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Syphilis Symptoms in Pregnancy
Late symptoms: Although the infectivity is weak, it may cause neurosyphilis and cardiovascular syphilis, with serious consequences. Now it is wedge-shaped, saddle nose, interstitial keratitis, periostitis, nervous deafness and so on; The mortality and disability rate were significantly increased.
Syphilis Symptoms in Pregnancy
Pregnant women suffering from primary and secondary syphilis are most contagious, and syphilis pathogens multiply in fetal viscera (mainly in liver, lung, spleen, adrenal gland, etc.) and tissues, causing abortion, premature birth, stillbirth and stillbirth after 6 weeks of pregnancy.
Almost 100% of untreated pregnant women with primary and secondary syphilis are transmitted to fetuses, and more than 80% of pregnant women with early latent syphilis (infection less than 2 years, clinical no syphilis damage, positive syphilis serological test) are infected with fetuses, and 20% are premature. The probability of untreated pregnant women with advanced syphilis infecting fetus is about 30%, and the probability of pregnant women with advanced latent syphilis (infected for more than 2 years, without syphilitic damage in clinic and positive syphilis serological test) is still 10%, although sexual contact is no longer contagious. Usually congenital syphilis accounts for about 30% of stillbirths.
If the fetus survives, the congenital mildew child (also called fetal mildew child) is delivered, and the condition is serious. Early manifestations include skin bullae, rash, rhinitis or nasal congestion, liver gland enlargement, lymph node enlargement and so on; Late congenital mycin mostly appears after 2 years old, showing cuneiform teeth, saddle nose, interstitial keratitis, periostitis, nervous deafness and so on; The mortality and disability rate were significantly increased.
Pregnancy syphilis in the diagnosis must be asked in detail whether the person and their spouses have a history of syphilis, I have a history of abortion and premature birth.
Pregnant women with syphilis must undergo syphilis serum test:
(1) Once in the first trimester and the second trimester (or late trimester) (do not do it several days before and after delivery, which is prone to false positive reaction);
② If the husband suffers from syphilis and I have no syphilis symptoms, and the serum reaction is negative, but the child has advanced syphilis symptoms before the age of 10, the mother of the child shall be treated as latent syphilis;
③ A few pregnant women can also have biological false positive reaction (mostly weak positive). If pregnant women and their spouses have no history of syphilis, symptoms of syphilis, and suspicious history in the past, they should continue to observe, do not give anti-plum treatment for the time being, and make serum reaction once every 2-3 weeks, and at the same time make serum quantitative test to observe whether the titer rises. I should have a detailed physical examination, and check whether the umbilical cord and placenta are abnormal during delivery. If there is doubt, the umbilical cord vein wall and the fetal face of placenta can be scraped for dark field microscopic examination of Treponema pallidum;
④ Pregnant syphilis often complicated with stubborn proteinuria, which can often disappear after anti-plum treatment;
⑤ In addition to a comprehensive examination of pregnant women, pregnant women with syphilis should also have a detailed examination of their spouses.
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