31例妊娠梅毒诊疗分析

目的 探讨妊娠梅毒的临床表现、诊断治疗方法及预后.方法 回顾性分析31例妊娠梅毒的临床表现、诊断治疗及预后情况.结果 31例孕母均未见有皮疹及其他梅毒相关临床体征.10例妊娠梅毒在妊娠早期、晚期各进行水剂青霉素联合苄星青霉素治疗一个疗程后,所生新生儿均无临床症状,血清学滴度低于母亲或为阴性.红霉素治疗及妊娠晚期开始青霉素治疗的孕妇所生新生儿,72.2%(13/18)血清滴度高于母亲,可伴有临床表现.结论 青霉素早期治疗妊娠梅毒是防止发生先天梅毒的有效措施,可望获得良好的妊娠结局.     

新生儿先天性梅毒30例临床分析

目的：探讨新生儿先天性梅毒的早期诊治与预后的关系。方法对该院2005～2012年收治的30例新生儿先天性梅毒的临床资料进行回顾性分析。结果新生儿梅毒的临床表现以皮疹、黄疸为主。梅毒血清学检查快速血浆反应素环状卡片试验和梅毒螺旋体血球凝集试验均阳性。选用青霉素静滴2～3周治疗,全部治愈。结论新生儿先天性梅毒早期使用青霉素静滴,疗效满意。常规开展孕期梅毒检测,早发现、早治疗,可明显降低先天性梅毒的发病率和病死率。     

新生儿先天性梅毒的早期诊断和治疗

目的 分析新生儿先天性梅毒进行早干预、早诊断、早治疗和减少新生儿病残率和死亡率的效果.方法 对28例确诊先天性梅毒的新生儿进行临床资料和治疗转归分析.结果 本组25例经治疗后,临床症状基本消失,出院后3个月复查TPHA试验均阴性.结论 对高危孕妇、高危儿常规进行筛查及随访,做到早期干预确诊、早期诊治、早期治疗.     

性传播疾病

宫颈涂片对诊断女性生殖道性传播疾病的价值；梅毒过筛检测方法ELISA、GICA、TRUST比较；二期梅毒40例口腔表现及病理分析；24例早期梅毒被误诊临床分析；妊娠合并梅毒患的医院感染控制；梅毒抗生素治疗的选择与分析（综述）；长骨X线摄片诊断早期新生儿无症状先天性梅毒的价值；青霉素G脱敏治疗二期复发性梅毒1例；新生儿先天性梅毒的临床分析与随访。     

宁波市2018-2021年新生儿先天性梅毒的流行病学特征调查分析

目的 分析宁波市2018-2021年新生儿先天性梅毒的流行病学特征,为新生儿先天性梅毒的防治提供参考依据.方法 收集宁波市2018年2月至2021年1月妇产医院接诊的新生儿2 183例临床资料,统计不同年份所有新生儿先天性梅毒的发生率,根据不同年龄阶段及性别分析流行病学特征.依据是否发生先天性梅毒将所有患儿分为发生组与...     

32例早期先天梅毒的诊疗分析

目的探讨早期先天梅毒的临床表现及诊断治疗方法。方法回顾性分析中国医科大学附属二院2003～2005年收治的32例早期先天梅毒的临床表现及诊断治疗情况。结果100%患儿能够达到临床痊愈,血清学痊愈81.5%(22/27),血清学有效18.5%(5/27)。结论不伴有先天畸形的早期先天梅毒患儿给予正规的治疗预后良好,早期发现并给予及时正规的治疗是防止发展至晚期先天梅毒的有效措施。     

163例新生儿感染乙型肝炎病毒流行病学分析

目的探讨精河县新生儿感染乙型肝炎病毒(以下简称HBV)的原因,并找出应对措施。方法2000年1月~2005年1月于新疆精河县医院住院分娩的2314例新生儿,对其脐带血进行乙型肝炎病毒血清学测定,分析新生儿脐带血血清两对半检测结果,找出精河县新生儿感染乙型肝炎病毒的原因及精河县孕产妇管理的应对措施。结果37.2%感染者孕母孕前期甚至孕期因各种原因未进行过乙肝两对半检测,61.4%感染者孕母孕前期或孕期感染乙肝病毒而未得到任何干预措施,22.7%感染者孕母感染乙肝病毒但却因各种原因拒绝手术分娩。结论存在问题为预防宣教不到位;孕期保健存在缺陷;感染乙型肝炎孕产妇干预治疗不到位;产时传播未得到有效控制。     

