Audit of management of pregnant women with positive VDRL tests.
BACKGROUND
Syphilis is a preventable cause of foetal loss and congenital disease. Although the VDRL test is an integral part of routine antenatal care in India, little is known about the disease burden in pregnancy in India. Therefore, we carried out a study to determine the prevalence of VDRL positivity and syphilis among pregnant women in Vellore and to audit the management and outcome of VDRL-positive pregnancies.


METHODS
A retrospective review of case records.


RESULTS
Only 0.98% of pregnant women were positive by the VDRL test. However, foetal loss occurred in 16 (32%) of the 50 seropositive women; 15 of these did not receive antenatal care. Seventeen of the 34 seropositive multiparous women had had previous foetal losses. Only 16 women had received penicillin.


CONCLUSIONS
Although the seroprevalence of syphilis in pregnancy is low, it is an unrecognized cause of foetal loss in Vellore. An audit of the testing and management of VDRL positivity in pregnancy provides valuable information on the quality of antenatal care in an area.
Mathai
E
E
Department of Clinical Microbiology, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India.
Mathai
M
M
Prakash
J A
JA
Bergström
S
S
D002308:Cardiolipins / Q000097:blood*; D002784:Cholesterol / Q000097:blood*; D005260:Female; D016519:Hospitals, Religious; D006801:Humans; D007194:India / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods; D008485:Medical Audit; D010406:Penicillins / Q000627:therapeutic use; D010713:Phosphatidylcholines / Q000097:blood*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care / Q000379:methods / Q000592:standards*; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D013587:Syphilis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D016896:Treatment Outcome
D002308:Cardiolipins; D010406:Penicillins; D010713:Phosphatidylcholines; C054448:VDRL antigen; D002784:Cholesterol