Talati Ajay J, Koneru Padmaja
Departments of Pediatrics and Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
South Med J. 2011 Dec;104(12):827-30. doi: 10.1097/SMJ.0b013e31823875e9.
To review the infants at risk for congenital syphilis (CS) and determine the optimal use of evaluations such as cerebrospinal fluid (CSF), the venereal disease research laboratory (VDRL) test, and long bone radiography studies.
A retrospective chart review of all of the infants at risk for CS from January 1997 to December 2002 at the Regional Medical Center at Memphis was conducted. Subjects were identified from a database of prenatal maternal records. Infant charts showing a diagnosis of presumptive CS were reviewed and data were collected.
Of the 24,245 deliveries, maternal serology (rapid plasma reagin and microhemagglutination for treponemal antibody) was reactive in 250 women during pregnancy. Of 92 infants with a presumptive diagnosis of syphilis, only 2 (2.1%) were symptomatic. CSF examination for VDRL was feasible in 74 (80%) of the 92 infants. Only 1 (1.35%) of the 74 infants had a positive CSF-VDRL. Three infants had radiographic changes that were consistent with CS.
The burden of syphilis in pregnancy remains high. Proper evaluation of neonates is important in preventing long-term consequences. The frequency of positive CSF and long bone radiography studies remains low. These evaluations should be made based on the symptoms and plan of treatment for individual neonates.
回顾先天性梅毒（CS）高危婴儿的情况，并确定脑脊液（CSF）、性病研究实验室（VDRL）检测和长骨放射学检查等评估方法的最佳应用。
对1997年1月至2002年12月孟菲斯地区医疗中心所有CS高危婴儿进行回顾性病历审查。从产前母亲记录数据库中识别出研究对象。对显示疑似CS诊断的婴儿病历进行审查并收集数据。
在24245例分娩中，250名女性在孕期的母体血清学检查（快速血浆反应素和梅毒螺旋体抗体微量血凝试验）呈阳性。在92例疑似梅毒诊断的婴儿中，只有2例（2.1%）有症状。92例婴儿中有74例（80%）可行CSF的VDRL检查。74例婴儿中只有1例（1.35%）CSF-VDRL呈阳性。3例婴儿有与CS一致的放射学改变。
孕期梅毒负担仍然很高。对新生儿进行适当评估对于预防长期后果很重要。CSF阳性和长骨放射学检查的频率仍然很低。这些评估应根据个体新生儿的症状和治疗计划进行。
