Uku Alison, Albujasim Zahraa, Dwivedi Tina, Ladipo Zana, Konje Justin C
Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton Under Lyne, OL6 9RW, UK.
Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton Under Lyne, OL6 9RW, UK.
Eur J Obstet Gynecol Reprod Biol. 2021 Apr;259:207-210. doi: 10.1016/j.ejogrb.2021.01.010. Epub 2021 Feb 1.
Syphilis remains a common congenital infection over the globe. There has been a tremendous rise in the number of congenital syphilis cases worldwide in the last 20 years. It affects large numbers of pregnant mothers in high burden regions causing a significantly high perinatal mortality and morbidity, which can be easily prevented by early antenatal screening and treatment. Diagnosis of maternal syphilis in pregnancy mainly based on clinical symptoms, serological tests and direct identification of treponemes in clinical samples. However, the diagnosis can be challenging due to the relapsing-remitting nature of the disease. The early stage of the infection is usually symptomatic which is commonly followed by an asymptomatic latent phase but infectious and as a result serological tests will be positive. The risk of transplacental transmission is high during the second and third trimester. Obstetric complications of syphilis include spontaneous miscarriage, non-immune hydrops, stillbirth, preterm labour, low birth weight, increased neonatal mortality and congenital syphilis among neonates. Penicillin is the drug of choice for treatment and should be commenced immediately. Babies born to mothers with syphilis should also be treated with penicillin. Early detection and prompt intervention are the key to the prevention and successful control of congenital syphilis. The aim of this review is to highlight the impact of syphilis infection on pregnancy and discuss the current trends in diagnosis and management of maternal and congenital syphilis.
梅毒在全球范围内仍是一种常见的先天性感染疾病。在过去20年里，全球先天性梅毒病例数量大幅上升。在高负担地区，大量孕妇受到影响，导致围产期死亡率和发病率显著升高，而通过早期产前筛查和治疗，这些情况很容易得到预防。孕期母体梅毒的诊断主要基于临床症状、血清学检测以及临床样本中梅毒螺旋体的直接鉴定。然而，由于该疾病的复发缓解特性，诊断可能具有挑战性。感染的早期通常有症状，随后通常会进入无症状的潜伏期，但仍具传染性，结果血清学检测会呈阳性。在妊娠中期和晚期，经胎盘传播的风险很高。梅毒的产科并发症包括自然流产、非免疫性水肿、死产、早产、低出生体重、新生儿死亡率增加以及新生儿先天性梅毒。青霉素是治疗的首选药物，应立即开始使用。梅毒母亲所生的婴儿也应接受青霉素治疗。早期发现和及时干预是预防和成功控制先天性梅毒的关键。本综述的目的是强调梅毒感染对妊娠的影响，并讨论目前母体和先天性梅毒诊断与管理的趋势。
