David Marion, Hcini Najeh, Mandelbrot Laurent, Sibiude Jeanne, Picone Olivier
Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Colombes Cedex, France.
Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, French Guyana. CIC Inserm 1424 et DFR Santé Université Guyane, ST Laurent du Maroni, France.
Prenat Diagn. 2022 May;42(5):643-655. doi: 10.1002/pd.6135. Epub 2022 Apr 9.
The recent recrudescence of syphilis among women of childbearing age is associated with an increasing number of cases of congenital syphilis. We aimed to summarize the fetal and neonatal abnormalities due to congenital syphilis infection, particularly signs amenable to prenatal diagnosis.
Eligible studies were retrieved from the PubMed collection database. Articles focusing on postnatal and antenatal abnormalities covered the periods from 1969 to 2019 and 1975-2019, respectively. This review included cohort studies, case series and case reports reporting findings regarding congenital syphilis infections described before and/or after birth. Articles were reviewed by three experts in prenatal diagnosis, and all findings were classified as amenable or not amenable to prenatal diagnosis.
A total of 432 cases of congenital syphilis infection were reported. Abnormalities were described antenatally in 161 cases, postnatally in 319 cases, and in both the antenatal and postnatal periods in 57 cases. The most frequently reported signs amenable to prenatal diagnosis were abdominal abnormalities (hepatomegaly, splenomegaly, and bowel abnormalities), fetal growth restriction, and elevated middle cerebral artery peak systolic velocity in the context of ascites or atypical hydrops. Brain abnormalities were rare and never isolated. In the neonatal period, the most common abnormalities were hepatosplenomegaly, bone damage and skin lesions.
We found that no individual sonographic sign or pattern of signs is pathognomonic for fetal syphilis. In fetuses with ultrasound abnormalities suggestive of congenital infection, syphilis must be considered as part of the work-up.
育龄期女性梅毒近期再度流行与先天性梅毒病例数增加有关。我们旨在总结先天性梅毒感染所致的胎儿及新生儿异常情况，尤其是适合产前诊断的体征。
从PubMed收集数据库中检索符合条件的研究。关注产后及产前异常的文章分别涵盖1969年至2019年以及1975 - 2019年这两个时间段。本综述纳入了报告出生前和/或出生后先天性梅毒感染相关结果的队列研究、病例系列和病例报告。文章由三位产前诊断专家进行评审，所有结果被分类为适合或不适合产前诊断。
共报告432例先天性梅毒感染病例。161例在产前描述有异常，319例在产后描述有异常，57例在产前和产后均有异常描述。最常报告的适合产前诊断的体征为腹部异常（肝肿大、脾肿大和肠道异常）、胎儿生长受限以及在腹水或非典型水肿情况下大脑中动脉收缩期峰值流速升高。脑部异常罕见且从未单独出现。在新生儿期，最常见的异常为肝脾肿大、骨损伤和皮肤病变。
我们发现没有任何单一的超声体征或体征模式对胎儿梅毒具有诊断特异性。对于超声检查有提示先天性感染异常表现的胎儿，必须将梅毒视为检查项目的一部分。
