Syphilis During Pregnancy
Contents:
- Symptoms of Syphilis/a>
- Congenital Syphilis
- Diagnosis of Syphilis
- Pregnancy and Treatment of Syphilis
- Syphilis in Pregnancy: Most Important Points
Syphilis in Pregnancy
Syphilis, or "lues", also known as "the French disease", or "Spanish disease" is known in Europe since the discovery of America. It is known that in the early 20th century 15 % of Europe's population suffered from syphilis.
With the advent of antibiotics, the situation had changed, while syphilis is still considered one of the most common sexually transmitted diseases. So in the 90-ties of the last century there was a sharp increase of the disease Russia. Now more than 50% of all reported cases of syphilis are among women from age 18 to 30 years of age, i.e. the age when the majority of them gives birth to children.
Symptoms of Syphilis
Symptoms of syphilis are very diverse. They vary depending on the stage of the disease. There are three stages of the disease.
Primary Syphilis
The earliest symptom of syphilis in his primary period is the appearance of a painless ulcer called a hard chancre. Most often, the chancres are on the genitals and around the anus, but they can develop on the lips, mouth, or on any other part of the body where the pathogen had penetrated into the skin. After 5-6 weeks the ulcer heals, only a small scar remains. But this is not a sign of recovery. Syphilis has passed in disguised form, during which a rapid reproduction of pale treponeme is going on in the body. During this latent period may appear weakness, malaise, headache, muscle pain, a slight increase in body temperature.
Secondary Syphilis
This stage begins after 1-6 months after the healing of chancre, if there had been no effective treatment. Pale skin rashes appear throughout the body, including palms and soles. The lymph nodes throughout the body also increase. The rash periodically appears and disappears, the hair loss on the head is also possible, as well as hoarseness of the voice, and the emergence of flesh-colored enlargements on the genitals. In most patients, this period lasts until the end of their life, but in cases the diseases passes to the last period of syphilis.
Tertiary Syphilis
During this period appear serious and irreversible failure of heart, eyes, joints, bones, the brain and spinal cord. The illness lasts for decades and leads to mental disorders, paralyses, deafness, blindness, bone deformities and death.
Pregnancy amid of syphilis is accompanied by an imbalance of hormones, especially sex hormones, that often manifests threat of pregnancy loss, miscarriage and premature birth. In addition, pregnancy in patients with syphilis is often accompanied by anaemia and late toxicosis.
Congenital Syphilis
Congenital syphilis is transmitted to the unborn baby in the uterus through the blood of the mother. Fetal syphilis occurs approximately at the 5-th month of pregnancy, when the pale treponema penetrate the placenta and actively multiply inside the body of the fetus, affecting virtually all internal organs, brain and bone system. Such a child has very small chances of survival, but if he survives, he is born with signs of the disease. Infants with congenital syphilis have extensive skin rashes, scars on the skin, affected the eyes, liver and heart. Dropsy of head or inflammation of the meninges may also develop. Bone and joints are affected, teeth, nose, skull and shins are deformed. Such children are weak, lag behind in growth and body weight, developmentally disabled, both physically and mentally.
Therefore, if the mother's illness became known during pregnancy, a woman should undergo a course of treatment and undertake preventive treatment for the child immediately after his birth. If a pregnant woman and the fetus get proper medical care, the likelihood of development of congenital syphilis is reduced practically to zero.
Diagnosis of Syphilis
Diagnosis is based on analyses of blood for syphilis. There are many types of blood tests for syphilis. They are divided into two groups.
Indicative (screening) tests, which are used in mass surveys for syphilis. First of all, it is Wasserman reaction (RW) with Pangborn’s antigen. Wasserman-positive reaction may be with different symptomatic degrees, indicated with «+» with the given index (from 1 to 4).
For further diagnosis more precise, treponeme methods are used. These include: IFA (immunofluorescent assay), treponema pallidum immobilization test and TPHA (treponema pallidum haemagglutination assay).
Pregnancy and Treatment of Syphilis
In the case of a confirmed diagnosis the pregnant woman should be hospitalized in dermatovenereologic hospital for treatment. The treatment normally includes antibiotics of the penicillin group: novocaine and sodium salt of penicillin, bicillinum, extencillin, retarpen. Primary syphilis treatment lasts for several weeks, while the tertiary – for several years.
To pregnant women which have positive blood tests for syphilis after the treatment before pregnancy, as well as everyone who was treated during pregnancy, additional prophylactic treatment with the aim of preventing congenital syphilis is assigned. This course is designated at the 20th week of pregnancy or immediately after the main course (if it did not finish before the 20th week).