Treated syphilis and pregnancy. Planning pregnancy after syphilis

Who said that there are no overnight shelters in Kazan? Take a look at the premises of the maneuverable fund on Tukaya Street, 105 - and you will find a real homeless place here. While the administrations of the Privolzhsky and Vakhitovsky districts are deciding who owns these square meters, the homeless have already completely inhabited them.

I was in the zone, but now here

I disdain to touch the railings, door handles, walls - they are very dirty. But one of the inhabitants of the homeless shelter is a lady of Balzac’s age: her cheeks are sunken, her face is yellow-green, her washed overalls are tied with a blue ribbon.

Hello, hello... - she mutters through her teeth. - I came here to visit a relative - Romka from the ninth room. I'm sick, killer whale...

Kasatik is an over-aged fellow in rags who has lost his human appearance. With difficulty lifting his head from the bed with an armored mesh, he mutters something under his breath. All we can understand is that he was in the zone, and now he’s here. Another comrade is also in a hurry to visit Romka.

“Get out of here, old man, he brought the infection back from the market again,” says the bright-tongued legal inhabitant of the maneuverable fund, Natalya Stepanova. - Girl, just don’t touch anything. Here we have common syphilis, scabies, and corridor tuberculosis...

Yes, yes, there is such a tuberculosis. My grandchildren were diagnosed with this disease at the tuberculosis clinic.

In general, we have horror here,” seventeen-year-old Zhenya keeps up the conversation. - Homeless people slaughter dogs in their rooms - the squeal is like a slaughterhouse. And then this dog meat is boiled...

We communicate with residents in the common kitchen. The aromas, I must say, are like in a station toilet. In the center there is a huge table made of rotten wood, along the walls there are shabby gas stoves without burners.

There are no common burners, everyone has their own, we bring them when we come to cook food. But you can’t leave the stove! Just now I was cooking chicken soup, went to get some salt - I looked, and the chicken had already flown away,” Natalya Fedorovna laments.

We can talk a lot more about the “charms” of the maneuverable fund, but one thing is clear - people do not live here, but serve time. And lifelong.

Who owns the maneuver fund?

Now the flexible fund has 4 apartments, each of them has nine rooms. And only six families are “legal residents.” They are all fire victims. The administration of the Volga region allocated these rooms to them temporarily, until they received normal housing.

Natalya Stepanova, now in her fifties, says that four years ago her whole family went to visit her daughter in a nursing home. And when they returned, they gasped: instead of their home in Mirny, there were ashes.

Only the clothes remained with the Kirillov family of fire victims, who lived in the room opposite the Stepanovs. Their private house on Vatutina Street burst into flames due to an electrical short circuit. For the same reason, pensioner Nurmukhamed Galyautdinov, who lived in Otary, was left homeless.

In addition to the fire victims, who in their nightmares could not imagine such living conditions, two cleaners from the housing trust of the Volga region are registered in the maneuver fund. They've been waiting for service apartments for ten years now.

Where the other inhabitants came from - only God knows. Apparently, first one homeless man came to visit the sick killer whale, then another, and so the whole camp remained. Nobody throws them out of here by the scruff of the neck! Come in, do what you want - slaughter the dogs, send everyone to their mother...

Today, the maneuverable fund of the Volga region is located on the territory of Vakhitovsky. This happened five years ago, when the districts changed their boundaries. For this reason, the fund was left without an owner.

Yes, I don’t go there, there’s a sea of ​​tuberculosis, and in general it’s unclear who lives, 80 percent are not our people,” says Nikolai Kuznetsov, chief engineer of housing department no. 24 of the Volga region, who is obliged by duty to restore order in the maneuverable fund. - Just don’t think that we are not solving this problem: we recently installed three gas stoves (these are the ones without burners? - N.V.).

The manager of the PTZHH of the Privolzhsky district, Rustem Matrosov, is also aware of what is happening - he says that the Volga residents should be resettled “on our territory”, to the vacant dilapidated building on Tekhnicheskaya Street. Now on the balance sheet of the district are the second and third floors of the building of the maneuverable fund, the first one belongs to the Vakhitovsky district. The prefecture "Staro-Tatarskaya Sloboda" is located here.

The neighborhood turned out to be inappropriate, says First Deputy Prefect Rafael Salakhutdinov. “We have repaired the facade and roof of the building, furnished offices, but the residents of the maneuverable fund living above us continually flood us with fecal water. Moreover, there is a crime situation there; you don’t know what to expect. But the situation cannot be changed - I do not have the right to evict someone from the territory of the Volga region. Back in the fall, I contacted the head of the Privolzhsky Housing Trust, Matrosov, about this, but there is still no answer.

Gee! Judging by the actions of officials, it is not difficult to assume that they will take action only when a gas leak or fire occurs in the maneuverable fund

OR THIS:
Domestic infection of children with syphilis.
Chebotarev V.V., Pavlik L.V., Khalaicheva E.E., Lipchansky V.A. – Russian Journal of Skin and Venereal Diseases. Moscow

Having published an article by E. A. Batkaev et al., the editors invited a discussion on the issue of mandatory treatment of children who were in household contact with patients with syphilis. Indeed, this issue is very relevant due to the fact that, on the one hand, the incidence rate of syphilis continues to remain high, on the other hand, the latest Guidelines do not contain clear recommendations for preventive treatment for those who were in household contact with a patient with syphilis, including and children.
At the same time, the data of E. A. Batkaev et al. and our observations indicate that infection of children with syphilis through domestic means is not uncommon.
We have summarized the material on household infection of children treated in the hospital of the Stavropol Regional Clinical Dermatovenerological Dispensary for the period from 1993 to 1999. When diagnosing household infection of children, we meticulously approached the establishment of the true source of infection and routes of transmission, explaining this by the fact that infection children of any age can occur as a result of sexual harassment, both from relatives and friends. All studied cases of acquired syphilis in children, without a doubt, were the result of domestic infection.
During this period, 83 children who became infected with syphilis in a similar way were treated in the hospital, of which 5 in 1993, 5 in 1994, 6 in 1995, 20 in 1996, and 20 in 1997. - 21, in 1998 - 10, in 1999 - 16 people. Thus, in 1996-1997. The number of children with syphilis, infected through domestic means, has sharply increased, and even now this figure is not decreasing.
Among the infected children, there were 32 urban residents, 51 rural residents, of which 29 were boys, 54 girls (girls clearly predominated among those infected). By age, the patients were distributed as follows: up to 1 year - 12, 1-3 years - 48, 4-7 years - 14, 8-10 years - 7, over 10 years - 2 children.
As you can see, the overwhelming number of patients were in infancy and early childhood (60 out of 83), preschool children are in second place in terms of infection frequency, children aged 8-10 years are in third place, household infection is also possible in children over 10 years of age .
According to the specified diagnoses, the patients were distributed as follows: secondary fresh syphilis was diagnosed in 9, secondary recurrent - in 34, latent early - in 40 children. Thus, syphilis in children was detected late from the moment of infection.
The sources of infection of children were: mother - in 75, grandmother - in 1, father - in 1, sister - in 1, uncle - in 1, aunt - in 1, mother's friend - in 1, the source of infection remained unknown - in 2 children. At the same time, the sources of infection were diagnosed with primary seropositive syphilis in 1, secondary fresh - in 4, secondary recurrent - in 42 and latent early - in 34 people. This indicates that the majority of children had very long contact with sources of infection (76 out of 81 patients).
Analysis of the study results showed that domestic infection of children is not uncommon and does not have a tendency to decrease. Infection of children occurs through prolonged contact with a sick mother or other person caring for the child. In this case, children in infancy or early childhood and preschool age are most often infected. Household syphilis in children is diagnosed late, which is associated with late diagnosis of syphilis at the sources of infection.
Prevention of household infection of children with syphilis should be aimed not only at early detection of syphilis in adults, but also at providing preventive treatment to children who are in close household contact with patients with syphilis.
Taking into account the conditions of modern life, the decrease in hygienic skills, caused by both material and moral factors, the appointment of preventive treatment to children who are household contacts of patients with syphilis should be approached in a differentiated manner.
Based on experience, we believe that all children under 3 years of age inclusive who have household contact with patients with secondary and latent early syphilis are subject to preventive treatment. In children 3-7 years old, the issue is most often resolved in favor of treatment, although this depends on the diagnosis, the location of the rash at the possible source of infection and living conditions in the family. The decision to conduct preventive treatment for children aged 8 to 14 years requires a purely individual approach. In this case, the degree of contact, the manifestation of the patient’s manifestations, and the general culture of communication are taken into account.
The lack of clear recommendations on this issue in the Guidelines is a big omission.