妊娠梅毒的孕期干预时机对妊娠结局的影响分析

目的探讨妊娠梅毒患者的不同干预治疗时机,对妊娠结局及新生儿先天梅毒的影响。方法收集2008年1月至2012年12月收治的妊娠梅毒孕妇,回顾性分析和比较不同干预治疗时机对妊娠梅毒患者的不良妊娠结局及新生儿先天梅毒的发生率。采用SPSS 11.5进行数据的统计分析。结果共调查妊娠梅毒孕妇127例,妊娠梅毒均经血清学检查确诊。根据患者孕期实施干预(长效青霉素治疗)时机的不同,分为A组(60例)早期规范干预组(孕20周),B组(41例)中期规范干预组(孕20-28周),C组(26例)未干预/不完整干预组。A+B组为规范干预组。不良妊娠结局总发生率A组为10.00%,B组为29.27%,C组为69.23%,差异有统计学意义(χB2=6.174,PB=0.013;χ2C=31.63,PC=0.000)。其中早产/低体重B组为26.83%,C组为50.00%,差异有统计学意义(χ2B=4.93,PB=0.026;χ2C=16.86,PC=0.000)。C组的不良妊娠结局高于规范干预的A+B组,差异有统计学意义(χ2=26.91,P=0.000);C组新生儿先天梅毒发生率为19.23%,A+B组为0.99%,差异有统计学意义(χ2=11.50,P=0.001)。快速血浆反应素球状卡片试验(RPR)滴度不同的妊娠梅毒患者,经规范干预后,规范干预组与未干预/不完整干预组的妊娠不良结局发生率差异有统计学意义(χ2高=13.01,P高=0.000;χ2低=7.65,P低=0.006),新生儿先天梅毒发生率差异也有统计学意义(χ2高=4.94,P高=0.026;P低=0.017)。结论早期规范治疗对改善妊娠梅毒患者的妊娠结局及降低先天梅毒发生率有着重要意义,不论患者RPR滴度高低,妊娠梅毒患者均应早期进行积极的规范治疗。     

南阳地区143例妊娠梅毒患者的临床及预后分析

<正>近年来,梅毒的发病率逐年上升,妊娠梅毒患者的数量也逐年增长,严重危害孕妇及新生儿的健康。梅毒是一种慢性性传播疾病,是梅毒螺旋体引起,可传染给胎儿,导致死胎、先天性梅毒、早产、私产、流产等,对围生儿造成极大危害。在妊娠期,如果对孕妇不进行治疗,60%以上的孕妇会发生不良的妊娠结果~([1])。因此,对妊娠梅毒患者进行治疗和研究,对于先天性梅毒的防治以及新生胎儿的保护具有重要的意义。本次研究对143例妊娠梅毒患者的临床特点以及预后进行研     

精河县163例新生儿感染乙肝病毒的调查分析

目的 探讨精河县新生儿感染乙型肝炎病毒(以下简称HBV)的原因,并找出应对措施.方法 2000年1月～2005年1月对新疆精河县医院住院分娩的2 314例新生儿其脐带血进行乙型肝炎病毒血清学测定,分析新生儿脐带血血清两对半检测结果,找出精河县新生儿感染乙型肝炎病毒的原因及精河县孕产妇管理的应对措施.结果 37.2%感染者孕母孕前期甚至孕期因各种原因未进行过乙肝两对半检测,61.4%感染者孕母孕前期或孕期感染乙肝病毒而未得到任何干预措施,22.7%感染者孕母感染乙肝病毒但却因各种原因拒绝手术分娩.结论 预防宣教不到位;孕期保健存在缺陷;感染乙型肝炎孕产妇干预治疗不到位;产时传播未得到有效控制.     

