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Related Experiment Videos

[Syphilis and pregnancy].

G Carles1, S Lochet, M Youssef

  • 1Service de gynécologie-obstétrique, centre hospitalier de l'Ouest guyanais, 16, avenue du Général-de-Gaulle, 97320 St-Laurent-du-Maroni, Guyane française. gabriel.carles@wanadoo.fr

Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|November 17, 2007
PubMed
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Maternal syphilis significantly impacts pregnancy outcomes, leading to high rates of perinatal deaths, stillbirths, and low birth weight. Early and adequate prenatal care, including syphilis screening, is crucial to prevent vertical transmission and adverse fetal/neonatal effects.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Maternal-Fetal Medicine

Background:

  • Antepartum syphilis poses a significant public health challenge, particularly in developing nations, with increasing occurrences in developed countries.
  • Late diagnosis and treatment of syphilis in pregnant women contribute to adverse pregnancy and neonatal outcomes.
  • Congenital syphilis can manifest with specific ultrasound and neonatal clinical features.

Purpose of the Study:

  • To assess the impact of maternal syphilis on pregnancy and fetal/neonatal outcomes.
  • To evaluate the effectiveness of early and complete syphilis treatment in preventing vertical infection.
  • To highlight the importance of prenatal care and syphilis screening for pregnant women.

Main Methods:

  • Retrospective study of 85 seropositive pregnant women in French Guyana (1992-2004).

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  • Inclusion criteria: positive Treponemal Pallidum Hemagglutination Assay (TPHA) ≥ 1/2560 and positive Venereal Disease Research Laboratory (VDRL) ≥ 1/16.
  • Evaluation of maternal characteristics, antenatal care, treatment, coinfections, fetal ultrasound, pregnancy outcomes, and neonatal exams.

    • Main Results:

    • High proportion (40%) of pregnant women had inadequate antenatal care, leading to late diagnosis and treatment.
    • Significant adverse obstetric outcomes observed: perinatal deaths (20%), stillbirths (12.9%), preterm deliveries (18.8%), and low birth weight (28.2%).
    • High correlation between vertical transmission and late/inadequate syphilis treatment in mothers.

    Conclusions:

    • Antepartum syphilis requires vigilant management, emphasizing adequate prenatal care and mandatory syphilis screening for all pregnant women.
    • Clinicians should consider syphilis in cases of suggestive maternal or fetal signs, such as hepatosplenomegaly, hydrops fetalis, or intestinal hyperechogenicity.
    • Timely and complete treatment of syphilis in pregnancy is essential to prevent congenital syphilis and improve neonatal outcomes.