妊娠合并梅毒126例妊娠结局分析

目的 探讨妊娠合并梅毒患者治疗后的妊娠结局及对围生儿预后的影响.方法 收集浙江中医药大学附属杭州西溪医院妇产科2010年4月至2013年3月126例妊娠合并梅毒病例的临床资料并进行回顾性分析,根据是否行驱梅治疗,将90例接受治疗的孕妇作为治疗组,36例未治疗的孕妇作为对照组,观察两组孕妇的妊娠结局及对围生儿预后的影响.结果 本组孕妇中仅53.97％（68/126）接受了常规产前检查,38例孕早期开始驱梅治疗.治疗组足月产率达93.33％（84/90）,对照组足月产率仅55.56％（20/36）,两组比较差异有统计学意义（x2=27.60,P＜0.01）.孕早期治疗组未出现流产、死胎及新生儿异常.孕中晚期治疗组上述情况发生率也明显低于对照组,且差异有统计学意义（11.54％：44.44％,x2=12.30,P＜0.05）；孕中晚期治疗组的新生儿先天性梅毒发生率（3.41％）也低于对照组（29.63％）,差异有统计学意义（x2=6.20,P＜0.05）.隐性梅毒孕妇的妊娠结局也优于其他各期梅毒.结论 妊娠早期开展梅毒筛查,并进行规范驱梅治疗可显著减少母婴传播,降低胎儿及新生儿异常的发生率,显著改善妊娠结局及新生儿预后.

Analysis on the pregnancy outcome of 126 pregnant women with syphilis

Objective To investigate the outcome of pregnant women after treatment of syphilis and the effect on perinatal prognosis.Methods The clinical data of 126 pregnant women with syphilis in Hangzhou Xixi Hospital affiliated to Zhejiang Chinese Medical University from April 2010 to March 2013 were retrospectively analyzed.The patients were divided into treated group （n=90） and control group （n=36） in light of the patient＇s acceptance of full course anti-syphilis therapy or not.The pregnant outcomes and perinatal prognosis were compared between the two groups.Results Of 126 patients,only 68 cases（53.97%） received prenatal examination and 38 cases accepted anti-syphilis therapy in early pregnancy.The term delivery rate was 93.33% （84/90） in treated group and 55.56% （20/36） in control group （x2=27.60,P〈0.01）.No abortion,stillbirth,and neonatal abnormality were seen in pregnant women who accepted treatment of syphilis in early pregnancy.The pregnant women who accepted the treatment of syphilis in middle and late pregnancy had lower incidence of these events （11.54% vs 44.44%,x2=12.30,P〈0.05） and fewer newborns with congenital syphilis （3.41% vs 29.63%,x2=6.20,P〈 0.05） than controls did.The pregnancy outcome of pregnant women with recessive syphilis also outperformed that of patients with other stage syphilis.Conclusions Syphilis screening and relevant treatment in early pregnancy may decrease mother-infant transmission and reduce the incidence of abnormal fetuses and newborns.