Pregnancy and syphilis - risks for the fetus and mother, diagnosis and treatment

Syphilis is an infectious disease caused by the Treponema pallidum spirochete. It can be transmitted through unprotected or blood-to-blood contact - through transfusions or the use of contaminated medical instruments. Also, a pregnant woman infected with syphilis can transmit the fetus infection. It does not manifest immediately after the infection. Only three weeks later, the infected person may notice the appearance of painless lesions (syphilis) at the level of the genitals. Infected during pregnancy, the most likely mother will transmit the fetus, the bacterium crossing the placenta at any stage of the pregnancy.

The more maternal contamination occurs later in pregnancy, the higher the risk of the newborn being infected. Treatment before the fourth month of pregnancy can help to avoid the risk of fetal illness. Risks of Syphilis Infection in Pregnancy The most important risk that may arise in pregnant women is spontaneous abortion. Other complications include excess amniotic fluid, premature birth, and fetal death in the uterus. There are also cases when syphilis does not cause problems in pregnancy - when syphilis is not located on the cervix, it may not affect the pregnancy.

Congenital syphilis is the newborn infection transmitted during pregnancy through the placenta from the mother to the fetus and has two forms: precocious and late. Early congenital syphilis is manifested in the first year of life, and clinical changes are multiple and include several forms: low birth weight of the newborn who may have anorexia, vomiting, hydrocephalus, changes in skull shape and various malformations may be present . Late congenital syphilis occurs around the age of 9-12 years. Testing for Syphilis Diagnosis Pregnant women will be tested for syphilis during the first months of pregnancy and will repeat the test after the 28th week. In some cases, a last test is performed before birth.

The most used test to diagnose the condition is VDRL - which causes antibodies against the Treponeme pallidum antigen. For newborns with seropositive mothers or treated during the last months of pregnancy, testing for syphilis (taking blood samples and cerebrospinal fluid (CSF). Other necessary investigations are bone radiographs, ophthalmologic examination, and CSF exam. Treatment and Prevention Treatment before the fourth month of pregnancy can help avoid all the risks of fetal disease. It consists of administering the penicillin applied to both the mother and, subsequently, the newborn.

Early treatment of future mothers infected with syphilis can prevent congenital syphilis. Birth in syphilis-infected women is normal, but if they experience extensive vulvar lesions, haemorrhagic complications. To avoid contamination with maternal secretions during labor / birth, cesarean delivery is recommended. The most important measure of infection prevention is protection during sexual intercourse. Most exposed people are those who have unprotected sex, those who have unprotected sex with infected or casual partners, those who are infected with HIV, or who have sex with people infected with HIV.

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