3RESEARCH INSTITUTE
Epidemiology and Microbiology named after Pasteur

Printed from: http://www.pasteur.socspb.ru/news/global_news/2002/03/23/events8853/
Infection News, March 23, 2002 | 16:33

Until the 90s of the twentieth century, household syphilis in our country was extremely rare for decades - only isolated cases were reported. But times have changed - now this type of venereal disease has received permanent registration in the capital. Here are the statistics for recent years in Moscow: in 1995, 14 cases of household syphilis were registered, in 1996 - 23 cases, in 1997 - 20 cases, in 1998 - 23 cases, in 1999 - 13 cases. In 2000, 15 cases of household syphilis were identified, including 8 boys and 7 girls. In most cases, the pale spirochete was transmitted to children from sick parents - through kisses, underwear, etc. The situation is reminiscent of the post-revolutionary years, as can be seen by reading the journal "Venereology and Dermatology" for 1924-1925. “People have forgotten what syphilis is,” says the chief dermatovenerologist of the Moscow Health Committee. “The low level of culture of certain segments of the population, among which homeless people, drug addicts and alcoholics predominate, contributes to the spread of the disease, including through everyday means.” True, last year the number of such patients decreased - only 8 cases of household syphilis were registered.

*****
Syphilis today
T.V. Krasnoselsky
URL

Questions and answers
In an epidemic, cases of syphilis are becoming routine in the practice of doctors of all specialties. Considering that this infection is characterized by a wide variety of clinical symptoms and can simulate the manifestations of many skin and somatic diseases, we asked to answer questions about the routes of infection with syphilis, its diagnosis and modern methods of treating candida. honey. Sciences, assistant at the Department of Dermatovenereology with the clinic of St. Petersburg State Medical University named after. acad. I.P. Pavlova Tatyana Valerievna Krasnoselskikh.

Epidemiological situation
Since 1989, Russia has seen an epidemic increase in the incidence of syphilis. In St. Petersburg during the 90s it increased 35 times and reached its peak in 1995. In 1996-97, according to official statistics, a decrease in incidence was noted. For the first time in many years, it was lower than the Russian average. However, there is a high probability of unreliability of these indicators due to the lack of information from private practitioners and commercial structures providing dermatovenerological, gynecological and urological care.
Currently, the epidemiological situation regarding the incidence of syphilis in St. Petersburg remains unfavorable. This is confirmed by an increase in the number of patients with late and unspecified forms, the number of those infected again, the number of children with congenital and domestic syphilis, and the increase in the registration of syphilis among pregnant women. According to scientists' forecasts, in the coming years we should expect an increase in the registration of late and latent forms of syphilis, damage to the nervous system, internal organs, and a further increase in congenital and domestic syphilis.

