- Many expectant mothers wonder if they prescribe tests for infections, sexually transmitted diseases: why do err, if, like, all right? Unfortunately, these diseases are nowadays quite common and often asymptomatic. Meanwhile, there are also those that may adversely affect the course of pregnancy, childbirth and the baby’s health. That is why these diseases deserve special discussion.
Syphilis, also known as «lues», also known as the “French disease”, also known as “Spanish disease”, known in Europe since the discovery of America
In 1530, Italian poet in his poem Frakastro described Sifilosa shepherd, who was punished for a serious illness disrespectful attitude to the gods – Venus and Apollo. On behalf of the literary hero and was the name of the disease. It is known that in the early XX century, syphilis, suffered 15% of the population of Europe. With the advent of antibiotics, the situation has changed, though gc syphilis is still considered one of the most common sexually transmitted diseases. Thus, in the 90 th Dah last century in Russia there was a sharp increase in the incidence of syphilis. Now more than 50% of all reported cases of syphilis in women between the ages of 18 to 30 years, that is the age when most children give birth.
“Culprit” of the disease
The causative agent of syphilis is Treponema pale or pale spirochete – a bacterium which enters the body through tiny, invisible damage of the skin and mucous membranes. Pallidum outside the body in a wet environment can live for several hours, but drying quickly dies. Therefore, in close contact with syphilis in the infectious stage is possible not only sexual but also the way of household transmission (when using common utensils, linens). Syphilis can be contracted by another – transfusion, ie, by blood transfusion. To prevent this, all donors are screened for syphilis and venereal disease examined. The duration of the incubation period for syphilis ranges from 10 to 80 days. Sometimes, the incubation period may be delayed for several years. The patient at this time is contagious, although they did not know about their disease. Immunity to syphilis body does not produce, so re-infection is possible even after a full recovery.
The symptoms of syphilis are very diverse. They vary depending on the stage became ill! There are three stages of the disease:
Primary syphilis. The earliest symptom of syphilis in its primary period is the appearance of a painless ulcer called a chancre. Most often, chancres are on the genitals and around the anus, but they may be formed on the lips, mouth, or in any other part of the body, where the pathogen has penetrated the skin. Venereologists chancre appears on the site say: “What a place of sin, place, and is punishable.” After 5-6 weeks, ulcer healing, there is only a small scar. But this is not a sign of recovery. Syphilis is passed in hidden form, in which the body is rapid multiplication of pale treponemes. During this latent period may occur weakness, malaise, headache and muscle pain, a fever.
Secondary syphilis. This stage begins after 1 to 6 months after healing of the chancre, if there had been no effective treatment. Appears pale rash all over his body, including palms and soles. Swollen lymph nodes throughout the body. The rash appears and disappears from time to time, except maybe her loss of hair, hoarseness, as well as the appearance of flesh-colored growths (called condylomas wide – rounded education) on the genitals. In most patients, this period lasts until the end of their lives, but some goes to the last, late, period of syphilis.
Tertiary syphilis. During this period, have been serious, irreversible damage to the heart, eyes, joints, bones, brain and spinal cord. The disease lasts for decades and lead to mental disorders, paralysis, deafness, blindness, bone deformities and death sick.
Pregnancy on the background of syphilis is accompanied by an imbalance in hormone levels, especially sexual, that is most often seen the threat of miscarriage, miscarriage and premature birth. In addition, pregnancy in patients with syphilis is often accompanied by anemia.
Pregnancy does not worsen for syphilis, but syphilis has a detrimental effect on the fetus. The child may become infected before their birth mother of the patient: the agent crosses the placenta from the mother’s blood. The most dangerous for the unborn child of pregnant secondary syphilis, which leads to the majority of miscarriages and stillbirths. In late syphilis untreated, even a woman can give birth to a perfectly healthy baby. This is explained by the fact that the disease does not have time to hit the kid. The best chance of having a healthy child in women who receive treatment early in pregnancy (before 16 weeks). Unfortunately, many women, syphilis, or do not go to the doctor at all, or treated too late, when the body of a child is very impressed pale treponema.
