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Syphilis in pregnant patients and their offspring
1Department of Obstetrics and Gynecology, University of the Orange Free State, Bloemfontein, South Africa.
Objectives:
To determine the prevalence of syphilis in antenatal women and their babies at birth.
Methods:
A cross-sectional study was made of 1508 women who delivered consecutively at Pelonomi Hospital, Bloemfontein. The initial test on each mother was a rapid plasma reagin test (RPR). If reactive, it was followed by a venereal disease research laboratory test (VDRL) and a confirmative Treponema pallidum hemagglutination test (TPHA). Cord blood was tested by a RPR test. Babies with reactive tests were examined clinically, and in addition the cord blood was tested with the VDRL test as well as the enzyme linked immunosorbent assays (ELISA) for IgG and IgM.
Results:
At delivery the data on 1476 mothers and 1399 babies were available for analysis. Sixty-five percent of the mothers had attended antenatal clinics at least once and 17% of them had tested positive for syphilis. Only 22% of these patients had been completely treated. At delivery 15% of the mothers (including women without antenatal care) tested positive for syphilis and 8% of the babies had a reactive RPR test. Clinical stigmata of congenital syphilis were evident in 15% of these babies.
Conclusions:
An extremely high prevalence of syphilis (15%) was documented, as well as a major deficiency in the treatment program of these patients.