Syphilis in pregnancy: what is dangerous for mom and baby

Syphilis during pregnancy can constitute violations of the mucosa, skin, various organs and tissues that rebuild the immune system and the organism as a whole.

Syphilis in pregnant women can be transmitted sexually, sometimes contact and household. Transmission may occur by contact of the infected genitals, oral cavity, infectious rashes. You can also very easily transmitted through traumatized skin. 100% infection occurs during sex with an infected partner.

How is syphilis?

There are several periods of the disease:

• the period of penetration and maturation, which lasts about a month;
• the first stage occurs on average about one and a half months;
• the second stage lasts from 3 to 5 years;
• the third phase occurs only in people who have neglected the disease and to take it from 6 to 10 years;
• the latent period may be latent and sometimes manifest relapses.

The causative agent, which forms the disease – Treponema pallidum. It refers to the tissue bacteria, which take place in cells and capable to earn there livelihoods. They actively share in various tissues and have a spiral shape that helps them to live longer. They have a high resistance to antibiotics. Therefore, the treatment here is always a little difficult.

In the initial stages of the disease Treponema pallidum inhabits the tissues in coiled form. Most infectious are the first, second initial and local. The immune system begins to reorganize itself under the influence of the pathogen, and begin to develop cellular infiltrates in the body, and later it goes into an inflammatory granuloma.

Granulomas develop in scars, and the new formation and destruction of granulomas leads to death.

The earliest consequence of syphilis is damage to the nervous system, which is accompanied by pathology of the membranes and vessels of the brain, at a later stage begins to marvel at and to break down the grey matter, with the development of mental disorders, confusion and memory disturbance. Begin to break the pathways in the spinal cord, functional disturbance of the pelvic organs, accompanied by severe pain.

What are the symptoms develop in pregnant women?

The symptoms depend on the stage of infection and consequences. Syphilis can be identified as conventional signs, and is hidden.

Syphilis during pregnancy can often lead to severe anemia and often leads to abortion.

The most dangerous for a toddler is the second stage that often leads to abortion or stillborn child. However, if the syphilis is at a late stage, the baby is born healthy, even if no treatment is administered.

A healthy baby can give birth to a woman who is already completely recovered from syphilis, as well as those who carried out the therapy in the early weeks after conception, and so on until 4 months. But a common problem of women is too late or just ignore going to the doctor. Just then, the fetus begins to actively be affected by the pathogen.

How to identify the disease?

If syphilis is acquired, it is necessary to understand in what ways the woman became infected (sexual, contact, airborne route). Chronic or congenital syphilis suggests that, most likely he was ill-treated mother.

To detect syphilis during pregnancy need to do a blood test. Such studies can be a bit. When you survey the population to identify the causative agent used screening tests. The standard analysis are a blood on RW. A positive response indicates the presence of syphilis. However, there is a possibility that a positive answer can be false, when it comes to pregnancy after syphilis.

When the test gave a positive response, you need to make a number of examinations that will confirm the exact availability of syphilis.

To verify the presence of the diagnosis resort to treponemal methods.

The main bell of the signs of syphilis is a chancre – dense formation, which is formed at the source of the causative agent, when probing the pain is. In addition, the first stage is characterized by symptoms:

The formation of sifrom on the mucous membranes of the uterus, vagina, oral cavity. After the occurrence of infection syphiloma appears in about a month and a half. Parallel to the chancre begin to inflame and swell the lymph nodes and lymphatic vessels. Often the chancre may occur in the rectum or on the cervix and because they are very difficult to notice because they don'tcause pain. Syphiloma in the first stage without proper treatment takes place and remains a scar.

The second stage is accompanied by a rash over the body and inside it. On the body can appear papules, roseola, syphilides. The rash occurs a month after the occurrence of the first stage. These rashes are contagious and any contact with the damaged area can lead to infection. Rashes are eliminated without treatment after 3-4 months. The second stage is accompanied by: fever, weakness, sore throat, swollen lymph nodes, which, subsequently, are eliminated without treatment. It can last for about 3-4 years, small pockets.

Latent syphilis is accompanied by periods of activity (rash) and passivity. If you run the disease, it goes into a latent phase, which may not manifest for several years and not be contagious. Such stages really only be determined with the help of serological tests, they give a positive result.

The third phase consists in the inflammation that occurs in 5-7 years after infection. Now, in addition to the skin and mucous membranes the lesions spread to the organs, nervous system, blindness, mental disorders. Often this leads to cardiac diseases, kidney failure and death.

The last stage is called neurosyphilis. It is accompanied by a prolonged period of decades and sometimes a lifetime. A small percentage of people neurosyphilis is formed already in the early stages of the disease. In many people the disease does not manifest itself. This stage is able to greatly affect the nervous system and to form different types of meningitis. When inflammation of the brain starts severe headache, rigidity of occipital muscles, making them rigid and temperature rise. When the inflammation reaches its full peak, the affected blood vessels, forming paralysis, blindness.

If not treated syphilis, the disease can be transmitted to the fetus, resulting in 30% can happen an abortion or the birth of a stillborn child, 50-80% of children with congenital syphilis.

In gynecology in the formation on account of conduct the analysis for syphilis at pregnancy. For the reliability of information these figures peremejayutsya for 6 months. If the mother was not on the account, this study was conducted during childbirth. Not yet, will put a correct diagnosis infants are in the hospital.

Congenital syphilis is early and late. Sometimes children have symptoms, but they develop from a few weeks to months after birth.

