Maternal syphilis: pathophysiology and treatment.
Despite the long history of medical interest in syphilis and its effects on pregnancy outcome, many fundamental questions about the pathophysiology and treatment of syphilis during pregnancy remain unanswered. However, understanding has been advanced by recent scientific reports such as those which delineate the complete sequence of the genome of the syphilis spirochaete, provide a more precise description of fetal and neonate infection by use of rabbit infectivity tests and describe the gestational age distribution of fetal death secondary to syphilis. It appears that fetal syphilitic involvement progresses in a rather predictable fashion, and although there is disagreement about the optimal prenatal treatment regimen, programmatic efforts to prevent fetal death must provide seropositive pregnant women with a recommended treatment early in pregnancy, and certainly before the third trimester.
Berman
Stuart M
SM
Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA 30306, USA. sberman@cdc.gov
D005260:Female; D005313:Fetal Death / Q000209:etiology / Q000517:prevention & control; D005315:Fetal Diseases / Q000382:microbiology; D005865:Gestational Age; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D010401:Penicillin G Benzathine / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000503:physiopathology; D011295:Prenatal Care; D013590:Syphilis, Congenital / Q000188:drug therapy* / Q000503:physiopathology; D014210:Treponema pallidum / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity
D010401:Penicillin G Benzathine