Maternal and perinatal risk factors associated with congenital syphilis

Objective

Mother-to-child transmission of syphilis remains an important global public health problem. Untreated intrauterine infection may result in adverse events for the fetus or newborn (NB). Maternal risk factors, such as prenatal care, early diagnosis, and appropriate treatment, significantly impact the likelihood of vertical transmission of syphilis. The purpose of this review is to evaluate maternal risk factors for congenital syphilis and the characteristics of exposed NB.

Methods

A total of 14 studies were evaluated, including 8 cohort studies, 4 cross-sectional and 2 control cases. A total of 12,230 women were included, with confirmed or highly probable congenital syphilis outcome, and 2285 NB. The studies evaluated risk factors for congenital syphilis, which were maternal, demographic, obstetric factors and characteristics of the exposed NB.

Results

Included in the risk factors studied, inadequate prenatal care and late onset, as well as inadequate or late treatment of maternal syphilis were significant risk factors for the outcome of congenital syphilis. When the time set of maternal diagnosis was correlated with neonatal infection, there was a tendency to worsen prognosis (more infected NB) in women diagnosed later in pregnancy, as well as in women who underwent few prenatal consultations and inadequate treatment. Women with recent syphilis with high VDRL titres had a higher rate of vertical transmission. The prior history of syphilis with adequate treatment was identified as a protective factor, resulting in lower rates of congenital syphilis. Among the epidemiological and demographic aspects surveyed, it was observed that young age, lower schooling, unemployment, low family income and no fixed residence were associated with higher risk of congenital syphilis.

Conclusions

The association of syphilis with adverse socio-economic conditions and inadequate prenatal care suggests that the improvement of the population's living conditions and equitable access to quality health services may have an impact on the reduction of congenital syphilis.     

Sífilis

Syphilis is an infectious disease caused by the spirochaete Treponema pallidum subsp. pallidum which is transmitted by sexual contact or vertical transmission during pregnancy. The incidence of syphilis has increased in the last years, mainly among men who have sex with men. Without treatment, the disease develops into different clinical stages, being able to present cardiovascular or irreversible neurological complications after a number of years. The disease is classified as early syphilis - primary, secondary and early latent syphilis (less than 12 months) - which is contagious, and as late syphilis - late latent and tertiary syphilis- which is rarely contagious. Diagnosis and management are often a challenge because of its diversity of manifestations and the difficulty of interpretation of serological tests. The treatment of syphilis is based on penicillin or doxycycline in allergic patients. Treatment failure because of resistance has been described with azithromycin. The follow up with a serological test is recommended in all patients with syphilis in order to ascertain cure after the treatment and to diagnose possible reinfections.     

Early syphilitic hepatitis in an immunocompetent patient: really so uncommon?

The incidence of syphilis has increased substantially over the past years, particularly in men who have sex with men. The clinical manifestations of syphilis are variable and liver involvement is uncommon, but may occur at any stage of the disease. We report a case of early syphilitic hepatitis (ESH) in an immunocompetent patient referring multiple bisexual exposures, who presented at admission with jaundice, tiredness, an ulcerated genital lesion and an increase of liver aminotransferases. During his hospital stay, he developed a skin rash, and serology for syphilis was found positive. Our case report strengthens the need to take into consideration the diagnosis of ESH in all patients with unexplained liver enzyme increase and epidemiological data of unsafe sexual exposures. Indeed, an early recognition of the clinical manifestations of syphilis can lead to a prompt treatment, and allows the prevention of the transmission of this disease to other individuals.     

Gastric syphilis: five recent cases and a review of the literature.

OBJECTIVE: To describe five cases of early syphilis with gastric involvement and to review the literature pertaining to this disorder. DATA IDENTIFICATION: Five patients were diagnosed with gastric syphilis at Kings County Hospital and the Brooklyn Veterans Affairs Hospital between 1987 and 1990. English-language articles pertaining to gastric syphilis were identified by searching MEDLINE and by manually reviewing bibliographies of retrieved articles. STUDY SELECTION: Sources containing information pertinent to the clinical manifestations and diagnosis of gastric syphilis were selected. DATA SYNTHESIS: The most common clinical manifestations of gastric syphilis are abdominal pain, vomiting, and weight loss. Endoscopic findings in the stomach range from minimal nodularity and erythema to deep ulceration. Complications of gastric syphilis include hemorrhage, gastric outlet obstruction, and perforation. The diagnosis can be confirmed by serologic testing and by demonstration of spirochetes on silver and immunofluorescent stains of gastric mucosal biopsy specimens. Response to treatment is usually prompt and complete. CONCLUSIONS: The current syphilis epidemic will likely result in an increased incidence of gastric syphilis. Unless syphilis is considered as a cause of gastric mucosal inflammation and ulceration, misdiagnosis may delay appropriate treatment, and serious complications can occur.     