Until recently, students were taught: “Household syphilis is a poorly collected anamnesis.” But now this concept is again entering the vocabulary of doctors. Is this related to the current epidemiological situation?
- In 95-98% of all cases, syphilis infection occurs through sexual contact with a patient. The everyday route of transmission of infection - through kisses, bites, through any objects contaminated with material containing pathogens - is very rarely realized in practice, since the infectious material loses its contagiousness as it dries.
But, despite its rarity, the household route of transmission of infection should not be ignored. Suffice it to say that in 1997 in St. Petersburg, 20 cases of domestic infection of children from parents with syphilis were registered. Therefore, according to existing instructions, children under 3 years of age who have particularly close contact with parents with syphilis, even with negative results of serological reactions, are required to receive preventive treatment; the issue of treatment for older children is decided individually.
- Is it possible to become infected with syphilis through medical instruments or during medical procedures?
- Infection through reusable medical instruments (uterine and rectal speculum, dental instruments, etc.), subject to the basic rules of its processing, is excluded.
Currently, the transfusion route of infection is practically not encountered. This is due to the fact that, firstly, serological testing is carried out on all donors before blood collection; secondly, with the fact that the causative agent of syphilis - Treponema pallidum - is a facultative anaerobe, and tissues with a high oxygen content are not suitable for its existence. Using blood as a transport medium for dissemination throughout the body, Tr. pallidum is found in it only at certain stages of the disease. But even if we imagine that the blood was taken from an unexamined donor during the period of so-called “treponemal sepsis,” then when it is preserved, the pathogen dies within 3-5 days. Thus, only direct blood transfusion is dangerous, the indications for which are currently extremely narrowed.
- Why in some cases does infection not occur when contacting someone with syphilis?
- When in contact with a person with syphilis, up to 15-20% of partners remain healthy. Several reasons can be identified for this:
1. lack of conditions necessary for infection - a sufficient number of virulent Treponema pallidums in the infectious material and an “entry gate” for infection (microtraumas of the stratum corneum of the skin or the epithelium of the mucous membrane);
2. one-time or rare sexual intercourse;
3. absence or low contagiousness of syphilides during sexual intercourse;
4. individual immunity of some individuals to infection, associated with the presence in the blood serum of special proteins that immobilize and lyse treponema.
The most contagious are patients with early forms of syphilis, which currently include all cases of the disease that do not exceed 2 years in duration. With late (latent and tertiary) syphilis, infection of contact persons rarely occurs.
In a patient with primary and secondary syphilis, any erosive, weeping rash is highly contagious. The so-called “dry” syphilides (for example, roseola, non-erosive papules, leucoderma) and papulopustular elements are less dangerous. Manifestations of the tertiary period (tubercles, gummas) are practically non-contagious. The patient's saliva is contagious in the presence of specific rashes on the oral mucosa, and the milk of nursing women, semen and vaginal secretions are contagious even in the absence of active manifestations of the disease in the area of ​​the mammary glands and genitals. According to most researchers, the secretion of the sweat glands, tear fluid and urine of patients with syphilis do not contain pathogens. In patients with active syphilis, all nonspecific lesions are contagious, leading to disruption of the integrity of the skin and mucous membranes - herpetic rashes, cervical erosion, banal balanitis, etc.
- Have methods for detecting syphilis in the incubation period been developed to date?
- Yes, such methods exist, but, unfortunately, they are not introduced into everyday practice due to high cost and technical complexity. In this regard, if no more than 2 months have passed since the suspected infection, all contact persons who do not have clinical and serological signs of the disease are given preventive (precautionary) treatment. If more than 2 months have passed since the moment of contact, and during this time no signs of the disease have appeared, then preventive treatment is not carried out, and the contact person remains under the supervision of a venereologist for six months.
- Are there ways to prevent syphilis infection?
- Since rashes in patients with syphilis can be localized on any part of the skin or mucous membranes, the use of condoms does not protect against infection. Condoms only reduce the likelihood of infection and protect against concomitant urogenital infections.
Individual prevention of infection, which consists of treating the genital area with disinfectants (gibitan, cidipal, miramistin), is effective only during the first 2 hours after sexual intercourse, since 2-4 hours after infection the pathogen enters the lymph nodes and occurs within the first day generalization of infection.
- What are the earliest clinical manifestations of syphilis?
- After an incubation period, the duration of which is on average 30 days (from 9 days to 6 months), the so-called primary affect (chancroid) appears, from this moment the primary period of syphilis begins. Its average duration is 45 days.
In the current epidemiological situation, every practitioner should remember that if a patient has single or multiple erosive or ulcerative elements on the genitals, syphilis should first be suspected and, to rule it out, the patient should be referred to a venereologist. Particular suspicion should be caused by painless defects of rounded outline with a dense infiltrate at the base, with clear, smooth, not undermined edges, a smooth bottom, scanty serous discharge, without signs of inflammation along the periphery.
It is completely unacceptable to prescribe any external agents, especially disinfectants and ointments with antibiotics, or general antibiotic therapy, before establishing a diagnosis. This will significantly complicate or make it impossible to detect the pathogen in the discharge of the primary affect. In addition, taking treponemocidal drugs in inadequate, subtherapeutic doses, without leading to the cure of syphilis, helps resolve all its external manifestations and transition the disease to a latent form. Patients with latent syphilis, while remaining dangerous from an epidemiological point of view, know nothing about their disease and are most often detected by chance during a serological examination.
The attention of the patient and the doctor may also be drawn to regional scleradenitis - an increase and hardening of the lymph nodes close to the primary affect, which occurs simultaneously or a few days after its onset. Detection of unilateral or bilateral enlargement of a group of lymph nodes (especially often inguinal), which have a dense elastic consistency, are mobile, painless, and are not accompanied by skin changes, should always raise suspicion of syphilis. In such cases, a thorough examination of the patient and his serological examination are necessary. It is unacceptable to prescribe treatment to patients (especially antibiotics!) for “lymphadenitis of unknown etiology.”
10-14 days before the end of the primary period, patients may experience polyadenitis and prodromal phenomena - weakness, fatigue, malaise, headache, low-grade fever, sleep disturbances, appetite, pain in muscles, joints, bones (especially at night). These symptoms are harbingers of the imminent appearance of generalized rashes, that is, the beginning of the secondary period of syphilis.
The secondary period begins on average 2.5 months after infection and lasts in most cases 2-4 years. Its course is characterized by waves with alternating periods of manifestation (relapses) and periods of a latent state. From relapse to relapse, the rashes become less and less abundant, but larger, faded, prone to grouping, merging and vegetating. As the duration of the disease increases, the periods of latency lengthen. Syphilides of the secondary period are highly contagious, in general they are characterized by a benign course without scarring and atrophy, dull coloring, lack of subjective sensations, peripheral growth, true polymorphism (roseola, papules, less often - papulopustules). In the secondary period of syphilis, such peculiar manifestations as leukoderma (skin dyschromia) and alopecia (hair thinning) of a diffuse, small-focal or mixed nature (most often in the temporo-occipital regions) can also be observed.
The clinical picture of lesions of the skin and mucous membranes in early acquired syphilis is very diverse. Its manifestations must be differentiated from the symptoms of many skin diseases. If we consider that in early forms of syphilis the nervous system and internal organs can be affected, and the clinical picture of these lesions is not pathognomonic for syphilis, then it becomes clear how difficult the diagnostic task is facing doctors of various specialties. The likelihood of diagnostic errors will decrease if the rule is followed: any patient hospitalized in a hospital or undergoing outpatient treatment must undergo a serological examination for syphilis.
- How common is tertiary syphilis today?
- Cases of tertiary syphilis are still a casuistic rarity. However, we cannot forget about the possibility of developing manifestations of the tertiary period of the disease in untreated or insufficiently treated patients. A few years after the start of the epidemic rise in the incidence of early forms of syphilis, an increase in the registration of its later forms will inevitably follow.
- What is “malignant syphilis”?
- Malignant syphilis is a special, unfavorable course of the disease observed in immunocompromised patients (alcoholics, drug addicts, people with severe somatic diseases, HIV-infected people, etc.). It has the following features:

