Syphilis and pregnancy: early diagnosis and timely treatment
DOI:
https://doi.org/10.18597/rcog.353Keywords:
syphilis, syphilis during pregnancy, gestational syphilis, pregnancyAbstract
Objective: this article presents a review of the epidemiology, clinical manifestations, diagnosis, treatment strategies, monitoring and prevention of gestational syphilis.
Materials and methods: Cochrane, Pubmed/ Medline, Scielo, Ovid, LILACS databases and medical journals and literature and the Cauca department’s Health Secretariat’s figures were searched using the following keywords: syphilis, syphilis in pregnancy, gestational syphilis and pregnancy, emphasising information made available during the last five years. 72 references were found; the 37 most relevant ones were chosen, mainly taking into account meta-analyses, randomised controlled trials, review articles, bulletins, texts, protocols and clinical guidelines.
Results: 110,000 newborn suffering from congenital syphilis were reported in Latin-America and the Caribbean in 2003, being the children of 330,000 women who had not received treatment during their antenatal controls. Early identification and timely treatment of syphilis may prevent complications such as gestational or perinatal foetal death, low birth weight, neonatal disease or latent infection which may lead to late sequelae.
Conclusion: great difficulty is found in trying to achieve early detection and offering accurate treatment to all infected women. This has meant that this disease’s incidente is still increasing and the goal of eradicating congenital syphilis has not been accomplished, even though penicillin is still the medication of choice. Strategies aimed at providing suitable antenatal control should be strengthened to ensure achieving this objective.
Author Biographies
Rodolfo L. Casas-P.
Magda Rodríguez
Jorge Rivas
References
Revollo R, Tinajeros F, Hilari C, García SG, Zegarra L, Díaz-Olavarrieta C. Sífilis materna y congénita en cuatro provincias de Bolivia. Salud pública Mex 2007;49:422-8.
Instituto Nacional de Salud de Colombia. Protocolo de vigilancia de sífilis gestacional y congénita; 2007. Visitado en 2008 Jul 24. Disponible en: www.ins.gov.co/?idcategoria=5599&download=Y.
Ministerio de Salud. Resolución 412. Normas técnicas y guías de atención integral; versión actualizada 2007. Visitada en 2008 Ago 10. Disponible en: http://www.saludcolombia.com/Actual/htmlnormas/ntsifili.htm.
Walker G. Antibiotics for syphilis diagnosed during pregnancy. [Systematic Review] Cochrane Pregnancy and Childbirth Group. Cochrane Database of Systematic Reviews 2001, Issue 3, Art. No.: CD001143.
Deperthes BD, Meheus A, O’Reilly K, Broutet N. Maternal and congenital syphilis programmes: case studies in Bolivia, Kenya and South Africa. Bull World Health Organ 2004;82:410-6.
Yahya-Malima KI, Evjen-Olsen B, Matee MI, Fylkesnes K, Haar L. HIV-1, HSV-2 and syphilis among pregnant women in a rural area of Tanzania: prevalence and risk factors. BMC Infect Dis 2008;8:75.
Blandford JM, Mwesigwa-Kayongo D, Narkunas D, Schmid GP, Neilsen GA, Ballard RC, et al. Onsite rapid antenatal syphilis screening with an immunochromatographic strip improves case detection and treatment in rural South African clinics. Sex Transm Dis 2007;34:S55-60.
Blandford JM, Gift TL, Vasaikar S, Mwesigwa-Kayongo D, Dlali P, Bronzan RN. Cost-effectiveness of on-site antenatal screening to prevent congenital syphilis in rural eastern Cape Province, Republic of South Africa. Sex Transm Dis 2007;34:S61-6.
Levin CE, Steele M, Atherly D, García AG, Tinajeros F, Revollo R, et al. Analysis of the operational costs of using rapid syphilis tests for the detection of maternal syphilis in Bolivia and Mozambique. Sex Transm Dis 2007;34:S47-54.
Centers for disease control and prevention (CDS). Sexually transmitted diseases treatment guidelines. Atlanta; 2006.
Organización Panamericana de la Salud.Unidad de VIH/SIDA. Eliminación de sífilis congénita en América Latina y el Caribe: marco de referencia para su implementación. Washington, D.C.; 2004. Visitado en 2008 Ago 13. Disponible en: http://www.paho.org/Spanish/AD/FCH/AI/eliminasifilislac.pdf.
Zetola NM, Engelman J, Jensen TP, Klausner JD. Syphilis in the United States: an update for clinicians with an emphasis on HIV coinfection. Mayo Clin Proc 2007;82:1434.
Sangani P, Rutherford G, Wilkinson D. Population based interventions for reducing sexually transmitted infections, including HIV infection. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD001220.
Agudelo A, Montoya J. Infecciones Propias de la Mujer. 1a. ed. Cali, Colombia: Editorial Feriva; 2001.
