妊娠合并梅毒的临床分析

目的 探讨妊娠合并梅毒的临床分期特点及妊娠结局，降低先天梅毒的发生率。方法 根据妊娠期是否行全疗程抗梅毒治疗，将64例经血清学检查确诊为梅毒的孕妇分为两组：治疗组31例，行全疗程抗梅毒治疗，应用苄星青霉素240万单位肌内注射，每周1次连续3周；未治疗组33例，未能行全疗程抗梅毒治疗。比较两组孕妇的妊娠结局。结果（1）64例妊娠合并梅毒患者中，一期5例（7．8％）、二期29例（45．3％）及潜伏梅毒30例（46．9％）；其中治疗组分别为4例、20例及7例，未治疗组分别为1例、9例及23例。（2）治疗组孕妇早产、死胎、死产均为0，新生儿先天梅毒为3例（9．7％）。未治疗组早产4例（12．1），死胎11例（33．3），死产3例（9．1），新生儿先天梅毒10例（30．3），两组比较，差异有显著性（P＜0．05）。结论 （1）妊娠合并梅毒患者的临床分期以潜伏梅毒为主，由于症状及体征不明显，容易误诊。因此，对梅毒高危妇的常规梅毒筛查特别重要。（2）妊娠合并梅毒患者有不良妊娠结局，但在妊娠期行规范并及早的抗梅毒治疗，能很好地控制早产、死胎，但不能明显降低新生儿先天梅毒的发生。

Sexual Transmitted Disease in Pregnancy Syphilis in pregnancy women

Objective To investigate obstetric treatment and pregnacy outcomes of syphilis infection during pregnancy Methods 64 pregnant women diagnosed with syphilis by serological assays were divided into treated group and untreated group according to whether they accepted full dose treatment against syphilis or not Patients in the treated group accepted benzathine penicillin(2 4 million units once per week)intramuscular injection for three weeks The outcome of pregnan after treatment was observed and compared between the two groups Results There were 5 cases of primary syphilis (7 8%), 29 cases of secondary syphilis (45 3%), and 30 cases of latent syphilis (46 9%) among the 64 cases The occurrences of premature birth, fetal intrauterine death, and stillbirth were 0, and 3 cases of congenital syphilis in total 13 cases who carried pregnancy to term in the treated group; while 4, 11, 3, and 10 in the untreated group respectively In treated group, the 3 babies with congenital syphilis were born from 10 mothers received treatment after 24 gestational weeks, while no congenital syphilis in the 3 women started treatment before 24 weeks Conclusions Pregnant syphilis is prone to be misdiagnosed because of its slight symptom, so it is especially important to screen syphilis as a routine among high risk pregnant women Premature, fetal death and congenital syphilis can be well controlled through regular and early treatment during pregnancy, yet congenital syphilis can not be avoided completely