Congenital syphilis is called, which is transmitted to the unborn baby in utero through the mother’s blood. Syphilis of the fetus occurs around the 5th month of pregnancy, when the pale treponemes cross the placenta and actively multiply within the body of the fetus, affecting virtually all internal organs, brain and skeletal system. Likely to survive for such a child is very small, but if he succeeds, he is born with specific signs of illness. In children with congenital syphilis observed extensive skin rashes, scars on the skin, affects the eyes, liver, heart, may develop hydrocephalus or inflammation of the meninges. Affects the bones and joints, there are deformations of the teeth, nose, skull, tibia. Such children are weak, stunted, and body weight, underdeveloped, both physically and mentally.
Therefore, if the mother’s illness became known during pregnancy, a woman must undergo a course of treatment of syphilis itself and to preventive health care of the child immediately after birth. If a pregnant woman receives proper medical supervision, the risk of congenital syphilis in the child is reduced to almost zero.
The main method of diagnosis – blood tests for syphilis. There are many types of analyzes. They are divided into two groups:
Estimated (screening) tests, which are used for mass screening for syphilis. First of all, it’s Wasserman (RW). A positive Wassermann reaction may be varying degrees of severity, which is denoted by “+” with a particular index (1 to 4). Wassermann reaction is positive in about 2-3 weeks since the formation of the chancre. Based on this primary syphilis is divided into seronegative (negative RW), even when the Wassermann reaction is negative and seropositive (positive RW), when the antibody is produced and the Wassermann reaction is positive. However, the RW can also give false positive results in pregnancy, syphilis after suffering under some other circumstances. If the test result is positive, the woman examined further to confirm or exclude the diagnosis of syphilis.
To clarify the use of more accurate diagnosis of treponemal methods. These include: RIF (immunofluorescence), RIBT reaction (immobilization pale treponemes) TRNA (optional RW with treponemnym antigen). FTA gives a positive result in the earlier stages of syphilis than the RW, because of its greater sensitivity. RIBT allows us to identify false positive RW, which can sometimes be a healthy person.
In addition, elements of the rash and chancre smear can be taken to identify themselves pale treponemes. In some cases, the use of other diagnostic methods such as computed tomography for the diagnosis of syphilis of the central nervous system.
Prenatal care and treatment
In the event of a confirmed diagnosis of pregnant women hospitalized for treatment of Skin and Venereal Diseases Hospital. To treat more likely to use antibiotics penicillin groups: procaine and sodium Penicillin, Bitsillin, EKSTENTSILLIN, RETARPEN. In primary syphilis treatment lasts several weeks, with tertiary – a few years.
Expectant mothers who have held up after pregnancy treatment remained positive results of blood tests for syphilis, as well as all those who took the medication during pregnancy, in addition appointed a preventive treatment to prevent congenital syphilis. Such a course is assigned to 20 weeks of pregnancy or immediately after the main course (if it did not have time to finish by the 20th week). Treatment PENICILLIN salts or erythromycin (if penicillin hypersensitive). This treatment should not only mothers, but also safe for the fetus and the last one.
After the birth of all children born to mothers of patients who have not passed the full course of treatment and prevention, and prophylactic – it is administered antibiotics.
Currently there are no clear recommendations when to interrupt pregnancy in syphilis. Modern methods of treatment of syphilis can prevent congenital syphilis in detecting disease in the mother during the first half of pregnancy. If syphilis is detected later, abortion is already too late, and the treatment is already pregnant, and treatment of the fetus.
Thus, if the pregnancy is desirable, it can be stored under compulsory treatment of syphilis.
Women with a previous syphilis is completely cured can give birth to a healthy baby without preventive treatment.
Prevention of congenital syphilis is, first of all, in the early detection of disease in pregnant women and its adequate treatment. The adopted mandatory three-fold examination of pregnant women and provides such preventive maintenance.
If a woman before pregnancy took a full course of treatment for syphilis and feels healthy, then before you plan a pregnancy, she should consult a gynecologist and a venereology. After the tests will be completed, confirming the recovery, it may become pregnant. Normally a pregnancy are advised to wait a year after complete recovery.