The incubation period can be lengthened or shortened depending on the depth of changes in the immune system.
The primary period is usually shortened to 3-4 weeks, chancre is prone to necrosis (gangrenization) and peripheral growth (phagedenization), regional adenitis and polyadenitis, as a rule, are not observed.
The secondary period is characterized by the appearance of papulopustular syphilides, a tendency to ulceration of the elements, but treponemas are difficult to detect in them. There is a continuous recurrence of rashes without periods of latency. Sometimes, against the background of secondary syphilides, lumpy and gummous rashes characteristic of the tertiary period of the disease can be observed.
Malignant syphilis often occurs with a violation of the general condition, intoxication, and fever.
Nonspecific serological reactions may remain negative due to a sharp decrease in the production of specific antibodies (uncontrolled development of infection). During antibiotic therapy, serological reactions may become positive.
- Tell us in more detail about latent syphilis...
- Latent (latent) syphilis is diagnosed in individuals who do not have active manifestations of the disease on the skin and mucous membranes, signs of specific damage to the nervous system and internal organs, based on positive serological reactions (including specific ones).
Latent syphilis is divided into early - with a disease duration of up to 2 years, late - more than 2 years and unspecified (unknown) - when - it is not possible to determine the timing of infection.
When determining the duration of the disease in persons without clinical manifestations, a set of indirect criteria is taken into account:
1. History - the presence at one time or another of rashes similar to syphilitic ones; antibiotic treatment of intercurrent diseases; the possibility of contracting syphilis during a certain period.
2. Data from the so-called confrontation (examination of sexual partners) - identification of early or late forms of syphilis or the absence of the disease.
3. Clinical signs - remains of chancre (scar or pigment spot with infiltration at the base), lymphadenitis.
4. The severity of the temperature reaction of exacerbation against the background of the start of specific therapy.
5. The value of titers of serological reactions.
- Does immunity develop after suffering syphilis?
- No. Syphilis is characterized by non-sterile infectious immunity, which exists only as long as there is a pathogen in the body. The literature describes cases of multiple reinfections (re-infections) in people who previously had syphilis and were completely cured.
- What are the criteria for diagnosing syphilis?
- Diagnosis of syphilis is based on:
1. The results of a clinical examination of the patient.
2. Detection of treponema pallidum in the serous discharge of rashes on the skin and mucous membranes. Identification of the pathogen is 100% confirmation of the diagnosis. However, in the absence of clinical manifestations of the disease or the presence of “dry” syphilides, the use of this diagnostic method is impossible.
3. Results of serological reactions (with serum, blood plasma, cerebrospinal fluid). This is one of the most reliable diagnostic methods. Meanwhile, during certain periods of the disease, serological reactions can be negative, and in some patients they can give false-positive results in the absence of syphilis.
4. Evidence of confrontation. Unfortunately, patients with syphilis often hide their sexual contacts or do not have information to find partners.
5. Results of trial treatment (therapia ex juvantibus). This diagnostic method is rarely used, only in late forms of syphilis (usually visceral), when other methods of confirming the diagnosis are impossible. In early forms of the disease, trial treatment (for example, antibiotics) is completely unacceptable.
Thus, there are no absolute criteria for diagnosing syphilis; it is based on their complex.
- What serological tests are currently used to diagnose syphilis?
- All serological reactions for diagnosing syphilis are divided into nonspecific (classical) and specific, as well as screening (screening), diagnostic and confirmatory.
To stage nonspecific reactions, nonspecific antigens are used: treponemal ultrasonic antigen, obtained from cultural (non-pathogenic) strains of treponemes (it allows the determination of group-specific antibodies), and cardiolipin antigen, produced synthetically (allows the determination of antibodies to the lipid antigens of treponema - reagins).
Screening reactions are used for mass serological surveys for syphilis; persons of decreed professions, patients in somatic hospitals, patients in clinics and outpatient clinics, as well as for express diagnostics in the hospital. In our country, microprecipitation reaction (MR) with cardiolipin antigen (done with serum) is usually used as a screening test. Recently, the RPR test (rapid plasma reagin reaction), based on the same principle as MR, but performed with blood plasma, has been increasingly used. The RPR test is usually performed only in a qualitative version.
Diagnostic reactions are used to confirm the clinical diagnosis of persons with suspected syphilis and examine their sexual partners, as well as to monitor the effectiveness of treatment (in combination with a microreaction); for examination of donors and pregnant women.
Diagnostic reactions include the complement fixation reaction (CFR, Wassermann reaction), which is performed with cardiolipin antigen and treponemal ultrasonic antigen. It should be noted that RSC is not currently used abroad to diagnose syphilis.
MR and RSC become positive by the end of the second week of the primary period of syphilis.
To set up specific reactions, specific antigens are used, obtained from pathogenic strains of Treponema pallidum, cultivated on the testicles of experimentally infected rabbits (they allow the determination of species-specific antibodies). They are used for the differential diagnosis of latent syphilis and false-positive serological reactions; examinations of persons who have had sexual and close household contact with a patient with syphilis (immunofluorescence reaction - RIF, passive hemagglutination reaction - RPHA, enzyme immunoassay - ELISA); to monitor the effectiveness of treatment (treponema pallidum immobilization reaction - RIBT).
RIF, RPGA and ELISA are usually used only in a qualitative version; they are highly sensitive and become positive at the end of the incubation period (about a week before the appearance of chancre).
RIBT becomes positive (31-50% of immobilization - weakly positive; 51-100% - positive) only at the end of the primary period and is used to diagnose late forms of syphilis. This is the most specific reaction, but it is quite technically complex and requires a long time to perform, so it is currently not used abroad for routine diagnosis of syphilis.
- Tell us about modern methods of treating syphilis. Is it true that the disease can be cured with one or two antibiotic injections?
- Antibiotics of the penicillin group remain the drugs of choice for the treatment of syphilis. So far, no reliable cases of Treponema pallidum resistance to penicillin have been described in the literature. There are various methods and regimens for using penicillin drugs for syphilis. The most effective are water-soluble penicillin preparations, which are treated in a hospital in the form of round-the-clock intramuscular injections or intravenous drips. Durant penicillin preparations are used for outpatient treatment. The volume and duration of treatment depend on the duration of the syphilitic infection.
In recent years, analogues of domestic bicillin-1 - benzathine benzylpenicillins (commercial names - retarpen (Biochemi) and extensillin (Ron-Poulenc Rohrer)) have been widely introduced into practice. Treatment of syphilis is carried out by 1-3 injections of these drugs (depending on the form of syphilis) with an interval of 1 week. Benzathine benzylpenicillin preparations have a number of undoubted advantages:
their use is very convenient in outpatient settings,
they are quite effective in early forms of syphilis,
they are well purified and rarely cause allergic reactions.
However, we consider it inappropriate to use these drugs in patients with a long duration of the disease (1 year or more) and in patients with visceral and neurosyphilis (they do not provide cerebrospinal fluid sanitization). In such cases, therapy with massive doses of water-soluble penicillin administered intravenously is more effective. So the question of choosing a specific method

Syphilis is a chronic infectious disease that occurs when infected with Treponema pallidum. Infection occurs primarily through sexual contact, which is why syphilis is classified as a sexually transmitted disease. Syphilis is one of the most severe sexually transmitted infections, as it affects all tissues and organs of the patient and can be transmitted in utero from a sick mother to a child.

Syphilis is characterized by an undulating, relapsing course, that is, the disease either subsides or resumes. After infection, treponema pallidum quickly enters the blood vessels and spreads throughout the body through the bloodstream. The course of syphilis is characterized by alternating active manifestations with latent periods. There are several stages of the disease:

1. Incubation period when infection has already occurred, but there are no clinical manifestations yet, it lasts 4 - 5 weeks.
2. Primary syphilis - at this stage, a specific syphilitic rash appears - chancre. This is a raised round or oval area of ​​redness that develops into a painless erosion and then into an ulcer ranging in diameter from a few millimeters to 1-2 cm with raised edges and scanty discharge. A crust sometimes forms on its surface. This education is painless. A chancre appears at the site of penetration of Treponema pallidum: in men - on the inner layer of the foreskin, the neck of the glans, glans, body or base of the penis; in women - on the cervix, vagina, vulva, clitoris. In women, hard chancre is found less frequently, because they are hidden from view (vagina, cervix). Hard chancroid can also appear in the rectum, oral cavity, lips, tongue, tonsils, fingers, toes, and mammary glands. The appearance of chancre is accompanied by enlarged lymph nodes. This period lasts from 6 to 7 weeks.
3. Secondary syphilis manifests itself in various rashes on the skin and genitals, hair loss is possible. During this period, which lasts from 2 to 4 years, all organs and tissues are actively affected, especially the nervous system.
4. Hidden syphilis - There are no manifestations on the skin, the activity of syphilis subsides, but further damage to internal organs occurs.
5. Late or tertiary syphilis - at this stage, maximum damage to internal organs (heart, liver, nervous system) and skin is detected, and death may occur.

Infection occurs from a person with syphilis through sexual contact. In pregnant women, infection of the child occurs in utero, through the placenta. The most dangerous period for a child is the secondary period of syphilis in the mother and the first 3 years after the mother is infected.

Consequences of syphilis infection for the fetus

Pregnancy can end in late miscarriage (usually at 12-16 weeks), stillbirth, premature birth, the birth of children with early manifestations of syphilis or late symptoms of congenital syphilis and the birth of normal-looking children with persistently positive serological reactions - laboratory indicators, with the help who are diagnosed with syphilis.

