The symptoms and treatment of syphilis in pregnancy
But competently conducted therapy before pregnancy and even treatment of syphilis in pregnancy allows you to give birth in a term baby with no abnormalities.
Is it possible pregnancy after syphilis
It is known that analyses women who have recovered a few years ago, you can stay positive. This indicates the presence of the organism immunity to Treponema.
In medical practice there were cases when the symptoms of congenital syphilis was detected among children whose mothers completed the full treatment before pregnancy. So to get pregnant earlier than 3-4 years after rehabilitation treatment is not recommended. Better to wait until the body is completely freed from all traces of the pathogen and the effectiveness of the treatment will be confirmed.
Syphilis during pregnancy
Wassermann reaction (RW) to detect antibodies to Treponema conducted three times during pregnancy: after putting in consultation on accounting, in the second and third trimesters. And it's not just reassurance, such a study in the dynamics allows us to calculate that there was infection before pregnancy or infection with syphilis occurred during gestation.
The longer the elapsed time after infection before fertilization, the lower the risks to the fetus and the higher the efficiency of the treatment.
If the infection occurred during pregnancy, the later it took place, the lower is the risk to the fetus. If perhaps the birth of a healthy baby from a sick woman, she is caesarean section. This allows you to avoid infecting the baby at birth. The baby after birth is solely on the feeding mixtures, because in the breast milk of a sick woman contains a lot of treponemes.
The effect of Treponema pallidum to the fetus
Transmission to the fetus from the sick mother through placenta. In the study of the placenta of an infected woman after a miscarriage revealed complete obliteration (obliteration) of the lumen of its vessels connective tissue. However, the child seat weighs almost twice more than in healthy pregnant women. Because of the overgrowth of blood vessels in the fetus ceases to receive blood flow of oxygen and food.
Most often syphilis in pregnant women without treatment ends in miscarriage. And it happens quite late (about 20 weeks). In addition, the disease threatens to stillbirth or premature birth. Premature infants born with extremely low weightunderdevelopment of internal organs and maseribane skin. They often die soon after birth due to pneumonia or meningitis.
In any case detection of syphilis in pregnancy is not an indication for termination. After timely treatment, it is possible to have a healthy baby regardless of the period of disease and infection.
Congenital disease in infants
If the child is born alive, he often immediately after birth symptoms of congenital syphilis. This:
- low body weight;
- sunken nose bridge;
- overly developed frontal bossing;
- a wrinkled "old man";
- hyperpigmentation thickening of the skin;
- cracks and scars in the corners of the mouth;
- syphilitic pemphigus in the palms and soles;
- chronic rhinitis;
- parageneses with the constant crying and anxiety.
The most specific of these symptoms are pemphigus, which is localized precisely at the extremities, and perioral scars.
Scars Robinson-Fournier develop due to cracks around the mouth when the child's attempt to breastfeed, and remain for life. Also characteristic is considered to be diffuse thickening of the skin, because of what it may look lacquered and shiny.
These symptoms can develop several days after birth. Unfortunately, sometimes congenital syphilis occurs in children whose mothers were treated during pregnancy.
Early and late congenital syphilis
The first symptoms can appear in a child after the neonatal period 1-4 years. At the same time develop all the manifestations of secondary syphilis: papules and pustules on the skin with possible swollen lymph nodes. The first signs of the disease may occur even later (after 4-5 years), and sometimes in adolescence. At the same time on the body of a child popping gum and bumps, which is characteristic for the tertiary period.
For late congenital syphilis characterized by a number of reliable signs, called the triad of Hutchinson. This parenchymatous keratitis, labyrinthine deafness, and tooth infections.
Keratitis (inflammation of cornea) without treatment often leads to drastic reduction and early loss of vision. If the affected ear up to 4 years, often to deafness in a child is also joined by muteness because of the inability of language development. And lesions of the teeth are hypoplastic enamel on the Central upper incisors and the lateral thickening of the necksteeth.
The treatment of the disease in pregnant women
If treponemal infection detected during pregnancy, the woman is being treated twice: first immediately after diagnosis and the second time prophylactically in 20-24 weeks.
Of course, treatment of syphilis is with antibiotics, the use of which is contraindicated during pregnancy. However, in this case, the consequences to the fetus if untreated, much worse than the harmful effects of antibiotics.
A period of 20-24 weeks is most suitable for therapy, as it is at this period often occurs the infection of the placenta and miscarriage.
The antibiotic selection for the treatment during pregnancy is based on the cultures and after receiving the antibiogram. This study allows you to learn which drugs Treponema sensitive to therapy was the most effective.
If earlier the woman already was treated with a single antibiotic, but it turned out to be unsuccessful, this drug is no longer used. Most often the drugs antisyphyllitic therapy penicillins and cephalosporins. To do this, a pregnant woman placed in a hospital. Childbirth in women, patients with syphilis, taking in specialized hospitals or observational unit of a General hospital.