There are a lot of people who ask questions about syphilis, especially pregnant women who have syphilis, and are at their wits’ end and anxious. For this series of questions, I have summarized, I hope that for those who need help, can help.
1.Overview
Syphilis is a chronic infectious disease caused by the pale spirochete, transmitted through sexual contact. At present, China has an epidemic trend, 2005 statistics incidence rate of 8.71 / 100,000, should not be ignored. Syphilis spirochetes enter the body from the epidermis or mucous membrane breakage, and it takes about 2~4 weeks of incubation period to start the disease, early vulva, cervical and vaginal mucous membrane redness, ulcers, if not treated in time about one third of the development of late syphilis, although the infectious power is weak, but can cause neurosyphilis and cardiovascular syphilis, the consequences are serious. Syphilis in pregnant women can also harm the fetus, so we must pay attention to it.
The syphilis spirochete is an anaerobic bacterium that can survive and reproduce in the body for a long time, and as long as the conditions are suitable, it will reproduce in two in a transverse fracture. The syphilis spirochete is very weak against the outside world and sensitive to chemicals, and it does not survive easily outside the body. Boiling, drying, soapy water and general disinfectants (such as mercury, carbolic acid, lysol, alcohol, 1:1000 potassium permanganate solution, etc.) can easily kill it, and sunlight and a dry environment can quickly kill it. Syphilis spirochetes generally survive outside the human body for no more than 1 to 2 hours. It can survive for several days in an oxygen-deprived environment, for several hours in damp clothing, and generally for 24 hours in blood banks. Syphilis spirochetes are intolerant of high temperatures and can die in 2-3 minutes at 40°C to 60°C, and instantly at 100°C. Syphilis spirochetes can be eliminated by targeting their weaknesses. For example, the clothing will be exposed to the sun, stored in a dry environment; will be disinfected by boiling utensils or disinfected with chemicals, can kill the syphilis spirochete to stop its spread.
2.Can syphilis be transmitted to the fetus?
Syphilis spirochetes can infect the fetus through the placenta. It is generally believed that during the first 4 months of pregnancy, the fetus is not easily infected due to the protection of the placental cytotrophoblast; after 4 months, the syphilis spirochete is prone to infect the fetus through the placenta due to the atrophy of the cytotrophoblast. If syphilis is detected during pregnancy, do not be afraid, pessimistic and desperate, but all prenatal examinations must be carefully checked for fetal development.
3.When is syphilis transmitted?
Syphilis is mainly transmitted by early active syphilis and latent syphilis patients. Early syphilis is usually within 2 years of infection, including stage 1 syphilis, stage 2 syphilis and early latent virus. So syphilis infection, whether treated or not, is not contagious after 2 years. Many couples, only one partner has syphilis, it is very difficult to understand, in fact, it is very simple, which means that this syphilis patient is in contact with their spouse 2 years before the infection of syphilis. So the syphilis infected person should consider pregnancy after 2 years of treatment and recovery.
4.Why didn’t I have any symptoms before the test?
Because your condition is latent syphilis. Usually there is a history of syphilis infection without any clinical symptoms or the clinical symptoms have disappeared and the syphilis seropositivity is positive. It may be caused by the patient being untreated but lightly infected, or resistant, or by an insufficient dose of treatment. Early latent syphilis is generally considered to be an infection of less than 2 years and late latent syphilis is considered to be more than 2 years. Early latent syphilis has a 25% recurrence of second-stage syphilis and is therefore infectious. Late latent syphilis is not contagious.
5, pregnant women tested for syphilis, the child should not want?
Pregnant women with positive blood test for syphilis antibodies, do not panic first, and do not rush to make a decision to have or not to have children. The first thing to do is to choose another authoritative medical institution to test to rule out false positives. If the titer is negative or <1:4, it proves that the pregnancy is not infectious and can continue. If both are positive, it is defined as syphilis in pregnancy, which is generally defined as active or latent syphilis that occurs or is detected during pregnancy. However, early and adequate treatment can not only cure the pregnant woman syphilis, and may save the fetus from infection; or although suffering from infection, after treatment its symptoms are mild and no or less developmental malformations occur.
6.If the test is active syphilis and you plan to have a baby, what do you need to pay attention to?
a) Depending on the stage of syphilis, use the appropriate penicillin regimen for treatment. Treat one course of treatment within 3 months of pregnancy and another course of treatment in the last 3 months of pregnancy.
b) Tetracycline and doxycycline are contraindicated in pregnant women and children up to 8 years of age. If the mother is treated with a non-penicillin regimen, the newborn is asymptomatic and the serologic test for syphilis is negative, Bianxin penicillin 50,000 U/kg may be given as a single dose intramuscularly if follow-up can be assured.
c) Once diagnosed, early, adequate and regular drug treatment should be given, and regular follow-up after treatment. There should be no sexual intercourse during the treatment period. Sexual partners should receive treatment at the same time.
d) Self-monitoring must be done during pregnancy, and fetal movements should be counted carefully every day. After 32 weeks of pregnancy, an umbilical flow chart should be done every 2 weeks for detailed information about the fetal development. Urine E3 measurement should be done every 2 weeks to check placental function. Sexual intercourse must be prohibited during pregnancy to avoid reinfection. Once a fetus is found to have congenital developmental abnormalities, it is important not to have the baby again from the eugenic point of view, otherwise both the adult and the child will suffer.
If you plan to have a baby again, you must actively go to the hospital within the next 2 years to check your health and prepare for pregnancy after you have fully recovered.
7.How is syphilis diagnosed in newborns?
If the RPR titer at birth is greater than or equal to 4 times the mother’s titer, it can be diagnosed as congenital syphilis. When available, the 19S-IgM-FTA-ABS test can be done to confirm the diagnosis. Neurosyphilis should be considered if there are abnormalities in the cerebrospinal fluid examination.
8.When are pregnant women with syphilis and their babies usually retested?
a) After treatment of syphilis in pregnancy, the serologic response to syphilis should be reviewed every month before delivery, and the follow-up after delivery should be the same as other syphilis, generally every 3 months in the first year, and every 6 months thereafter, with a follow-up of 3 years.
b) Infants born to pregnant women with syphilis who have been adequately treated.
①At birth, if the infant is seropositive, it should be rechecked once a month; at 8 months, if it is negative and there is no clinical manifestation of congenital syphilis, observation can be stopped.
②If the infant is born with a negative serologic reaction, it should be rechecked in January, February, March and June after birth, and if it is still negative by June and there is no clinical manifestation of congenital syphilis, syphilis can be excluded.
③ If a gradual increase in titer occurs during the follow-up period, or if clinical manifestations of congenital syphilis appear, treatment should be given immediately.
c) Infants born to pregnant women with syphilis who have not been adequately treated or treated with penicillin, or who are not in a position to follow up their infants, may be treated with prophylactic syphilis for the infant and supplemental treatment for the pregnant woman.
Precautions.
Even if syphilis is detected during pregnancy, since you plan to have a child, you must keep a good mood and welcome the baby.