Fonck K, Claeys P, Bashir F, Bwayo J, Fransen L, Temmerman M. Syphilis control during pregnancy: effectiveness and sustainability of a decentralized program. Am J Public Health 2001;91:705-7.
Genç M, Ledger W. Syphilis in pregnancy. Sex Transm Infect 2000;76:73-9.
World Health Organization. Global prevalence and incidence of selected curable sexually transmitted diseases: Overview and estimates. Geneva: WHO; 2001. (WHO/CDS/CSR/EDC/2001.10). Visitado en 2008 Jul 25. Disponible en: http://www.who.int/hiv/pub/sti/pub7/en/.
Organización Mundial de la Salud en nombre del Programa Especial de Investigaciones y Enseñanzas sobre Enfermedades Tropicales (TDR). El uso de las pruebas rápidas para sífilis. The Sexually Transmitted Diseases Diagnostics Initiative (SDI). Iniciativa de Métodos de Diagnóstico para las Enfermedades de Transmisión Sexual (IMDETS); 2007. p. 7-25.
Gallego L, Vallejo WE. Guía: diagnóstico y manejo de la sífilis gestacional y congénita. Nacer Centro Asociado al CLAP/SMR -OPS/OMS de la Universidad de Antioquia; 2007. p. 3-10.
Organización Panamericana de la Salud. Resolución: 116a Reunión del Comité Ejecutivo de la OPS; XXXVIII Reunión del Comité Regional de la OMS para las Américas. Documento oficial CD38/15. Washington, D.C.: OPS; 1995.
Noyola DE, Malacara-Alfaro O, Lima-Rogel V, Torres-Montes A. Seroprevalencia de sífilis en mujeres embarazadas en San Luis Potosí. Salud pública Méx 2006;48:151-4.
Secretaría de Salud Departamental del Cauca. Sífilis gestacional [programa de computador]. SIVIGILA versión 2008. Popayán, Cauca; 2007.
Cabero L, Saldivar D, Cabrillo E. Obstetricia y medicina materno-fetal. Enfermedades infecciosas y embarazo II. Madrid, España: Editorial Panamericana; 2007. p. 721-24.
Emmert DH, Kirchner JT.Sexually transmitted diseases in women. Gonorrhea and syphilis. Postgrad Med 2000;107:181-4.
Ohyama M, Itani Y, Tanaka Y, Goto A, Sasaki Y. Syphilitic placentitis: demonstration of Treponema pallidum by immunoperoxidase staining. Virchows Arch A Pathol Anat Histopathol 1990;417:343-5.
Kiss H. Universal antenatal screening for syphilis: is it still justified economically? A 10-year retrospective analysis. Eur J Obstet Gynecol 2004;112:24-8.
Hammerschlag MR, Rawstron SA, Bromberg K. Sexually transmitted diseases. En: Krugman S, Gershon AA, Hotetz PJ, Katz SL. Krugman’s infectious diseases of children. 11 ed. Philadelphia: Mosby; 2004.
Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev 1995;8:1-21.
Berdasquera Corcho D, Gala González A, Oropesa González L, Suárez Larreinaga CL. El control de la sífilis reciente. Rev Cubana Med Gen Integr 2006;22:4.
Myer L, Wilkinson D, Lombard C, Zuma K, Rotchford K, Karim S. Impact of on-site testing for maternal syphilis on treatment delays, treatment rates, and perinatal mortality in rural South Africa: a randomised controlled trial. Sex Transm Infect 2003;79:208-13.
Lumbiganon P, Piaggio G, Villar J, Pinol A, Bakketeig L, Bergsjo P, et al. The epidemiology of syphilis in pregnancy. Int J STD AIDS 2002;13:486-94.
Benzaken AS, Galbán García E, Sardinha JC, Dutra Junior JC, Peeling R. Rapid tests for diagnosing syphilis: validation in an STD clinic in the Amazon Region, Brazil. Cad Saude Publica 2007;23:S456-64.
Peeling RW, Ye H. Diagnostic tools for preventing and managing maternal and congenital syphilis: an overview. Bull World Health Organ 2004;82:439-6.
Goh BT. Syphilis in adults. Sex Transm Infect 2005;81:448-2.
Jacques SM, Qureshi F. Necrotizing funisitis: a study of 45 cases. Hum Pathol 1992;23:1278-1.
Riedner G, Rusizoka M, Todd J, Maboko L, Hoelscher M, Mmbando D, et al. Single-dose azithromycin versus penicillin G benzathine for the treatment of early syphilis. N Engl J Med 2006;354:204-5.
Valderrama J, Zacarías F, Mazin R. Sífilis materna y congénita en América Latina: un problema grave de solución sencilla. Rev Panam Salud Pública 2004;16:211-7.
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