Syphilis in pregnancy and the neonatal period

The recent increase in the number of cases of syphilis in the UK, including among women of reproductive age, has stimulated the need for a review of practices concerning assessment and management of syphilis in pregnancy and the neonatal period. This paper summarizes available evidence from published guidelines, primary and secondary research. Optimal management of syphilis in pregnancy and the neonatal period relies on the early diagnosis and staging of maternal disease, prompt treatment to prevent congenital syphilis, and timely assessment of newborns.     

妊娠晚期生殖道感染检测分析及对妊娠结局的影响

目的分析妊娠晚期生殖道微生物感染状况及其对妊娠结局的影响,为临床防治提供理论依据。方法选取2015年3月—2019年3月我院收治的286例妊娠晚期妇女为研究对象,入组孕妇均进行生殖道病原微生物感染的检测,分析生殖道微生物感染状况,并观察妊娠晚期生殖道感染对妊娠结局的影响。结果入组286例妊娠晚期妇女,52例(18.18%)出现生殖道病原微生物感染,其中2.10%(6/286)为滴虫感染,11.89%(34/286)为解脲支原体感染,1.40%(4/286)为沙眼衣原体感染,6.64%(19/286)为假丝酵母菌感染,共11例合并有2种或2种以上微生物感染,占3.85%;此外,妊娠晚期生殖道存在微生物感染者早产、胎膜早破、产褥期感染、胎儿窘迫、新生儿窒息和新生儿感染等不良妊娠结局发生率均明显高于无微生物感染者(P均<0.05);多重微生物感染者早产发生率明显高于单一微生物感染者(P<0.05);治愈组不良妊娠结局发生率明显低于无效组(P<0.05)。结论妊娠晚期生殖道微生物感染以解脲支原体、假丝酵母菌较为常见,且妊娠晚期生殖道微生物感染会增加孕妇不良妊娠结局发生风险,多重微生物感染会增加妊娠妇女的早产发生率,临床上可据此为妊娠期妇女制定合理的防治方案,对确保母婴良好结局有重要临床意义。     

The epidemiology of syphilis in pregnancy

This study evaluated the magnitude, risk factors and outcomes of syphilis in pregnancy in a large cohort of women in four countries participating in the World Health Organization (WHO) antenatal care trial. All women attending the first prenatal care at each selected clinic were enrolled. Screening at the first antenatal visit was routinely performed with either rapid plasma reagin or Venereal Disease Research Laboratory and confirmed by fluorescent treponemal antibody absorption. All women also had the same syphilis tests after delivery. The initial prevalence, the incidence during pregnancy and the overall prevalence of syphilis at delivery were 0.9%, 0.4% and 1.3% respectively. Risk factors for syphilis during pregnancy were younger age for the incidence and older age and a history of stillbirth for the prevalence. Women with syphilis during pregnancy had significantly more adverse outcomes. We support the recommendation that in addition to the initial testing, a second routine test for syphilis ought to be established early in the third trimester even in low prevalence areas.     

Resurgence of congenital syphilis.

As a result of the alarming increase in primary and secondary syphilis in the United States, congenital syphilis has resurged in many areas, including Detroit. Several maternal risk factors have been identified as contributing to the increase in congenital syphilis, the most important of which are poor prenatal care and the trading of sex for illicit drugs, specially "crack" cocaine. Contact tracing programs are currently ineffective. To prevent the continuing increase in congenital syphilis, a comprehensive prenatal care program starting in early pregnancy is essential. STS should be determined during pregnancy and may be required more than once in high-risk mothers. Results of STS must be verified before infants are discharged from nurseries. Obstetricians, neonatologists, pediatricians, and general practitioners should be more aware of the problem of congenital syphilis and the need for early intervention and treatment.