Symptoms early congenital syphilis appear immediately after the birth of the baby. This disease is characterized by prematurity of the newborn, characteristic skin lesions, rhinitis (runny nose), damage to the bones, nervous system, liver, and lungs. Such children gain weight very slowly, develop poorly, and often cannot breastfeed. They are restless, anxious, sleep poorly, cry almost constantly, and sometimes emit a sharp, piercing cry. Death in such children can occur from pneumonia.

First symptoms late congenital syphilis may appear 2 years after birth, but more often between the 7th and 14th years of a child’s life, before which no manifestations of the disease are observed. Typical symptoms of late congenital syphilis are eye damage, deafness and dental damage. Since all organs and tissues were involved in the process, damage to all organs is possible.

Diagnosis of syphilis

I would like to note that all pregnant women, without exception, take a blood test for syphilis three times during pregnancy - upon registration, then in the second and third trimesters of pregnancy. This is advisable, because with such a testing schedule, there is a great opportunity to detect the disease in a timely manner.

The criteria for diagnosing syphilis are positive serological tests (these tests determine the presence of antibodies to the causative agents of the disease).

Serological tests are divided into non-treponemal and treponemal tests.

1. Non-treponemal tests are always positive for syphilis, but can also be positive for other conditions and diseases. These tests are used to determine the activity of the disease, and only they are used to monitor the treatment of syphilis, since they can become negative or become negative with successful treatment. But now in Russia there are big changes in the diagnosis of syphilis, and from 2006 the Wasserman reaction 1 will be abolished. It was replaced by better and more sensitive tests - RPR and VDRL, EM or RMP will still be placed.

2. Treponemal tests are highly sensitive and specific, that is, they can only be positive for syphilis, but

they can remain positive for life and speak of syphilis suffered in the past. Such analyzes include ELISA general, IgM and IgG, RPGA, REEF and RIBT. Availability ELISA IgM (antibodies of type M, which are produced upon initial entry into the body of an infectious agent or exacerbation of the disease) indicates an acute process.

If there are 1 nontreponemal and 2 treponemal positive tests, a diagnosis of syphilis is made.

Due to the high prevalence of the disease and severe consequences for pregnancy outcomes, it is mandatory to screen pregnant women for syphilis 3 times: upon registration, at 28-30 weeks and at 36 weeks of pregnancy.

Currently, in all maternity hospitals, pregnant women undergo one of the non-treponemal tests and RPGA. Test RPGA may remain positive even decades after syphilis treatment. Therefore, if you have had syphilis in the past, tell your doctor about this, since pregnancy management tactics depend on this, in particular the decision on whether to treat you or not.

False positive results are extremely rare, so if positive data is received from the laboratory, the tests must be repeated.

If syphilis was detected during pregnancy...

If a woman has been diagnosed with syphilis during pregnancy, then, in order to avoid severe consequences of the disease for the mother and child, two courses of treatment are required: the first, the main one, is carried out only in hospitals, immediately after diagnosis; the second, preventive, - in a hospital or outpatient. If syphilis is detected in the first and second trimester of pregnancy, then treatment is carried out twice: the first course - upon diagnosis, the second - at 20-24 weeks.

Penicillin antibiotics are used to treat syphilis. CEFTRIAXONE. The same drugs are used in other cases.

Currently in Russia, only a few commercial medical centers are licensed to treat syphilis. Some centers are closing or moving, and information is no longer available to patients. This leads to the lack of necessary clinical and serological monitoring of patients after treatment for syphilis for a certain time (from 6 months to several years), lack of medical documentation and the impossibility of obtaining various certificates and statements about the diagnosis, treatment and test results. Therefore, treatment of syphilis is still recommended in public health facilities. If a commercial medical center has been chosen, then it is necessary to save for many years an extract with the diagnosis (the word “syphilis” is not a diagnosis - the stage of the disease must be determined), the name of the drug that was treated, and its dose. This may assist other doctors in addressing issues related to maternal and child health. I would especially like to note that for the treatment of syphilis during pregnancy, drugs are used that do not have a negative effect on the fetus.

After treatment, the disease stops its development, that is, primary syphilis does not turn into secondary, and secondary into tertiary, damage to organs and tissues by treponema stops, there are no rashes on the skin and no further damage to the nervous system occurs. This means that there is no threat to the health of the pregnant woman. After completing the course of treatment, it becomes non-contagious. Modern methods of treating syphilis make it possible to most likely prevent congenital syphilis in a child if the disease is detected in a woman in the first two trimesters of pregnancy. There is no doubt that the detection of syphilis in a pregnant woman is an indication for treatment, and not for termination of pregnancy, if desired. After birth, the child is subject to mandatory screening for syphilis.

If the diagnosis was made for the first time during pregnancy, then the pregnant woman is usually treated in a specialized maternity hospital or infectious diseases hospital; childbirth is also carried out in a specialized maternity hospital or in the observation department of a regular maternity hospital.

If a woman had syphilis before pregnancy...

If the diagnosis of syphilis was made before pregnancy and full treatment was carried out, then the risk of transmitting the infection to the child is less, the more time passes after treatment before pregnancy. It is believed that 2-3 years after treatment the risk of infection becomes minimal, because after 2-3 years a cure can be most likely guaranteed. The risk of infection of the child is determined by the doctor based on the results of tests on the pregnant woman, and to prevent the occurrence of congenital syphilis in the child, if necessary, preventive treatment is prescribed to the mother.

Treatment is usually prescribed between 20 and 24 weeks of pregnancy. By this point, the placenta is fully formed, so treatment carried out after 20 weeks of pregnancy will be the most complete: the child will fully receive medications through the placenta. Throughout pregnancy, a woman remains epidemically harmless, that is, non-infectious. Childbirth can, at the request of the pregnant woman, take place in any maternity hospital and in any department (if there are documents confirming the diagnosis and treatment provided).

• If the infection occurred recently, a full course of treatment was carried out, but the reactions still remain positive and the woman has not yet been removed from the register for syphilis, then during pregnancy tests are carried out 1 time for each trimester, that is, tests are performed three times, but in a larger volume, than healthy pregnant women, and preventive treatment is carried out at 20-24 weeks of pregnancy. After birth, the child is subject to mandatory screening for syphilis.
• If infection with syphilis occurred a long time ago and currently non-treponemal tests are still positive (and the doctor speaks about the state of seroresistance after treated syphilis), then during pregnancy tests are taken once every trimester, and at 20-24 weeks of pregnancy preventive treatment. When planning pregnancy in these situations, additional treatment is recommended before pregnancy. After birth, the child is subject to mandatory screening for syphilis.
• If syphilis infection occurred a long time ago and currently non-treponemal tests are negative, then during pregnancy it is recommended to repeat the tests 3 to 4 times during pregnancy. If nontreponemal tests are negative, treatment is not required. If there is even one positive test, preventive treatment can be carried out in the interests of the child. After the birth of a child, recommendations for examining him for syphilis are possible.

All doubtful cases are resolved in favor of the child, that is, additional treatment is carried out.

If the child's father has syphilis...

First, you need to figure out when the disease began and whether the child’s father received full treatment. Syphilis is transmitted to the child only from a sick mother in the second trimester of pregnancy, and the presence of untreated syphilis in the father is dangerous for the health of the mother and child. At conception, the child does not become infected from the father.

