Le Chevalier de Préville M, Alessandri J-L, Traversier N, Cuillier F, Robin S, Ramful D
Neonatal and Pediatric Intensive Care Unit, Félix Guyon Hospital, CHU de La Réunion, La Réunion, France.
Microbiology/Virology Laboratory, Félix Guyon Hospital, CHU de La Réunion, La Réunion, France.
J Perinatol. 2017 Feb;37(2):116-121. doi: 10.1038/jp.2016.158. Epub 2016 Oct 6.
To evaluate the maternal-fetal management and follow-up of infants at risk for congenital syphilis.
Monocentric retrospective cohort study at the Félix Guyon Hospital, Saint-Denis, La Réunion between January 2008 and December 2014. Management of 38 pregnancies (35 women, 39 fetuses) with a positive syphilis serology was evaluated according to the Centers for Disease Control and Prevention (CDC) guidelines.
A total of 68% (n=26) of pregnancies were screened before 16 weeks of gestation, and 26% (n=10) had appropriate treatment. Adverse outcomes were noted in 45% of pregnancies. Neonatal serology was not performed in 7 live-born neonates (19%) and 33 infants were classifiable according to the four CDC scenarios. In the infants, adequate complementary evaluation and appropriate treatment were noted in 42% (n=13) and 55% (n=17) of cases, respectively. Rate of infant follow-up was 76% (n=16). No treatment failure was observed in infants.
Reinforcement of public health policies and a better sensitization, training and collaboration among perinatal caregivers are warranted given the gaps revealed in our study.
评估先天性梅毒高危婴儿的母婴管理及随访情况。
2008年1月至2014年12月在留尼汪圣但尼的费利克斯·居永医院进行的单中心回顾性队列研究。根据美国疾病控制与预防中心(CDC)的指南,对38例梅毒血清学阳性的妊娠(35名女性,39名胎儿)的管理情况进行评估。
共有68%(n = 26)的妊娠在妊娠16周前进行了筛查,26%(n = 10)接受了适当治疗。45%的妊娠出现了不良结局。7名活产新生儿(19%)未进行新生儿血清学检查,33名婴儿可根据CDC的四种情况进行分类。在婴儿中,分别有42%(n = 13)和55%(n = 17)的病例进行了充分的补充评估和适当治疗。婴儿随访率为76%(n = 16)。未观察到婴儿治疗失败的情况。
鉴于我们研究中发现的差距,有必要加强公共卫生政策,并提高围产期护理人员的认识、培训和协作水平。