Congenital syphilis natural history

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2] Aravind Kuchkuntla, M.B.B.S [3]

Overview

Congenital syphilis is a result of transplacental transmission of the infection and severity of manifestations depend on the duration of maternal infection and duration of exposure to the fetus in utero.

Natural History, Complications and Prognosis

Natural History

Syphilis is a sexually transmitted disease and is more prevalent in high risk population. Women with syphilis infection can transmit the infection to the fetus in utero resulting in a wide spectrum of outcomes. The risk of transmission is higher in pregnant women who do not undergo regular antenatal screening or in women who are untreated or adequately treated during the period of gestation. The risk of transmission to the fetus is dependent on the stage of syphilis infection in the mother (primary, secondary, tertiary or latent), duration of maternal infection and the exposure to fetus in utero. The transmission of infection typically occurs during the second trimester but early transmission also occurs. Syphilis can complicate the outcome of pregnancy and is dependent on the severity of infection in the fetus, severe infection has adverse outcomes in the new born.^[1]^[2]

Complications

Severe infection in the fetus can result in spontaneous abortion, stillbirth, non-immune hydrops, intrauterine growth restriction, and perinatal death, and other serious sequelae in liveborn.^[3]

Prognosis

Adequate treatment of infected mother during the period of gestation can prevent the transmission of disease significantly and treatment of the mother with one dose of penicillin is proven to improve outcomes in the fetus.^[4]
In newborns and infants with congenital syphilis treatment with penicillin has good prognosis with normal development.^[5]

References

↑ Charles D (1983). “Syphilis”. Clin Obstet Gynecol. 26 (1): 125–37. PMID 6340889.
↑ Qin, Jia-Bi; Feng, Tie-Jian; Yang, Tu-Bao; Hong, Fu-Chang; Lan, Li-Na; Zhang, Chun-Lai; Yang, Fan; Mamady, Keita; Dong, Willa (2014). “Risk Factors for Congenital Syphilis and Adverse Pregnancy Outcomes in Offspring of Women With Syphilis in Shenzhen, China”. Sexually Transmitted Diseases. 41 (1): 13–23. doi:10.1097/OLQ.0000000000000062. ISSN 0148-5717.
↑ Cohen SE, Klausner JD, Engelman J, Philip S (2013). “Syphilis in the modern era: an update for physicians”. Infect Dis Clin North Am. 27 (4): 705–22. doi:10.1016/j.idc.2013.08.005. PMID 24275265.
↑ Watson-Jones D, Gumodoka B, Weiss H, Changalucha J, Todd J, Mugeye K, Buvé A, Kanga Z, Ndeki L, Rusizoka M, Ross D, Marealle J, Balira R, Mabey D, Hayes R (2002). “Syphilis in pregnancy in Tanzania. II. The effectiveness of antenatal syphilis screening and single-dose benzathine penicillin treatment for the prevention of adverse pregnancy outcomes”. J. Infect. Dis. 186 (7): 948–57. doi:10.1086/342951. PMID 12232835.
↑ Caddy SC, Lee BE, Sutherland K, Robinson JL, Plitt SS, Read R; et al. (2011). “Pregnancy and neonatal outcomes of women with reactive syphilis serology in Alberta, 2002 to 2006”. J Obstet Gynaecol Can. 33 (5): 453–9. PMID 21639965.

Template:WikiDoc Sources

[pmid6340889-1] Charles D (1983). “Syphilis”. Clin Obstet Gynecol. 26 (1): 125–37. PMID 6340889.

[QinFeng2014-2] Qin, Jia-Bi; Feng, Tie-Jian; Yang, Tu-Bao; Hong, Fu-Chang; Lan, Li-Na; Zhang, Chun-Lai; Yang, Fan; Mamady, Keita; Dong, Willa (2014). “Risk Factors for Congenital Syphilis and Adverse Pregnancy Outcomes in Offspring of Women With Syphilis in Shenzhen, China”. Sexually Transmitted Diseases. 41 (1): 13–23. doi:10.1097/OLQ.0000000000000062. ISSN 0148-5717.

[pmid24275265-3] Cohen SE, Klausner JD, Engelman J, Philip S (2013). “Syphilis in the modern era: an update for physicians”. Infect Dis Clin North Am. 27 (4): 705–22. doi:10.1016/j.idc.2013.08.005. PMID 24275265.

[pmid12232835-4] Watson-Jones D, Gumodoka B, Weiss H, Changalucha J, Todd J, Mugeye K, Buvé A, Kanga Z, Ndeki L, Rusizoka M, Ross D, Marealle J, Balira R, Mabey D, Hayes R (2002). “Syphilis in pregnancy in Tanzania. II. The effectiveness of antenatal syphilis screening and single-dose benzathine penicillin treatment for the prevention of adverse pregnancy outcomes”. J. Infect. Dis. 186 (7): 948–57. doi:10.1086/342951. PMID 12232835.

[pmid21639965-5] Caddy SC, Lee BE, Sutherland K, Robinson JL, Plitt SS, Read R; et al. (2011). “Pregnancy and neonatal outcomes of women with reactive syphilis serology in Alberta, 2002 to 2006”. J Obstet Gynaecol Can. 33 (5): 453–9. PMID 21639965.

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