There are several typical situations:

• If the child’s father has recently been diagnosed with syphilis and has not yet undergone treatment, then it is certainly dangerous to the health of both the pregnant woman and the child, and is subject to emergency treatment. Sexual relations should be avoided until treatment is completed.
• If at some time in the past the child's father had syphilis, full treatment was carried out and there are currently no positive non-treponemal tests (Wassermann reaction, RPR, BDRL, EM or RMP are negative), then the child's father cannot be source of infection and is safe for the health of the child and pregnant woman.
• If in the past the father of the child also had syphilis, full treatment was carried out, but at the moment there are still positive non-treponemal tests, and more than a year has passed since the end of treatment, then this situation poses a danger primarily to the health of the man who may need additional treatment. It is not dangerous for a pregnant woman and child.

Child monitoring

Doctors watch especially closely for a baby whose mother has ever suffered from syphilis. If a child shows signs of congenital syphilis, treatment is carried out immediately after birth. In this case, the baby is transferred from the maternity hospital to a specialized infectious diseases hospital. Children who do not have signs of congenital syphilis are observed during the first year of life: the first test is taken immediately after birth from the umbilical cord, then studies are carried out every 3 months. In the first analysis, the presence of antibodies to the causative agent of syphilis is allowed: these are antibodies received by the child from the mother (by the way, like antibodies to any other infection). In the results of subsequent tests, the amount of antibodies normally decreases. If this does not happen and the number of antibodies increases, this indicates that the child is infected. In this case, the baby also needs treatment in a specialized hospital.

At the moment, on the territory of Russia, of all the laws adopted in relation to sexually transmitted diseases in the USSR, Article No. 121 of the Criminal Code “On liability for intentional infection with a sexually transmitted disease” is in force. Syphilis is one of them, and this is another reason to take your health and the health of your loved ones seriously.

1 The Wassermann test has been used since 1906 to diagnose syphilis; the analysis is named after one of the authors of this reaction - German microbiologist and immunologist August Wasserman.

During pregnancy, this is a serious problem, since the disease can provoke premature birth and subsequently lead to dangerous pathologies in the child. Therefore, expectant mothers are required to undergo a test to detect this disease, which will allow timely treatment.

If this disease is detected, the question of the need to terminate the pregnancy is raised. In most cases, this is not necessary - the disease can be cured without consequences for both the expectant mother and the fetus. By the way, half of women infected with syphilis learn about their disease during pregnancy when appropriate screening is carried out. However, in some cases abortion is recommended. This happens if a woman becomes pregnant while already infected.

If the mother previously suffered from syphilis and successfully treated it, then she is recommended to become pregnant no earlier than 3 years after the “healthy” conclusion. The more time passes from the moment of treatment, the greater the chance of carrying and giving birth to a healthy baby, since the likelihood of relapse of the disease and infection of the fetus is minimal. Before planning a pregnancy, you should definitely be tested for syphilis and, if necessary, undergo preventive treatment.

The signs of this disease in expectant mothers are no different from the symptoms of other patients. This disease can occur latently, without showing certain signs, or violently. Most often, pregnant women are diagnosed with a latent form of syphilis. Symptoms of syphilis depend on the stage of the disease.

Stage 1

The main symptom is a hard chancre in the place where the treponema has entered the body. This is a firm, painless ulcer that usually appears in the perineum, cervix, vulva or penis, rectum or mouth - where the virus enters the body. The ulcer goes away on its own within a few weeks. This indicates that syphilis has moved to the next stage.

Stage 2

Lymph nodes throughout the body become inflamed and enlarged. The appearance of characteristic or mucous membranes is possible. If it appears on the scalp, then hair loss is possible. Wide condylomas or growths appear on the skin, which serve as a source of infection. When such changes occur, the risk to the fetus increases significantly, and there is almost no chance of maintaining the pregnancy. The fact is that at this stage, treponema - the causative agent of syphilis - enters the blood, so all organs and systems of the body are under attack. Gradually this leads to irreversible changes.

Stage 3

It is characterized by dangerous pathological processes that affect many internal organs. The heart and liver are most often affected. The nervous system is also under attack, which leads to disruption of the functioning of other organs. This stage of the disease is incompatible with pregnancy; there is no point in trying to save the fetus at this stage, since, most likely, the child will die anyway. In addition, the third stage of syphilis is considered the last and often leads to death.

Diagnostics

To detect syphilis during pregnancy, several tests and samples are prescribed at once. This will allow you to accurately determine whether a woman is infected. Screening (MR or RF) is usually prescribed. The disadvantage of the analysis is that it is often false positive during pregnancy. If a woman receives such a result, she undergoes RPGA and RIF tests.

If both tests are negative, the doctor concludes that the expectant mother is healthy. If one of the two tests also showed a positive result, then either the woman has an early stage of the disease, or the test also turned out to be false positive - although rare, this does happen. Then additional tests are prescribed: immunoblotting, RIBT, ELISA. They will help clarify the clinical picture. If the screening and the results of both tests are positive, then a diagnosis of syphilis is made, since false positive results in all three cases are excluded.

It must be remembered that the Wasserman reaction is not the most accurate diagnostic method, since during pregnancy women often show a false positive. So don't panic when you see this result. In addition, this possibility exists in patients with lupus erythematosus, rheumatoid arthritis, hepatitis, etc. In patients who previously had syphilis, but successfully got rid of it, a similar result of screening and tests is also possible.

According to standards, a woman undergoes screening and tests for syphilis three times during the entire period of pregnancy.

Why is syphilis dangerous during pregnancy?

The disease cannot be ignored, since it is dangerous for both the woman and the unborn child. This is largely due to the fact that the functioning of the cardiovascular system is disrupted: the lumen of the blood vessels narrows, and this leads to an increase in the volume of the placenta. The supply of nutrients to the child is sharply reduced, he does not receive enough oxygen and many other substances necessary for his development.

Due to syphilis, there is a high risk of spontaneous abortion throughout pregnancy. In the early stages this is a miscarriage, in the third trimester - premature birth.

There is also a possibility:

• stillbirth;
• frozen pregnancy;
• death of a baby in the first days after its birth;
• the appearance of a baby with congenital syphilis.

If syphilis in a pregnant woman has not been treated, then it is possible that this disease will appear in the child not immediately after birth, but within 3-5 years. In this case, this leads to disability of the baby and can provoke his early death. Such consequences can be avoided if you undergo comprehensive treatment and follow all the recommendations of specialists. The earlier the disease is detected, the greater the chance of successful treatment.

There is no need to immediately have an abortion if the expectant mother is diagnosed with syphilis. Some doctors may recommend this outcome, but this is not always justified - timely treatment ensures the birth of a healthy baby.

How does a fetus become infected?

There is a danger of infecting the fetus at any stage of pregnancy. There are two ways of transmitting infection from mother to unborn child:

1. Through the placenta- it usually serves as a protective barrier for the baby, stopping toxins and infections from reaching the baby. However, the placenta often becomes infected, which invariably causes infection of the fetus. This usually occurs in the secondary period of syphilis.
2. During childbirth- this path is possible if the mother did not undergo treatment while carrying the child. Since during childbirth the baby comes into direct contact with the mother's blood, infection occurs at this moment. Therefore, women diagnosed with syphilis are recommended to give birth by caesarean section - thus the risk of infection is significantly reduced.

