妊娠梅毒治疗时机与妊娠结局的关系分析

目的探讨妊娠梅毒在不同时期诊断及治疗对妊娠结局的影响。方法回顾性分析本院2006年~2010年5年里筛查的24859例孕妇中确诊为妊娠梅毒150例患者妊娠结局及预后情况,并按照孕早期、孕中期、孕晚期即不同治疗时机进行分类统计。结果妊娠梅毒近5年的发病率从4.88‰到7.67‰呈逐渐上升的趋势。150例妊娠梅毒患者中,孕早期诊断和治疗的妊娠梅毒患者娩出先天梅毒儿4例(7.55%)未发现不良结局,孕中期组娩出先天梅毒儿18例(45%),不良结局的发生率20.45%。孕晚期娩出先天梅毒儿27例(84.38%),不良结局的发生率66.03%。结论早期的治疗对改善妊娠梅毒的预后有积极意义,因此积极规范开展孕前、孕早期血清学的筛查工作,及时有效地抗梅治疗,有效完善的跟踪随访,既可治愈孕妇梅毒,又可改善妊娠结局和围产儿预后,减少胎传梅毒的发生。

The relationship between pregnancy syphilis treatment timing and pregnancy outcome

Objective To explore the effect of diagnosis and treatment at different stages on pregnant women with syphilis and possible outcomes,Methods 150 subjects diagnosed as syphilis were analyzed retrospectively from 24859 pregnant women treated in the hospital from 2006 to 2010 and classified as different stages of pregnancy.Results It was found that incidences of pregnant syphilis increased from 4.88‰ to 7.67‰ in five years.Among the 150 cases,women with syphilis at early stage of pregnancy,if treated,delivered 4(7.55%) babies with congenital syphilis,and no harmful effects were found.Those in mid-pregnancy delivered 18(45%) babies with congenital syphilis and incidences of harmful effects were 20.45% and late pregnancy delivered 27(84.38%) babies with congenital syphilis and incidences of harmful effects were 66.03%.Conclusion Early treatment has a positive effect on the prognosis of the patients with pregnant syphilis standard serological assays before pregnancy and in-pregnancy.Full-course anti-syphilis therapy and effective inquiries not only improve the outcomes of pregnancy with syphilis,prognosis of neonates but also reduce incidence of congenital syphilis.