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妊娠合并梅毒的临床分析

Syphilis in pregnancy women

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【作者】 吕军黄彩霞曾燕丁红杨新孔欣陈春林

【Author】 L Jun *, HUANG Caixia, ZENG Yan,et al *First Municipal People Hospital of Guangzhou, Guangzhou 510180, China

【机构】 广州市第一人民医院妇产科广东省武装警察部队医院妇产科广东省顺德市第一人民医院妇产科中山医科大学第二附属医院妇产科广州市第一人民医院妇产科 510180510180

【摘要】 目的 探讨妊娠合并梅毒的临床分期特点及妊娠结局 ,降低先天梅毒的发生率。方法根据妊娠期是否行全疗程抗梅毒治疗 ,将 64例经血清学检查确诊为梅毒的孕妇分为两组 :治疗组 3 1例 ,行全疗程抗梅毒治疗 ,应用苄星青霉素 2 4 0万单位肌内注射 ,每周 1次连续 3周 ;未治疗组 3 3例 ,未能行全疗程抗梅毒治疗。比较两组孕妇的妊娠结局。结果  ( 1) 64例妊娠合并梅毒患者中 ,一期5例 ( 7 8% )、二期 2 9例 ( 4 5 3 % )及潜伏梅毒 3 0例 ( 4 6 9% ) ;其中治疗组分别为 4例、2 0例及 7例 ,未治疗组分别为 1例、9例及 2 3例。 ( 2 )治疗组孕妇早产、死胎、死产均为 0 ,新生儿先天梅毒为 3例( 9 7% )。未治疗组早产 4例 ( 12 1) ,死胎 11例 ( 3 3 3 ) ,死产 3例 ( 9 1) ,新生儿先天梅毒 10例 ( 3 0 3 ) ,两组比较 ,差异有显著性 (P <0 0 5 )。结论  ( 1)妊娠合并梅毒患者的临床分期以潜伏梅毒为主 ,由于症状及体征不明显 ,容易误诊。因此 ,对梅毒高危孕妇的常规梅毒筛查特别重要。 ( 2 )妊娠合并梅毒患者有不良妊娠结局 ,但在妊娠期行规范并及早的抗梅毒治疗 ,能很好地控制早产、死胎 ,但不能明显降低新生儿先天梅毒的发生。

【Abstract】 Objective To investigate obstetric treatment and pregnacy outcomes of syphilis infection during pregnancy Methods 64 pregnant women diagnosed with syphilis by serological assays were divided into treated group and untreated group according to whether they accepted full dose treatment against syphilis or not Patients in the treated group accepted benzathine penicillin(2 4 million units once per week)intramuscular injection for three weeks The outcome of pregnan after treatment was observed and compared between the two groups Results There were 5 cases of primary syphilis (7 8%), 29 cases of secondary syphilis (45 3%), and 30 cases of latent syphilis (46 9%) among the 64 cases The occurrences of premature birth, fetal intrauterine death, and stillbirth were 0, and 3 cases of congenital syphilis in total 13 cases who carried pregnancy to term in the treated group; while 4, 11, 3, and 10 in the untreated group respectively In treated group, the 3 babies with congenital syphilis were born from 10 mothers received treatment after 24 gestational weeks, while no congenital syphilis in the 3 women started treatment before 24 weeks Conclusions 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 Premature, fetal death and congenital syphilis can be well controlled through regular and early treatment during pregnancy, yet congenital syphilis can not be avoided completely

  • 【文献出处】 中华妇产科杂志 ,Chinese Journal of Obstetrics and Gynecology , 编辑部邮箱 ,2001年08期
  • 【分类号】R714.25
  • 【被引频次】84
  • 【下载频次】496
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