PP-16 The importance of early diagnosis in maternal syphilis . Perinatal Journal 2023;31(3):24
- University of Health Sciences İzmir Tepecik Training and Research Hospital, Department of Gynecology and Obstetrics, İzmir, Türkiye
- University of Health Sciences, Izmir Tepecik Training and Research Hospital, Gynecology and Obstetrics Department, Division of Perinatology, İzmir, Türkiye
Sevim Tuncer Can, University of Health Sciences İzmir Tepecik Training and Research Hospital, Department of Gynecology and Obstetrics, İzmir, Türkiye,
Earlyview Date: September 22, 2023
Publication date: October 01, 2023
Conflicts of Interest
No conflicts declared.
Infection is of particular concern during pregnancy because of the risk of transplacental transmission to the fetus. In this case report; Prenatal diagnosis and management of syphılıs is discussed.
A 20-year-old G1P0 patient at 12w5d gestational week was refered to our department with a positive Venereal Disease Research Laboratory (VDRL) test result. His history was obtained and systemic examination was performed. There was no recent acute febrile infection or vaccination history. No additional systemic disease was observed. There were no signs of infection including maculopapular rash, genital ulcer and oral aphthae. The patient had symptoms of groin pain, burning during urination, chills and shivering. Anti-HIV test result was negative. T. pallidum particle agglutination test (TPPA) was used as a confirmatory test because of the possibility of false positive screening test result. The diagnosis of syphilis was confirmed with a positive TPPA test result (26.32 s/co) and 2.4 million units of Penicillin G benzathine was initiated intramuscularly.
Treponema Pallidum easily infects the placenta and causes amniotic fluid infection, placentomegaly and fetal anemia, thrombocytopenia, ascites, hydrops and intrauterine growth retardation by transplacental transmission. Manifestations of congenital infection are affected by gestational age, maternal syphilis status, maternal treatment, and fetal immunological response.
Screening all pregnant women for syphilis infection at the first trimester is recommended. Benzathine Penicilline G is effective in preventing transmission of infection to the fetus in most settings.
Pregnacy, prenatal management, syphilis
- Newman L, Kamb M, Hawkes S, et al. Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data. PLoS Med. 2013;10(2):e1001396.
- Rac MW, Revell PA, Eppes CS. Syphilis during pregnancy: a preventable threat to maternal-fetal health. Am J Obstet Gynecol. 2017;216(4):352-363.
- Wendel GD Jr, Sheffield JS, Hollier LM, Hill JB, Ramsey PS, Sánchez PJ. Treatment of syphilis in pregnancy and prevention of congenital syphilis. Clin Infect Dis. 2002;35(Suppl 2):S200-S209.