Syphilis and pregnancy

Another infection, dangerous in terms of intrauterine infection of the fetus, is syphilis.

Like tuberculosis, syphilis was at one time considered a social disease associated with an inadequate cultural level of the population. It can not be said with certainty that this is not the case, since the successes in the fight against it were at face value. A special role was played by the fact that patients with syphilis were looked for almost as criminals (with the police) and forcibly treated, thus interrupting the further chain of infection. Today, approaches to identifying and treating this disease have changed somewhat. And if even 15-20 years ago, a demonstration to students of a medical patient with syphilis was a rare success for the teacher, but now this infection has again become very common in the society.

Congenital syphilis as the cause of stillbirths occurs in 0.5-0.8% of cases. Infection of the fetus occurs irrespective of whether the woman was ill before pregnancy or when she was infected during or after conception. Moreover, the fetus is affected earlier, the shorter the period from the moment of infection. Thus, if a woman has several pregnancies after infection, then at each subsequent risk of intrauterine infection decreases and pregnancy can even result in the birth of a healthy child. However, it should be noted that the birth of a healthy child is observed nevertheless mainly in the treated women.

Usually intrauterine infection of the fetus with a pale spirochete (the causative agent of syphilis) occurs between 6 and 8 months of pregnancy (very rarely before). And spirochetes immediately get to the fetus, and only later the placenta is damaged. Once in the body of the fetus, spirochetes multiply and cause specific changes in its tissues. Most often the liver, lungs, bone tissue are affected.

In addition to the changes listed above, neonates with congenital syphilis have other symptoms: rhinitis (syphilitic rhinitis), pemphigus (blisters on the skin), and, unlike pemphigus caused by pyogenic microorganisms (staphylococci), with syphilitic pemphigus, blisters can appear on the palms and feet of the newborn. Symptoms of congenital syphilis may not appear immediately, but after a while (up to 10 weeks).

The placenta is affected only after the fetus is infected. In the umbilical vessels, spirochaetes enter the placenta and cause damage to the walls of the vessels. These changes are widespread and seriously disrupt all functions of the placenta. If this happens, the fetus dies in utero and the pregnancy ends with either miscarriage or premature birth.

According to statistical data, spontaneous abortions in women with syphilis are found in 10-15% of cases, stillbirths in 5-50%, birth of sick children in 20-30% of cases. Prevention of congenital syphilis consists in the fact that all pregnant women infected with syphilis undergo serological examination 2 times: 1 time in the first half of pregnancy and 1 time in the second. If a woman has signs of active syphilis, then she is being treated.

Specific antisyphilitic treatment should be started from the very beginning of pregnancy in order to prevent the transition of pale spirochetes through the placenta in a timely manner. During subsequent pregnancies, the treatment of syphilis must be repeated. As well as with tuberculosis, the treatment of syphilis is carried out taking into account the possibility of the emergence of medical fetopathies. Treatment is also carried out by newborns, even in cases when the mother received a full course of antisyphilitic therapy.