Gestational and congenital syphilis in Hualien.
From September 1987 to April 1991, 19 pregnant women (0.97%) with syphilis were detected out of 1,955 pregnant women who received prenatal serologic screening at the Buddhist Tz'u-Chi General Hospital. The ages ranged from 17 to 34 years (average, 26). Three cases had recurrent gestational syphilis. The time of diagnosis was: the third trimester, 11 cases; the second trimester, six cases; and the first trimester, two cases. The reasons for late (third trimester) diagnosis were: delay of prenatal care, four cases; failure to screen syphilis in the pregnancy, four cases; and negative first test and late infection, three cases. Late diagnosis and treatment often resulted in poor fetal outcome: syphilitic stillbirth, two cases; probable and possible congenital syphilis, seven cases; and normal infant, two cases. Patients (delivered, five; undelivered, two; abortion, one) who had been diagnosed before the third trimester had a better fetal outcome: possible congenital syphilis, one case; and normal infant, four cases. The perinatal mortality and morbidity were significantly higher in the late diagnosis group (9/11) than in the early diagnosis group (1/5). Pregnant women should be screened in early pregnancy by a serologic test for syphilis. In areas of high prevalence, or in patients at high risk, screening should be repeated in the third trimester and again at delivery.
Chang
Y K
YK
Department of Obstetrics and Gynecology, Buddhist Tz'u-Chi General Hospital, Hualien, Taiwan R.O.C.
Chao
S L
SL
Huang
L W
LW
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology; D013587:Syphilis / Q000188:drug therapy* / Q000453:epidemiology; D013590:Syphilis, Congenital / Q000188:drug therapy* / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology