妊娠合并梅毒对围产儿预后的影响

房思宁; 郑利雄; 杜晓红; 童秋生; 李放娟

妊娠合并梅毒对围产儿预后的影响

Effect of pregnancy complicated syphilis on perinatal prognosis

摘要

摘要:
目的揭示妊娠梅毒流行特征, 探索最大限度降低对围产儿危害的有效途径.
方法 1997~2002年经梅毒快速血浆反应试验(RPR)和梅毒螺旋体颗粒凝集试验(TPPA)筛查, 对本院确诊的妊娠合并梅毒患者共41例进行回顾流行病学研究.采用苄星青霉素全程抗梅毒治疗和追踪.
结果妊娠合并梅毒患者初中文化程度和无业者各占85%;丈夫梅毒感染率达100%, 其中香港居民占29.3%;妊娠潜伏梅毒达97.5%.在孕20周确诊占65.9%, 治疗率58.5%.治疗组围产儿死亡率(0.0)和先天梅毒发生率(8.0%), 显著低于未治疗组(58.8%和85.7%, P均 < 0.01).
结论妊娠合并梅毒是严重造成围产儿死亡及传播先天性梅毒的重要因素.早期发现、全程治疗是降低围产儿死亡和防止感染先天性梅毒的重要保证.加强孕期安全性行为是杜绝再感染的重要途径.

Abstract:
Objective To find the epidemic feature of pregnant syphilis and to explore the effective way to decrease the influence on the perinatal.
Methods To make a retrospective study on 41 patients diagnosed after being screened by syphilis rapid plasma reponse test(RPR)and treponema pallidum puticulate agglulinate test(TPPA)from 1997 to 2002.To use penicillin in the whole treatment and make a trail.
Results Among the patients, the juniors and unemployees occupied 85%.The rate of their husbands with syphilis was 100%, including 29.3% Hongkong residents.Pregnant insidious syphilis 97.5%, 6519% patients were diagnosed in week 20 of pregnancy and 58.5% were treated.The death rate of the perinatal in treated group(0.0)and congenital syphili rate(8.0%)were lower than untreated group(58.5% and 85.7%, P_ar < 0.01).
Conclusion Pregnancy complicated syphilis had severe influence on death of the perinatal, which was an important factor on spreading congenital syphilis.So, it is important to find early and have a whole treatment.Enhancing the pregnant safe behaviors wasthe useful method to aviod being reinfected.

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