Syphillis in pregnancy

Question 1

What is Syphillis in pregnancy

Answer 1

Syphillis is systemic ifnecion caused by gram -ve spriochete (trepanema pallidium)
Sexual contact, blood born, vertical
RF - young, african american, other STI, drugs

Question 2

Sx of Syphillis in pregnancy

Answer 2

See other gyne card-
but over all
primary - large painless chancre
2nd ary (25% get it)- rough rash on hand/feet/trunks, uvueitis)
latent- mx guide if >2y since Sx

tertiary -
gummatour, cardiovasc or neurosyph

Question 3

Ix of Syphillis in pregnancy

Answer 3

Microbiology - Darkground, PCR
Serology - routine antenatal screen for all preg -for antibodies
(take 3m for antibodies to show up)
Non treponomal test have high fasle +ve- RPR (rapid plasmin reagin), VDRL

Trepanomal test -
EIA,
TPHA (heamagluttinin assay
FTAABS

Question 4

Mx of Syphillis in pregnancy

Answer 4

Earlyt - IM bezathin-Pen or doxy 14d
Late latent, 3rd- IM benzathine pen, 3/52 *or doxy 28d
Neurosyphilis - IV benzathinpen or doxy 28d + prednisolne

Question 5

Complications of Syphillis in pregnancy

Answer 5

Congenital syphilis 0 PTL, Still birth, misscariage

rash on soles and hands, bloody retinitis
Hepatosplenomegaly, glomerulonephritis

Hutchisnons teeth -small widely spaced
Frontal bosing of skull
Sabers shins - bowing
Cluttons joints- symetrical knee swelling