period (01.01.1999 - 31.12.2003) and an assessment of the effect of the disease on the fetus and the neonate.

Anamnesis, clinical investigation, serology, ultrasound of the fetus, cardiotocography, path morphology and statistical analysis.

The retro- and prospective investigation made gives an idea of a slight tendency of increased frequency of pregnant women with positive serological probes, necessitating active treatment during pregnancy and after delivery (1999 - 0,32%, 2000 - 0,28%, 2001 - 0,51%, 2002 - 0,54% and 2003 - 0,65%). The most often inflicted contingent is among the illiterate population with a low social status. Frequency of obstetrical complication is not greater than with the seronegative women. Pronounced pathology in neonates is observed in newly diagnosed untreated cases. Frequency of operative delivery is independent of the accompanying disease. Higher among the diseased women is the incidence of premature, born-dead and death in the early neonatal period.

From our results and data from literature we conclude as follows: 1. Wide screening of the sexually active population which covers the socially poor structures is necessary; 2. In timely started treatment with sufficient dose of Penicillin prophylaxis pevents complications to the fetus and the neonate; 3. Pertinent is the use of wide spectrum serological probes with pregnant women; 4. Changes in the health system have inferred a reduced efficacy of mass screening during pregnancy.