PP-16 The importance of early diagnosis in maternal syphilis

Objective

Infection is of particular concern during pregnancy because of the risk of transplacental transmission to the fetus.  In this case report; Prenatal diagnosis and management of syphılıs is discussed.

Case

A 20-year-old G1P0 patient at 12w5d gestational week was refered to our department with a positive Venereal Disease Research Laboratory (VDRL) test result. His history was obtained and systemic examination was performed. There was no recent acute febrile infection or vaccination history. No additional systemic disease was observed. There were no signs of infection including maculopapular rash, genital ulcer and oral aphthae. The patient had symptoms of groin pain, burning during urination, chills and shivering. Anti-HIV test result was negative. T. pallidum particle agglutination test (TPPA) was used as a confirmatory test because of the possibility of false positive screening test result. The diagnosis of syphilis was confirmed with a positive TPPA test result (26.32 s/co) and 2.4 million units of Penicillin G benzathine was initiated intramuscularly. 

Discussion

Treponema Pallidum easily infects the placenta and causes amniotic fluid infection, placentomegaly and fetal anemia, thrombocytopenia, ascites, hydrops and intrauterine growth retardation by transplacental transmission. Manifestations of congenital infection are affected by gestational age, maternal syphilis status, maternal treatment, and fetal immunological response. 

Conclusion

Screening all pregnant women for syphilis infection at the first trimester is recommended. Benzathine Penicilline G is effective in preventing transmission of infection to the fetus in most settings.

Keywords

Pregnacy, prenatal management, syphilis

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