If the fetus was infected through the placenta, then the first irreversible changes occur only after 5-6 months. Therefore, there is always a chance to completely cure syphilis even before the child is born.

If it was not possible to avoid infection of the fetus, then the manifestation of early or late congenital syphilis is possible. In the first case, the newborn has skin damage, prematurity, and bone deformation. Such a baby does not recover well, shows restlessness and anxiety, constantly cries, and refuses to eat. With late congenital syphilis, symptoms appear no earlier than 2-3 years after birth. But more often people learn about the disease between 7 and 14 years. In this case, the child’s organs of vision and hearing are affected, and teeth develop incorrectly. Many systems and organs do not work correctly due to modification, which leads to various chronic pathologies.

Treatment

The selection of therapy depends on the duration of pregnancy and the stage of syphilis. In the first months of pregnancy (up to 18 weeks), medications are used that take a long time to be eliminated from the body (durant). In the 2nd and 3rd trimesters, preference is given to drugs that are eliminated much faster.

In the first trimester

If syphilis is discovered at 2-3 months of pregnancy, then treatment is carried out in two stages: first, medications are prescribed - antibiotics of the penicillin group, which are safe for both mother and baby. Treponema is very sensitive to this medicine, so it has almost no chance and treatment is most often successful. At the second stage of treatment, preventive therapy is carried out to prevent relapse of the disease.

In the second and third trimester

The most unfavorable prognosis concerns those cases where pregnancy occurred after syphilis entered the mother’s body. Almost half of pregnancies (45% of cases) end in miscarriage or death of the fetus inside the womb.

But if the infection occurred after the woman became pregnant, then there is every chance of keeping a healthy child. For this purpose, preventive therapy for syphilis is prescribed, antiviral medications and immunostimulants are prescribed. The baby receives these medications through the placenta, which helps prevent infection.

Traditional treatment

It is impossible to get rid of syphilis using traditional methods, but some techniques, when combined with drug therapy, can speed up recovery and have a positive effect on the treatment process.

Of the most popular non-traditional methods, we note:

• drinking a decoction of burdock root and hops;
• ingestion of propolis (20 drops per ¼ cup);
• honey compresses on the area of ​​ulcerative rashes;
• drinking wine-garlic tincture.

In some cases, it is appropriate to use homeopathic medicines containing mercury, arsenic and iodine. But such medications are strictly contraindicated for pregnant women!

After childbirth

If the mother of a born child once had syphilis (even if it was cured long before pregnancy), then the baby is given especially close attention. Tests and samples are regularly carried out to determine this disease. If signs of congenital syphilis are detected, appropriate treatment is immediately prescribed. The baby is in a specialized institution, where pediatricians monitor him and conduct examinations. If no symptoms of syphilis are detected in the newborn, then the baby is discharged and sent home, but is closely monitored for 12-18 months.

The first step is to take an analysis from the umbilical cord, and then specific studies are prescribed at intervals of three months. The first test usually shows the presence of antibodies in the child’s blood - this is normal, since they entered the baby’s body from the mother. Further tests should show that the number of antibodies to syphilis is gradually decreasing. In this case, the child is removed from the register. If, on the contrary, their number increases, this indicates that the baby is infected. In this case, therapy and observation in a specialized hospital are prescribed.

Prevention

Even if there are people with syphilis in the family, infection is easy to avoid. To do this, pregnant women and everyone else need to follow simple recommendations:

• use personal hygiene products;
• do not contact sick people, especially avoid touching affected areas of the skin;
• use condoms during intimacy;
• regularly take tests for the presence of antibodies;
• undergo preventive treatment if infection is suspected.

If a pregnant woman is diagnosed with syphilis, then treatment is mandatory for all her sexual partners - she must inform them of her diagnosis so that they have the opportunity to see a doctor in a timely manner.

In this video, a dermatovenerologist talks about the treatment of syphilis during pregnancy.

This is a chronic venereal disease known since the end of the 15th century. The causative agent of syphilis is Treponema pallidum. Once in the body, it multiplies very quickly, enters the bloodstream and spreads throughout the body, which is why syphilis is a disease that requires long-term treatment, and also after complete recovery, positive tests can be detected. Subsequent pregnancy requires constant monitoring and prevention, since the disease affects all organs and can be transmitted in utero.

Pregnancy after syphilis - how does it proceed?

If syphilis was diagnosed before pregnancy, then in such cases there are a couple of options for the development of events:

The infection occurred long before pregnancy, the full course of treatment was completed and no positive tests appeared for 2.5-3 years.

Under such conditions, there are fewer circumstances for alarm in the event of pregnancy after syphilis, but they exist. There is a small risk of infection of the fetus, which is determined by the doctor based on the tests of the pregnant lady. To prevent congenital syphilis, preventive treatment can be prescribed, in most cases at 20-24 weeks, at a time when medications can reach the baby through the placenta. Tests are taken once a trimester, and at the end of childbirth, the child must be tested for syphilis.

The infection occurred before pregnancy, the full course of treatment was completed, but the positive reactions remained.

In this case, pregnancy after syphilis ends is more dangerous, but with proper monitoring and prevention, the risk is reduced to zero. Regular testing, also once every trimester, but in a larger volume than for healthy ladies, and mandatory preventive treatment at 20-24 weeks, constant supervision by a doctor significantly reduce the risk of infection of the child. At the end of childbirth, the child must also undergo a preventive examination.

The woman infected before pregnancy was not treated,

A pregnant woman is subject to mandatory hospitalization and undergoes a full course of treatment. At the end of the course, regular tests are taken, and at 20-24 weeks, preventive treatment is prescribed to prevent intrauterine infection. In the case of pregnancy after syphilis ends and the fetus is infected, the ending is usually disastrous, but if the child survives, he may be born with skin rashes and inflammations, damage to the eyes, liver, etc.

Read with this article:

Pregnancy after completion of treatment for syphilis.

Hello. 4 months ago they found syphilis reaction 4+, completed a 10-day course of treatment with ceftriaxone, and are currently 3 weeks pregnant. Please advise what to do. Thank you in advance. Ksenia

The first thing that needs to be stated is that if this pregnancy is desired for you, contracting syphilis before pregnancy and also during pregnancy is not an indication for its termination.

Yes, in your case there is a certain risk of intrauterine infection of the child through the placenta, as a result of which it is likely that the child will be born with early manifestations of syphilis or late symptoms of congenital syphilis, or the presence of persistent positive serological reactions in an apparently healthy child.

If complete treatment for syphilis was carried out before pregnancy, the risk of transmitting the infection to the child is less, the more time passes after the end of treatment before pregnancy.

The most dangerous period for a child is the secondary period of syphilis in the mother and the first 3 years after the mother’s infection ends. It is believed that only after 2-3 years have passed after the end of treatment it is possible to say whether the treatment of the disease was successful, and the risk of infection is minimal.

