Congenital syphilis after maternal treatment for syphilis during pregnancy

Sheffield, Jeanne S.; Sánchez, Pablo J.; Morris, George; Maberry, Mark C.; Zeray, Fiker; McIntire, Donald D.; Wendel, George D.

doi:10.1067/mob.2002.121541

Cited by 137 publications

(90 citation statements)

References 10 publications

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“…Despite the efficacy of penicillin, there are some factors that can justify these outcomes, especially an early stage of maternal syphilis/severity of fetal infection, gestational age at treatment or interval of time without treatment. 17 Overall, all studies showed a lower prevalence of adverse outcomes between women who had received an intervention in the first or second trimesters of pregnancy. 13 Of those who did not undergo syphilis screening and treatment until the 3rd trimester, Hawkes et al 13 With regard to our well-treated CS case, the first penicillin administration was at 30 WG, although the exact time of infection was unknown (latent syphilis of unknown duration).…”

Section: Discussionmentioning

confidence: 99%

Syphilis in Pregnancy and Congenital Syphilis: Reality in a Portuguese Central University Hospital

Magalhães

Basto

Areia

et al. 2017

Rev Bras Ginecol Obstet

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Purpose To evaluate maternal-fetal surveillance and follow-up of infants at risk for congenital syphilis (CS). Methods Retrospective cohort study in a Portuguese Tertiary Referral Hospital. The main inclusion criterion was a positive syphilis serology. The study included all pregnant women that delivered in our hospital between January 2004 and December 2013. The neonates were classified according to their probability of infection based on the Centers for Disease Control and Prevention guidelines. Results Among the 27 pregnancies at risk for CS, 48.2% (n ¼ 13) of the women had a diagnosis during the 1st trimester, and the median gestational age at the end of the treatment was 28 weeks. Inadequate treatment was noted in 44.4% (n ¼ 12) of the women. Adverse pregnancy outcomes were observed in 30.8% of the cases (n ¼ 8), 5 of which had been adequately treated. We found 2 (7.7%) cases with "proven or highly probable CS," 10 (38.5%) with "possible CS," 12 (46.1%) with "less likely CS," and 2 (7.7%) with "unlikely CS." Among the infants, the treatment was successful, except for 1 neurosyphilis case. Conclusion This study highlights many of the difficulties/concerns encountered in the maternal-neonatal management of syphilis. We highlight the importance of assuring the early detection of the infection as a way of guaranteeing the timely treatment, as well as a good compliance to the treatment and follow-up through a more efficient pregnant women surveillance network.

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Section: Discussionmentioning

confidence: 99%

Syphilis in Pregnancy and Congenital Syphilis: Reality in a Portuguese Central University Hospital

Magalhães

Basto

Areia

et al. 2017

Rev Bras Ginecol Obstet

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“…Of even greater concern, 11% of women in this study were tested within only 30 days of delivery. This circumstance is important because the highest risk for congenital syphilis, or syphilitic stillbirth, occurs when a woman is treated within 30 days of delivery (27). More research is needed to understand the prenatal-care-seeking practices of rural Haitian women, and increased efforts are needed to educate women about the importance of early prenatal care.…”

Section: Table 1 Centers For Disease Control and Prevention Case Defmentioning

confidence: 99%

Maternal and congenital syphilis in rural Haiti

Lomotey¹,

Lewis²,

Gebrian³

et al. 2009

Rev Panam Salud Publica

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Objectives. A study was conducted to assess the prevalence of maternal syphilis and esti- ABSTRACTSyphilis continues to be a widespread global health problem, affecting 12 million people each year and resulting in significant morbidity and mortality (1). SubSaharan Africa has the highest prevalence of gestational syphilis, with up to 17% of pregnant women testing positive for syphilis at antenatal clinics (2). Several Latin American and Caribbean countries, including Haiti, also have very high reported rates of the disease (3, 4). Congenital syphilis rates closely parallel rates of primary and secondary syphilis in women of child-bearing age (5).Syphilis in pregnancy is a major risk for the mother and the fetus, frequently causing miscarriage, stillbirth, and neonatal death (6). Adverse pregnancy outcomes are known to occur in up to 80% of women with active syphilis during gestation (7). Congenital syphilis, particularly if untreated, usually causes deleterious consequences to the child-including deafness, blindness, and mental retardation. Given that 50% of infants with congenital syphilis are asymptomatic at birth (8), many such children born to women with unrecognized gestational syphilis could remain untreated. Early prenatal screening for syphilis, and proper treatment of women during pregnancy, is therefore the most costeffective approach to avoid prenatal complications and the high morbidity

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“…pallidum can be transmitted from the bloodstream of the infected woman to her developing fetus at any time during pregnancy, although risk of fetal infection is much higher during early maternal syphilis (the first year of infection) than during later stages (284). Antibiotic treatment of the mother during the first two trimesters is usually sufficient to prevent negative outcomes, but later treatment or lack of treatment may result in fetal death, fetal damage, or birth of an infected infant.…”

Section: Congenital Syphilismentioning

confidence: 99%

Biological Basis for Syphilis

2006

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SUMMARY Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum subsp. pallidum. Clinical manifestations separate the disease into stages; late stages of disease are now uncommon compared to the preantibiotic era. T. pallidum has an unusually small genome and lacks genes that encode many metabolic functions and classical virulence factors. The organism is extremely sensitive to environmental conditions and has not been continuously cultivated in vitro. Nonetheless, T. pallidum is highly infectious and survives for decades in the untreated host. Early syphilis lesions result from the host's immune response to the treponemes. Bacterial clearance and resolution of early lesions results from a delayed hypersensitivity response, although some organisms escape to cause persistent infection. One factor contributing to T. pallidum's chronicity is the paucity of integral outer membrane proteins, rendering intact organisms virtually invisible to the immune system. Antigenic variation of TprK, a putative surface-exposed protein, is likely to contribute to immune evasion. T. pallidum remains exquisitely sensitive to penicillin, but macrolide resistance has recently been identified in a number of geographic regions. The development of a syphilis vaccine, thus far elusive, would have a significant positive impact on global health.

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Congenital syphilis after maternal treatment for syphilis during pregnancy

Cited by 137 publications

References 10 publications

Syphilis in Pregnancy and Congenital Syphilis: Reality in a Portuguese Central University Hospital

Syphilis in Pregnancy and Congenital Syphilis: Reality in a Portuguese Central University Hospital

Maternal and congenital syphilis in rural Haiti

Biological Basis for Syphilis

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