妊娠梅毒36例临床分析

目的回顾性分析妊娠梅毒36例,研究妊娠梅毒临床及辅助检查特点,寻求早期有效处置措施,改善妊娠结局,将梅毒对妊娠的危害降至最低。方法回顾性分析2016年6月至2020年10月于东台市中医院皮肤科性病中心门诊就诊的36例妊娠梅毒患者的资料,依次接受快速血浆反应素环状卡片试验(RPR)和梅毒螺旋体抗体明胶颗粒凝集试验(TPPA),并根据检查结果为患者实施有效治疗。结果36例妊娠梅毒患者RPR检查结果显示,滴度1∶2~1∶8之间18例,1∶16~1∶32之间12例,1∶32以上6例;TPPA检查显示患者均呈阳性。36例患者中1例临近分娩未接受治疗,1例青霉素过敏给予红霉素治疗,其余予以芐星青霉素治疗,患者中死胎1例,人工流产2例,自然流产2例。产后新生儿7例RPR阳性,TPPA检查显示均呈阳性;跟踪随访得知多数患者在1年内RPR结果转为阴性,仅有3例1年后转阴。结论妊娠梅毒患者早期运用RPR、TPPA检查方法进行诊断,并及时采取有效治疗方案进行处理,可有效预防不良妊娠结局,并改善新生儿预后情况。

Clinical analysis of 36 cases of syphilis in pregnancy

Objective To retrospectively analyze 36 cases of syphilis in pregnancy,to study the clinical and auxiliary examination characteristics of pregnancy syphilis,seek early effective treatment plan disposal measures,improve pregnancy outcomes,minimize the harm of syphilis to pregnancy.Methods A retrospective analysis of the data of 36 pregnant syphilis patients was made who came to Dongtai Hospital of Traditional Chinese Medicine from June 2016 to October 2020 and received rapid plasma reagin(RPR)and Treponema Pallidum particle assay(TPPA),and effective treatment was implemented according to the examination results.Results The RPR test results of 36 pregnant syphilis patients were 18 cases with titer of 1∶2-1∶8,12 cases with titer of 1∶16-1∶32,and 6 cases with titer of 1∶32 or above.TPPA test showed that all patients were positive.Among the 36 patients,1 case was not treated near delivery,1 case was treated with Erythromycin for Penicillin allergy,and the rest was treated with Benzathine Penicillin.Among them,1 case was stillborn,2 cases were induced abortion,and 2 cases were spontaneous abortion.7 cases of postpartum newborns were positive for RPR,and TPPA examination showed that all of them were positive;followup showed that most of the patients turned negative for RPR within 1 year,and only 3 cases turned negative after 1 years.Conclusion Early diagnosis by RPR and TPPA and timely treatment can effectively prevent adverse pregnancy outcomes and improve neonatal prognosis.