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1996-03-30
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Document 1097
DOCN M9651097
TI Lues-lues: maternal and fetal considerations of syphilis.
DT 9505
AU Ray JG; Department of Medicine, McMaster University, Hamilton, Ontario,;
Canada.
SO Obstet Gynecol Surv. 1995 Dec;50(12):845-50. Unique Identifier :
AIDSLINE MED/96164290
AB Although syphilis occurs infrequently among Canadian and American women,
global antenatal screening is still warranted. The reason is that
congenitally acquired syphilis is serious, yet largely preventable.
Those women at highest risk for the disease seem to be crack and cocaine
users, as well as those without antenatal care. These women should be
screened for syphilis during the first and early-third trimesters,
whenever possible, or at the time of delivery. HIV testing should be
routinely recommended. Syphilis is diagnosed using microscopy and/or
serologic testing. Although nontreponemal serology (VDRL and RPR) is
acceptable as the initial screening test, sensitivity and specificity
for syphilis vary between 60 and 75 percent and 84 and 99 percent,
respectively. These are also many causes of false-positive test results.
Treponemal serology (FTA-ABS and MHA-TP) are used to confirm
nontreponemal tests. The only acceptable treatment of syphilis during
pregnancy is penicillin. For those with disease of less than 1 year's
duration, it is suggested that two doses of benzathine penicillin G (2.4
million units I.M.) be administered 1 week apart. Disease of greater or
unknown duration requires a longer, modified regimen. Serious adverse
reactions to therapy are rare, and penicillin-allergic mothers can be
skin tested, followed by desensitization if required. Exactly how HIV
infection modifies the detection and treatment of syphilis in pregnancy
is unclear. Treatment of HIV-infected women with syphilis is presently
no different than non-HIV patients, unless invasion of the central
nervous system is suspected.
DE Female Fetus/DRUG EFFECTS Human HIV Infections/DIAGNOSIS Infant,
Newborn *Mass Screening Penicillins/THERAPEUTIC USE Pregnancy
*Pregnancy Complications, Infectious/DIAGNOSIS/PHYSIOPATHOLOGY/ THERAPY
Syphilis/DIAGNOSIS/PHYSIOPATHOLOGY/THERAPY Syphilis Serodiagnosis
Syphilis, Congenital/*PREVENTION & CONTROL JOURNAL ARTICLE REVIEW
REVIEW LITERATURE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).