Successful outcome with intrauterine transfusion in non-immune hydrops fetalis secondary to congenital syphilis.
BACKGROUND
Congenital syphilis is rare, but the incidence has increased over the last few years in Alberta. Previous reports of fetal hydrops secondary to syphilis are few and have not demonstrated the application of middle cerebral artery peak systolic velocity (MCA PSV) to monitor for fetal anemia, or reported successful management with intrauterine transfusion.


METHODS
A 17-year-old primigravida at 28 weeks' gestational age with positive syphilis serology and fetal hydrops was treated with high-dose intravenous penicillin. An elevated MCA PSV suggested fetal anemia. Successful intrauterine cordocentesis and transfusion of packed red blood cells led to resolution of fetal hydrops. The fetus delivered spontaneously at 35 weeks' gestation with no clinical signs of congenital syphilis.


CONCLUSIONS
Syphilitic hydrops may be successfully managed with high dose intravenous penicillin, measurement of MCA PSV, and intrauterine transfusion.
Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB.
Innie
I
Chen
Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB; Division of Maternal-Fetal Medicine, University of Alberta, Edmonton AB.
Sujata
S
Chandra
Division of Infectious Diseases, University of Alberta, Edmonton AB.
Ameeta
A
Singh
Division of Neonatal Intensive Care, University of Alberta, Edmonton AB.
Manoj
M
Kumar
Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB; Division of Maternal-Fetal Medicine, University of Alberta, Edmonton AB.
Venu
V
Jain
Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB; Division of Maternal-Fetal Medicine, University of Alberta, Edmonton AB.
Roger
R
Turnell
D000293:Adolescent; D001805:Blood Transfusion, Intrauterine; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D013590:Syphilis, Congenital / Q000150:complications*