Parkland Health and Hospital System, University of Texas Southwestern Medical Center, Dallas, Texas.
Obstet Gynecol. 2020 May;135(5):1121-1135. doi: 10.1097/AOG.0000000000003788.
Despite a national plan to eliminate syphilis by 2005, recent trends have reversed previously achieved progress in the United States. After a nadir between 2000 and 2013, rates of primary and secondary syphilis among women and congenital syphilis rose by 172% and 185% between 2014 and 2018, respectively. Screening early in pregnancy, repeat screening in the third trimester and at delivery among women at high risk, adherence to recommended treatment regimens, and prompt reporting of newly diagnosed syphilis cases to local public health authorities are strategies that obstetrician-gynecologists can employ to fight the current epidemic. In this report, clinical manifestations and management of syphilis in pregnancy are reviewed, and both traditional and reverse sequence screening algorithms are reviewed in detail in the context of clinical obstetrics.
尽管美国有一个到 2005 年消除梅毒的国家计划，但最近的趋势扭转了之前取得的进展。在 2000 年至 2013 年期间达到最低点后，2014 年至 2018 年期间，女性的一期和二期梅毒以及先天性梅毒的发病率分别上升了 172%和 185%。在妊娠早期对高危妇女进行筛查，在妊娠晚期和分娩时重复筛查，遵循推荐的治疗方案，以及及时向当地公共卫生部门报告新诊断的梅毒病例，这些都是妇产科医生可以用来对抗当前梅毒流行的策略。在本报告中，回顾了妊娠梅毒的临床表现和处理，详细讨论了传统和反向序列筛查算法，并结合临床产科进行了讨论。
