妊娠合并梅毒回顾分析

目的　探讨妊娠梅毒的临床分期特征及妊娠结局 ,降低先天梅毒发病率。方法　根据妊娠期血清学检查确诊 4 8例梅毒孕妇。治疗组 2 9例 ,经全疗程抗梅毒治疗 ,采用苄星青霉素 2 4 0万单位肌肉注射 ,每周 1次连续 3周 ,未治疗组 19例 ,比较两组妊娠结局。结果　在孕 2 0周确诊 35例 (72 9% ) ,除 1例 (2 1% )为Ⅰ期梅毒 ,潜伏期梅毒 4 7例 (97 9% ) ;治疗组人流 5例 ,妊娠至围产期的孕妇有 2 4例 ,其中死胎及引产均为 0 ,新生儿先天梅毒 2例 (8 0 % ) ,P均 <0 0 1,低于未治疗组。结论　妊娠合并梅毒的临床分期以潜伏梅毒为主 ,常规筛查特别重要 ;妊娠合并梅毒有不良结局 ,但早期实施规范的抗梅毒治疗 ,能显著的控制围产儿死亡 ,并能显著地降低新生儿先天梅毒的发生。

Reviewed analysis of pregnant syphilis

Objective To investigate clinic stage and pregnancy outcomes of syphilis infection during pregnancy.Methods 48 pregnant women diagnosed with syphilis by serological assays were divided into treated group and untreated group.29 patients in the treated group accepted benzatheine benzyl penicillin(2.4 million units once per week) intra muscular injection for three weeks.The outcomes of pregnancy after treatment was observed and compared between the two groups.Results There were 35 cases diagnosed in 20 weeks pregnancy(72.9%).There were 1 case of primary syphilis(2.1%) and 47 cases of latent syphilis(97.9%).In the treatment group the occurrences of still birth and induction of labor were 0,and there were 2 cases of congenital syphilis in total 24 cases finishing pregancy(0.0% and 8.0%),which were lower than untreated group P<0.01.Conclusion 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.Fetal death and congenital syphilis can be well controlled through regular and early treatment during pregnancy.