title: [Pregnancies complicated by maternal syphilis and fetal death].
abstract: OBJECTIVE
  To describe the characteristics of pregnancies complicated by maternal syphilis and fetal death.
  
  
  METHODS
  Retrospective descriptive study performed by reviewing the medical records of 48 pregnant women with maternal syphilis and fetal death outcome admitted to Hospital Geral de Nova Iguaçu, Baixada Fluminense, State of Rio de Janeiro, during the period from 2005 to 2008. Birth weight >500 g and fetal death documented by Death Certificate were the inclusion criteria. The following aspects were analyzed: sociodemographic factors, reproductive history, aspects of the current pregnancy, prenatal care, Venereal Disease Research Laboratory (VDRL) testing, and other gestational conditions, in addition to syphilis. The fetal deaths were classified as maternal, placental or fetal. Percentage, mean, standard deviation (SD), maximum and minimum values were reported.
  
  
  RESULTS
  The mean maternal age was 22.7 years (SD=0.9 years), and at least 50% of the patients had low educational level. At hospital admission, 68.8% of the subjects were in the third trimester, with a mean gestational age of 29.2 weeks (SD=0.5), and more than 50% were in labor. The vast majority of fetal deaths (93%) occurred before maternal hospitalization. Among the patients who received prenatal care (54.2%), 30.8% had no VDRL test, 30.8 and 15.4% had a reactive and non-reactive result, respectively, and none had more than one prenatal VDRL test. At the time of childbirth, most of the mothers (95.8%) carried out VDRL testing. Overall, the VDRL titers varied from 1:1 to 1:512, with predominant values >1:4 (91.7%). In 23% of cases other clinical conditions related to fetal death, in addition to syphilis, were found.
  
  
  CONCLUSIONS
  The infection was the main clinically identified cause of fetal death in this patient series. Fetal death occurred during the preterm period and in the presence of high titers of maternal infection, suggesting recent syphilis infection.
authors.affiliation: Clínica de Ginecologia, Hospital Geral de Nova Iguaçu, Nova Iguaçu, RJ, Brasil.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: do Nascimento
authors.forename: Alfredo de Almeida
authors.initials: Ade A
authors.lastname: Cunha
authors.forename: Elisângela Victor
authors.initials: EV
authors.lastname: Guimarães
authors.forename: Felipe Silva
authors.initials: FS
authors.lastname: Alvarez
authors.forename: Sandra Regina Dos Santos Muri
authors.initials: SR
authors.lastname: Oliveira
authors.forename: Eduardo Loyola
authors.initials: EL
authors.lastname: Villas Bôas
mesh_terms: D000328:Adult; D005260:Female; D005313:Fetal Death / Q000382:microbiology*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D012189:Retrospective Studies; D013587:Syphilis / Q000453:epidemiology; D055815:Young Adult