The symptoms, which can be seen syphilis in a child:

• Skin wrinkled, with grayish-yellow color, with the appearance of papules, pemphigus.
• Violations of the musculoskeletal system.
• Rise in temperature.
• A lack of iron.
• Heart disease.

It often happens that the signs does not manifest itself and occurs congenital syphilis. However, in a few years they will definitely show itself in the form of osteoporosis, crysania teeth, deterioration of sight and hearing.

What research is conducted?

As a biological material used: blood, serous discharge from ulcers, spinal fluid, tissue taken by biopsy. Cord blood for research is not in use.

The methods used in the study of syphilis:

• Darkfield microscopy finds of the pathogen.
• For the detection of pathogens in the oral cavity, and rectum using the method of Bang. Progress: material labeled with a fluorochrome, and he clings to Treponema. When the material is Treponema, it starts bright glow means the result is positive.
• Also for research use, the contents of the purulent exudate. It drips with natural solution, pressed with a cover glass and view the preparation through the microscope. This method can also give exactly a positive response.
• Serology can be divided into groups: treponemal and non-treponemal.

Group doing non-treponemal screening, which includes many methods. This group undoubtedly has many advantages – quick result, effectiveness. VDRL test helps to examine spinal fluid to find antibodies and can give accurate positive response. However, in the first month after infection, this test can show a false positive result.

Treponemal group gives accurate confirmation of the results of non-treponemal methods. They also contain a sufficient number of methods and are highly specific. But these methods are not suitable for the diagnosis of spinal fluid. If a woman has newamericanow treponematoses, it may be a false positive result.

What reasons can cause a false positive for syphilis? Several of them:

• Non-treponemal tests: varicella, pneumonia, hepatitis, heart disease, liver disease, cancer, myeloma, malignant and benign tumors, pregnancy.
• Treponemal tests: yaws, myeloma, atherosclerosis, malaria, Lyme disease etc.

Each diagnosis has its pros and cons. However, the final word can only tell the doctor-venereologist.

What doctors need to visit?

Treatment should be serious, as well as the necessary visits to the doctor. In addition to the gynecologist and the venereologist must be visiting a cardiologist, neurologist, ophthalmologist, internist, Laura, and other specialists, if you have any complaints and require additional treatment.

How to treat syphilis during pregnancy?

Usually the treatment is always medication. Here is a small list of what pregnant women are treated at different stages of syphilis. Sometimes that the treatment was due, the pregnant woman is best to go to the hospital.

Treatment pregnant up to 5 months is the same as for regular women. If more than six months, treatment is recommended such schemes:

The first stage of syphilis take:

• The dosage of benzylpenicillin, 1.2 million IU by injection. The duration of treatment is 7-10 days.
• Lebensinteressen procaine salt at a dosage of 600 thousand UNITS per buttock. Treatment lasts 7-10 days, the drug to inject 2 times a day.
• At the second stage and latent syphilis prescribe:
• Procaine benzylpenicillin dose of 1.2 million UNITS in the buttock. The duration of treatment is around 21 days.
• Lebensinteressen of the procaine salt is taken in the same dosage, but the treatment is 21 days for 2 times

Prevention of syphilis must be carried out if there is a suspicion that there was a risk. It is taking penicillin for 10 days. Treatment of syphilis in pregnant women is carried out after the establishment of the disease regardless of pregnancy. Preventive measures for the prevention of congenital syphilis begin the 4th month of pregnancy. The patient is safe in a day after the start of therapy. Sometimes women, for example, HIV-positive, do not take the regular dose of penicillin, requires some modification of treatment regimens.

Treatment of congenital syphilis is to identify period and resolve it. Highlight:

• Early congenital syphilis. He treated benzylpenicillin sodium salt at a dosage of 100 thousand IU/kg in the buttocks 5-6 times a day for a period of two weeks.
• Lebensinteressen procaine salt at a dosage of 50 thousand IU /kg / day in the buttocks, 2 times a day for two weeks.
• Ilibrarian+benzylpenicillin dosage of 50 thousand IU /kg / day in the buttocks, 2 times a day for two weeks.
• Alimentatia benzylpenicillin 50 thousand IU /kg in the buttocks 3 times a day, lasting a week (for this treatment, it is necessary that the baby weighed less than 2 kg.

When the lesion in the spinal fluid it is impossible to diagnose, then prescribe the same medication. The exception is benzathine benzylpenicillin.

Congenital syphilis in the later stage benzylpenicillin 50 thousand IU /kg / day in the buttock. The duration of treatment lasts 28 days, 2 weeks break and re-taking the drug for a duration of 2 weeks. The same treatment is carried out and Lebensinteressen procaine salt.

If a patient is not a suitable antibiotic penicillin, then take oxazolidinyl, Ceftriaxone for a duration of 2 weeks.

If a woman didn't recover, carry out preventive treatment in infants

When received the proper treatment, the regimen much easier:

• Penicillin g sodium for 100 thousand UNITS/kg 6 times a day. Treatment lasts 7-10 days.
• Benzylpenicillin procaine salt or a procaine benzylpenicillin is taken at a dosage of 50 thousand IU/kg 2 times a day for 10 days.

Often you may experience the reaction of Herxheimer–Arise (fever, discomfort) the day after the start of treatment of syphilis — an immune system response to therapy. The reaction occurs when the treatmentthe initial stages of the disease, is toxic and runs itself after awhile, perhaps taking drugs, lowering the temperature.