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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Syphilis in pregnancy</title><author><name sortKey="Genc, M" sort="Genc, M" uniqKey="Genc M" first="M." last="Genc">M. Genc</name></author><author><name sortKey="Ledger, W" sort="Ledger, W" uniqKey="Ledger W" first="W." last="Ledger">W. Ledger</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">10858706</idno><idno type="pmc">1758294</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758294</idno><idno type="RBID">PMC:1758294</idno><idno type="doi">10.1136/sti.76.2.73</idno><date when="2000">2000</date><idno type="wicri:Area/Pmc/Corpus">002F44</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002F44</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Syphilis in pregnancy</title><author><name sortKey="Genc, M" sort="Genc, M" uniqKey="Genc M" first="M." last="Genc">M. Genc</name></author><author><name sortKey="Ledger, W" sort="Ledger, W" uniqKey="Ledger W" first="W." last="Ledger">W. Ledger</name></author></analytic><series><title level="j">Sexually Transmitted Infections</title><idno type="ISSN">1368-4973</idno><idno type="eISSN">1472-3263</idno><imprint><date when="2000">2000</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p> Syphilis can seriously complicate pregnancy and result in spontaneous abortion, stillbirth, non-immune hydrops, intrauterine growth restriction, and perinatal death, as well as serious sequelae in liveborn infected children. While appropriate treatment of pregnant women often prevents such complications, the major deterrent has been inability to identify the infected women and get them to undergo treatment. Screening in the first trimester with non-treponemal tests such as rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) test combined with confirmation of reactive individuals with treponemal tests such as the fluorescent treponemal antibody absorption (FTA-ABS) assay is a cost effective strategy. Those at risk should be retested in the third trimester. Treatment during pregnancy should be with penicillin. In determining a penicillin regimen, the clinician must consider the stage of the maternal infection and the HIV status of the mother. Patients who are allergic to penicillin should be desensitised before treatment. Despite appropriate treatment, as many as 14% will have a fetal death or deliver infected infants. Treatment may further be complicated by the Jarich–Herxheimer reaction, a complex allergic response to antigens released from dead micro-organisms, which can cause fetal distress and uterine contractions. Thanks to effective intervention strategies and inexpensive penicillin, syphilis rarely complicates pregnancy in the Western world today. In parts of the world where the traditional sexually transmitted diseases have not been controlled, the magnitude of problems associated with syphilis during pregnancy is reminiscent of that faced by the West during the early 1900s. </p><p><bold>Key Words:</bold> syphilis; pregnancy</p></div></front></TEI><pmc xml:lang="EN" article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Sex Transm Infect</journal-id><journal-title>Sexually Transmitted Infections</journal-title><issn pub-type="ppub">1368-4973</issn><issn pub-type="epub">1472-3263</issn><publisher><publisher-name>BMJ Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">10858706</article-id><article-id pub-id-type="pmc">1758294</article-id><article-id pub-id-type="doi">10.1136/sti.76.2.73</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review</subject></subj-group></article-categories><title-group><article-title>Syphilis in pregnancy</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Genc</surname><given-names>M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Ledger</surname><given-names>W.</given-names></name></contrib></contrib-group><aff>Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, USA.<email>mgenc@rcn.com</email></aff><pub-date pub-type="ppub"><month>4</month><year>2000</year></pub-date><volume>76</volume><issue>2</issue><fpage>73</fpage><lpage>79</lpage><self-uri xlink:role="pdf" xlink:type="simple" xlink:href="http://sti.bmj.com/cgi/reprint/76/2/73.pdf"></self-uri><self-uri xlink:role="abstract" xlink:type="simple" xlink:href="http://sti.bmj.com/cgi/content/abstract/76/2/73"></self-uri><self-uri xlink:role="fulltext" xlink:type="simple" xlink:href="http://sti.bmj.com/cgi/content/full/76/2/73"></self-uri><abstract><p> Syphilis can seriously complicate pregnancy and result in spontaneous abortion, stillbirth, non-immune hydrops, intrauterine growth restriction, and perinatal death, as well as serious sequelae in liveborn infected children. While appropriate treatment of pregnant women often prevents such complications, the major deterrent has been inability to identify the infected women and get them to undergo treatment. Screening in the first trimester with non-treponemal tests such as rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) test combined with confirmation of reactive individuals with treponemal tests such as the fluorescent treponemal antibody absorption (FTA-ABS) assay is a cost effective strategy. Those at risk should be retested in the third trimester. Treatment during pregnancy should be with penicillin. In determining a penicillin regimen, the clinician must consider the stage of the maternal infection and the HIV status of the mother. Patients who are allergic to penicillin should be desensitised before treatment. Despite appropriate treatment, as many as 14% will have a fetal death or deliver infected infants. Treatment may further be complicated by the Jarich–Herxheimer reaction, a complex allergic response to antigens released from dead micro-organisms, which can cause fetal distress and uterine contractions. Thanks to effective intervention strategies and inexpensive penicillin, syphilis rarely complicates pregnancy in the Western world today. In parts of the world where the traditional sexually transmitted diseases have not been controlled, the magnitude of problems associated with syphilis during pregnancy is reminiscent of that faced by the West during the early 1900s. </p><p><bold>Key Words:</bold> syphilis; pregnancy</p></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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