Pregnancy with syphilis
Introduction
Introduction to pregnancy combined with syphilis Syphilis is a chronic infectious disease caused by Treponema pallidum, which is transmitted through sexual intercourse. At present, there are popular trends in China that cannot be ignored. Treponema pallidum enters the body from the epidermis or mucosal damage, it takes about 3-4 weeks of incubation, and then begins to develop, early genital, cervical and vaginal mucosa redness, ulcers, if not treated in time, about one-third develop into Late syphilis, although weak, but may cause neurosyphilis and cardiovascular syphilis, the consequences are serious. Pregnant women with stage I and II syphilis have the strongest infection. The syphilis pathogens multiply in the fetal viscera (mainly in the liver, lung, spleen, adrenal gland, etc.) and tissues, causing miscarriage, premature delivery, stillbirth, stillbirth after 6 weeks of gestation. . Untreated first- and second-stage syphilis pregnant women are almost 100% passed to the fetus. Early latent syphilis (less than 2 years of infection, clinical syphilis-free performance, syphilis serological test positive), the possibility of pregnant women infected with the fetus is more than 80%. And 20% of premature birth. Untreated late syphilis pregnant women are about 30% likely to contract the fetus, late late syphilis (infection for more than 2 years, clinical syphilitic damage, syphilis serological test positive) pregnant women, although sexual contact has no contagious, infected fetus The probability is still 10%. Usually congenital syphilis accounts for about 30% of stillbirths. basic knowledge The proportion of illness: 0.005%, more common in multiple partners Susceptible population: pregnant women and newborns Mode of transmission: sexual transmission, vertical transmission Complications: abortion, premature delivery
Cause
Pregnancy with syphilis
Syphilis is a chronic infectious disease caused by Treponema pallidum, which is transmitted through sexual intercourse. Pregnant women with syphilis sera are about 2% positive, while the incidence of congenital syphilis is 1.2 live birth. The increase in syphilis in pregnant women is associated with drug abuse, prostitution, HIV infection and lack of prenatal care due to poverty. With the increase in syphilis infection in pregnant women, congenital syphilis within 1 year of age is also increased by 4 times.
Prevention
Pregnancy with syphilis prevention
1. Syphilis should not be treated arbitrarily until it is diagnosed. Be sure to first confirm the diagnosis. If syphilis is treated as a general inflammatory disease, it is not only difficult to treat, but also the spirochete in the lesion is reduced, the syphilis serum reaction is delayed, and the positive rate and the reaction intensity are lowered, which delays the course of the disease.
2. The preferred drug for the treatment of syphilis is penicillin. For those who are allergic to penicillin, erythromycin can be used. The therapeutic dose should be sufficient and the course of treatment must be regular. Irregular, incomplete treatment can increase the chance of recurrence and develop into advanced syphilis.
Complication
Pregnancy with syphilis complications Complications, abortion, premature delivery
Pregnant women with first- and second-stage syphilis are the most contagious, and Treponema pallidum can infect the fetus through the placenta, causing miscarriage, premature birth, stillbirth, and stillbirth.
Symptom
Pregnancy with syphilis symptoms Common symptoms Embryo stop development Embryonic development disorder Lymph node enlargement Abortion blister or bullous damage Saddle-nose stillbirth
Pregnant women with primary and secondary syphilis are the most contagious. The syphilis pathogens multiply in the fetal viscera (mainly in the liver, lung, spleen, adrenal gland, etc.) and tissues, causing miscarriage, premature delivery, stillbirth, stillbirth after 6 weeks of pregnancy. . Untreated first- and second-stage syphilis pregnant women are almost 100% passed to the fetus. Early latent syphilis (less than 2 years of infection, clinical syphilis-free performance, syphilis serological test positive), the possibility of pregnant women infected with the fetus is more than 80%. And 20% of premature birth. Untreated late syphilis pregnant women are about 30% likely to contract the fetus, late late syphilis (infection for more than 2 years, clinical syphilitic damage, syphilis serological test positive) pregnant women, although sexual contact has no contagious, infected fetus The probability is still 10%. Usually congenital syphilis accounts for about 30% of stillbirths.
If the fetus survives, the birth of the congenital mildew (also known as the fetus), the condition is heavier. Early manifestations of skin bullae, rash, rhinitis or nasal congestion, hepatic gland enlargement, lymphadenopathy, etc.; late connamycin appeared more than 2 years old, showing wedge-shaped, saddle-nose, interstitial keratitis, periosteum Inflammation, neurological deafness, etc.; the mortality rate of the mortality rate is significantly increased.
Examine
Pregnancy with syphilis
1. Pathogen examination A small amount of serum exudate is taken from the hard sacral site of syphilis in the first stage, placed on a slide, and observed under a dark field microscope. The judgment is based on the strong refractive power and movement pattern of the spiral, which can be diagnosed.
2. Syphilis serological test Non-treponema pallidum antigen serum test is a routine screening method for syphilis, including Sexually Transmitted Disease Research Laboratory Slide Test (VDRL), serum unheated responsive slide test (USR), rapid plasma responsive ring Card test (RPR). If VDRL, USR and RPR are positive, quantitative tests should be performed. It is best to do treponema pallidum antigen test to determine serum-specific antibodies. The commonly used methods are fluorescent trepone antibody absorption test (FTA-ABS) and treponema hemagglutination test ( TPHA). In recent years, the use of PCR technology to take amniotic fluid detection spiral to diagnose congenital mold.
Diagnosis
Diagnosis and differentiation of pregnancy complicated with syphilis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Common clinical diseases that are easily misdiagnosed as syphilis and their characteristics are as follows.
Condyloma acuminata
A sexually transmitted disease caused by human papillomavirus infection causing squamous epithelial hyperplasia. Skin lesions in the perianal, external genital or reproductive tract papillary and cauliflower-like hyperplasia, the surface is wet with stench. The acetic acid white test was positive. For cytological examination, smear of vaginal cervical tissue was taken and pasteurized, and vacuolar cells and keratinocytes were observed.
2. Bowenoid papulosis
The disease is a skin carcinoma in situ, which may have evolved from condyloma acuminata and is associated with papillomavirus type 16 (HPV16) infection. Lesions are distributed in the labia majora and perianal, and are scattered, linear or ring-shaped reddish or brown papules and flat rashes. Histopathological changes are similar to Bowen's disease-like changes.
