Fetüslerin Sifilizden Zarar Görmemesi: Antenatal Bakım, Maternal ve Neonatal Sonuçlar

Abstract

Amaç: Sifiliz insanlık tarihi kadar eski bir hastalıktır. Gebelikte tedavi edilmeyen sifiliz, ölü doğum da dahil ciddi prenatal sonuçlara ve konjenital sifilize neden olabilir. Dünya Sağlık Örgütü, obstetrik ve jinekoloji dernekleri ilk antenatal muayenede sifilizin taranmasını önermektedir. Bu çalışmada, gebeliğinde sifiliz enfeksiyonu saptanan hastaların, antenatal takipleri, maternal ve neonatal sonuçlarının tartışılması amaçlanmıştır. Gereç ve yöntemler:Gebelik sırasında sifiliz tanısı alan hastalar çalışmaya dahil edildi. Hastalar Non-Treponomal test(RPR) ile tarandı ve pozitif sonuçlar Treponemal test(TP-HA) ile doğrulandı. Antenatal bakılar, maternal ve neonatal sonuçlar, sifiliz tedavisi, yenidoğanın muayene bulguları, sifiliz tedavi takibini içeren hasta verileri retrospektif olarak hastane kayıt sistemi ve hasta telefon görüşmeleri ile elde edilerek değerlendirildi. Bulgular:Yaklaşık 2.5 yıllık süreçte 24427 hasta gebeliğinin ilk antenatal muayenesinde sifiliz için RPR testi ile taranmıştır. On hastaya Treponemal test (TP-PA) ile doğrulanarak sifiliz tanısı koyulmuştur. Tüm hastalara,1 hafta aralıklarla 3 doz Penisilin Benzatin G 2.4 milyon ünite intramuskuler yolla tedavi uygulandı. Tüm kadınlar miadında, komplikasyonsuz olarak doğum yaptı. Hastaların yüzde 40'ı gestasyonel diyabetes mellitus tanısı aldı. Konjenital sifiliz olgusu saptanmadı. Hiçbir hastada eşlik eden HIV ve HCV enfeksiyonu saptanmadı. Sonuç:Sifiliz için eradikasyon mümkündür. İlk antenatal kontrolde erken tarama ve penisilin ile yeterli tedavi, maternal ve konjenital sifilizi ortaya çıkmasını engelleyecek ve bebeklerin sifilizin etkilerinden kurtarılmasını sağlayacaktır.

Keywords

• Sifiliz
• gebelikte sifiliz
• Non-treponemal test
• Treponemal test
• Penisilin benzatin G

Recovering Fetuses from Syphilis: Antenatal Care, Maternal, and Neonatal Outcomes

Abstract

Objective: Syphilis is a disease as old as human history.Untreated syphilis during pregnancy can cause serious prenatal adverse outcomes, including stillbirth, and congenital syphilis. World Health Organization, obstetrics and gynecology societies recommends screening syphilis at the first antenatal care visit. In this present study, it was aimed to discuss antenatal follow-up, maternal and neonatal outcomes of patients having syphilis infection during pregnancy. Material and Method: Patients diagnosed with syphilis during pregnancy were included in the study. Patients were screened by a Non-Treponomal test and positive results were confirmed by the Treponemal test. Patients data including antenatal examinations, maternal and neonatal results, syphilis treatment, newborn examination findings, syphilis treatment follow-up were obtained and evaluated retrospectively through the hospital registry system and telephone interviews. Results: The total number of patients who were screened with RPR in the first antenatal visit of the pregnancy over two and a half years period was 24427. Ten patients were diagnosed with syphilis by Treponemal test (TP-PA) confirmation. All patients were treated by three doses of Penicillin Benzathine G 2.4 million units via intramuscular route each at a one-week interval. All women gave birth at term without complication. Forty percent of patients diagnosed gestational diabetes mellitus. No congenital syphilis occurred. None of the patients had concomitant HIV and HCV infection. Conclusion: Eradication is possible for syphilis. Early detection at the first antenatal visit and adequate treatment with penicillin would prevent maternal and congenital syphilis, and recover babies from adverse outcomes of syphilis.

Keywords

• Non-treponemal test
• Treponemal test
• Syphilis
• syphilis in pregnancy
• Penicillin benzathine G

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