Retrospective analysis of burden of maternal syphilis and the outcome in the fetus in a tertiary care centre
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20181819Keywords:
Maternal Syphilis, Penicillin, Congenital syphilisAbstract
Background: Syphilis in pregnancy has its own significance with regards to the outcome of pregnancy. In the meanwhile, it also reflects the effectiveness of health system in the community.
Methods: A retrospective study was carried out in a tertiary care centre in Chennai between January 2014 and July 2015 to determine the seroprevalence of syphilis in pregnant women. A total of 4423 ANC mother attending the hospital were included in the study.
Results: Of the 4423 cases studied, 7 cases were found to be positive for RPR accounting to the prevalence of 0.15%. One mother was symptomatic, presenting with condyloma lata. TPHA was positive in 2 cases (28.5%) Most common association was with HIV infection, 2/7 (28.5%). All the RPR positive patients were treated with tablet erythromycin 500 mg qid × 14 days. Epidose for the partner was given. The outcome was uneventful except for one. A single case of congenital syphilis was reported.
Conclusions: Though the prevalence of RPR positive in routine screening is less, the outcome of single congenital syphilis is worrisome. To conclude, although the prevalence of syphilis (0.1%) is low, routine screening of asymptomatic ante natal women is recommended to reduce the incidence of congenital syphilis & perinatal complications and it is always better to treat the ANC mothers with syphilis with Penicillin, preferably with a second dose also.
Metrics
References
Aman S, Hasleton P, Hanna A. The Great Imposter, the Great Imitator. Br J Cardiol. 2011;18:94-96.
Nishal PK, Kapoor A, Jain VK, Dayal S, Aggarwal K. Changing trends in acquired syphilis at a Tertiary Care Center of North India. Indian J Sex Transm Dis. 2015;36:149-53.
Values M, Kirk D, Ramsey P. Syphilis in pregnancy: a review. Prim Care Update Ob/Gyns 2000;7:26–30.
WHO, Eliminating congenital syphilis,Initiative to eliminate mother-to-child transmission (EMTCT) of HIV and syphilis. Available at: http://www.who.int/reproductivehealth/congenital-syphilis/WHO-validation-EMTCT/en/&hl=en-IN&geid=1024.
Genç M, Ledger WJ. Syphilis in pregnancy Sex Transm Infect. 2000;76:273-9.
Phiske MM. Current trends in congenital syphilis. Indian J Sex Transm Dis. 2014;35:12-20.
CDC Congenital syphilis -- New York City, 1986-1988. MMWR. 1989;38:825–9.
Nair N, Urhekar AD, Pachpute S, Srivastava A. Incidence of Syphilis among pregnant women attending a tertiary care hospital in Navi Mumbai, India. Int J Curr Microbiol App Sci. 2013;2(8):79-84.
Chen XS, Khaparde S, Turlapati LNP, Srinivas V, Anyaike C, Ijaodola G, et al. Estimating disease burden of maternal syphilis and associated adverse pregnancy outcomes in India, Nigeria, and Zambia in 2012. Int J Gynaecol Obstet. 2015;130:4-9.
Fatima N, Malik A, Khan PA, Ali S, Khan HM, Nabeela. Sero Prevalence of Syphilis Infection among Patients Attending Antenatal Care & Sexually Transmitted Disease (STD) Clinics: Observations from a Tertiary Care Hospital of Northern India. Am J Internal Med. 2014;2(1):6-9.
Walker GJ. Antibiotics for syphilis diagnosed during pregnancy. Cochrane Database Syst Rev. 2001: CD001143.
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(2):200–9.
Zhu L, Qin M, Du L, Xie RH, Wong T, Wen SW. Maternal and congenital syphilis in Shanghai, China, 2002 to 2006. Int J Infect Dis. 2010;14(3):45–8.
Hawkes S, Matin N, Broutet N, Low N. Effectiveness of interventions to improve screening for syphilis in pregnancy: a systematic review and meta-analysis. Lancet Infect Dis. 2011;11:684–91.
Hollier LM, Harstad TW, Sanchez PJ, Twickler DM, Wendel GD Jr. Fetal syphilis: clinical and laboratory characteristics. Obstet Gynecol. 2001;97:947–53.
Alexander JM, Sheffield JS, Sanchez PJ, Mayfield J, Wendel GD Jr. Efficacy of treatment for syphilis in pregnancy. Obstet Gynecol. 1999;93(1):5-8.
Klein VR, Cox SM, Mitchell MD, Wendel GD Jr. The Jarisch-Herxheimer reaction complicating syphilotherapy in pregnancy. Obstet Gynecol 1990;75(3):375–80.
Sheffield JS, Sánchez PJ, Morris G, Maberry M, Zeray F, McIntire DD, et al. Congenital syphilis after maternal treatment for syphilis during pregnancy. Am J Obstet Gynecol. 2002;186:569-73.
US Preventive Services Task Force. Screening for syphilis infection in pregnancy: reaffirmation recommendation statement. Ann Intern Med 2009;150:705–9.
Walker GJ. Antibiotics for syphilis diagnosed during pregnancy. Cochrane Database Syst Rev. 2001: CD001143.