In addition, a patient with syphilis is likely to have pregnancy complications: late miscarriage (in most cases at 12-16 weeks), stillbirth, premature birth,

Based on this, in order to avoid serious consequences, you should register with the antenatal clinic as soon as possible. Along with this, be sure to inform your doctor about the illness you have suffered, since pregnancy management tactics depend on this, in particular, the decision on whether to treat you or not treat you. Modern methods of treatment make it quite possible to prevent congenital syphilis in a child if the disease is detected in a woman in the first two trimesters of pregnancy. In addition, when registering for pregnancy, blood tests for syphilis are mandatory, and an extended test for syphilis will necessarily demonstrate positive reaction.

The possibility of infection of the baby is assessed by the doctor based on the results of tests on the pregnant woman, and to prevent the occurrence of congenital syphilis in the child, preventive treatment is prescribed to the mother.

Syphilis in pregnant women

In most cases, if the infection occurred relatively recently, reactions to syphilis remain positive even after the full course of treatment has been completed, and the woman has not yet been deregistered for syphilis.

In this case, the pregnant woman is prescribed control tests at least once a trimester, in an expanded form. Preventive treatment is carried out at 20-24 weeks of pregnancy, at a time when the placenta is already fully formed, and medications reach the baby through the placenta in the required volume. To treat syphilis during pregnancy, penicillin antibiotics are used, which do not have a negative effect on the fetus.

If there are documents confirming the diagnosis and treatment, the birth will be able to take place in a simple maternity hospital in a simple department.

After birth, the child must be examined for syphilis.

If indicators of congenital syphilis are detected, if indicators of congenital syphilis are detected in a child, postpartum treatment of the child is carried out. For this purpose, mother and baby are transferred to a specialized infectious diseases hospital.

If syphilis indicators are not recognized at birth, the child is noticed during the first year of life, and blood tests for syphilis are taken every three months.

Quite often, the first blood test from the baby’s umbilical cord contains antibodies to the causative agent of syphilis, received by the child from the mother. Normally, subsequent tests should contain fewer antibodies. If it increases, this means that the child himself is infected and needs hospital treatment.

Symptoms of syphilis that appear on the skin disappear over time, while internal disorders only increase. The most important consequences of the disease are characteristic of the tertiary period

Syphilis may be accompanied by complications in the genitals, leading to infertility, but such cases are rare. The situation in which a pregnant woman suffers from syphilis is more terrible. This threatens fetal infection, miscarriage or stillbirth.

With timely and systemic treatment, the consequences of syphilis can be avoided. Much more often, treponemal blood tests for syphilis remain positive as before, even after the end of treatment. Therefore, to evaluate the effectiveness of therapy, other laboratory examination methods are used, comparing them with each other (for example, RPR or THRA analysis).

Pregnancy after syphilis

A healthy pregnancy after the end of syphilis is likely if a full course of treatment has been carried out and comprehensive tests indicate recovery.

And yet, after completing the course of treatment for the disease, domestic couples are advised to postpone planning a pregnancy. In addition, if syphilis is defeated, the body needs some time to recover after the end of antibiotic therapy (on average, 1-2 years).

Are preventive measures necessary after syphilis ends during pregnancy?

• If a woman has completed a full course of treatment for syphilis, but non-treponemal tests for syphilis remain positive, then specific prophylaxis is carried out during pregnancy, and during childbirth the patient may be transferred to a separate delivery unit or observational department.
• If non-treponemal tests are negative after the end of syphilis, and the woman is removed from the dispensary register with a venereologist, then pregnancy management and childbirth after syphilis ends are carried out in a general manner, without additional preventive measures.

• Analysis for chlamydia, trichomoniasis, herpes 700 R
• Syphilis + HIV + hepatitis B, C 1000 R
• Culture for sensitivity to antibiotics RUB 1,200
• PCR (smear) 350 R

Determine the correct price of treatment by calling the number or filling out the form:

Syphilis and pregnancy are an important threat to the fetus

Syphilis and pregnancy are a threat from congenital syphilis to the fetus, and therefore a real threat to his life and health. It is precisely on this basis that all pregnant women are required to be examined for syphilis at least several times, as well as at the time of registration at the antenatal clinic and before childbirth.

Syphilis in pregnant women

This is invariably a danger to the child. This disease can be caused by spontaneous miscarriage. Miscarriage - is it possible to insure against it? or premature birth. If childbirth occurs on time, children are often stillborn with symptoms of maceration or with indicators of congenital syphilis.

The causative agent of syphilis reaches the fetus through a pathologically altered placenta (placental syphilis). In the placenta, along with this, major transformations are revealed: the chorionic villi are thickened, rich in connective tissue, the blood vessels are largely obliterated (their lumen is reduced or completely absent).

Syphilis during pregnancy leads to the placenta, which significantly increases in volume, acquires a pale pink color and increased density. The placenta affected by syphilis may be two or more times heavier than the placenta of a healthy woman. With such an afterbirth, termination of pregnancy occurs at 24-28 weeks due to the fact that the child’s body does not receive the necessary nutrients and oxygen and dies - just based on this, most experts are confident that syphilisSyphilis is the punishment of Venus and pregnancy are incompatible concepts.

If the fetus is infected with syphilis during pregnancy, the child is born with indicators of congenital syphilis and may die immediately after birth. If such a child survives, then major transformations in his internal organs and central nervous system are likely. From time to time, all manifestations of congenital syphilis develop a couple of years after birth.

Syphilis and childbirth are also invariably troubles: birth is quite often premature and the child dies. If infection with syphilis occurred in the last months of pregnancy and the fetus was late to become infected with syphilis, then infection is likely during childbirth.

Test for syphilis during pregnancy

All women are tested for syphilis three times during pregnancy: during registration at the antenatal clinic, at 28-30 and 36 weeks of pregnancy.

Non-treponemal tests such as the Wasserman reaction (RW) and its more sensitive and high-quality modern analogues - RPR, VDRL - are carried out. In the presence of syphilis, they are invariably positive. But these tests will be able to recognize false-positive syphilis in pregnant women, since they are nonspecific and can be positive for other diseases.

When a positive RW is detected, treponemal tests (ELISA, RPGA, RIF, RIBT) are mandatory, which are positive only for syphilis. The disadvantage of these tests is that they can remain positive even after successful treatment of syphilis until death. These tests detect antibodies to the causative agent of syphilis, Treponema pallidum.

To completely confirm the diagnosis of syphilis, one positive non-treponemal test (for example, RW) and two non-treponemal tests (for example, ELISA and RPGA) are required.

Treatment of syphilis during pregnancy

Treatment is carried out in the second trimester from 20 to 24 weeks of pregnancy - this is the most reliable period for the fetus. It is believed that until the 24th week of pregnancy, infection of the fetus with syphilis does not occur.

Treatment of syphilis in pregnant women is performed with antibiotics of the penicillin group according to regimens specifically designed for pregnant women.

Treated syphilis and pregnancy

Syphilis during pregnancy is transmitted to the fetus through the body of a mother with syphilis. The more time has passed from the moment of her infection to the onset of pregnancy and the more intensively she was treated before pregnancy and during it, the less the risk of infection of the fetus, its intrauterine death or the birth of a child with congenital syphilis. Congenital syphilis is intrauterine infection of the fetus from a sick mother.

Is it possible to give birth after syphilis ends? Yes, it is entirely possible that the birth of a healthy child will be possible. It is believed that the optimal period for planning pregnancy is two to three years after the end of treatment. If, without paying attention to treatment, during pregnancy there is a suspicion of an infection, treatment is carried out throughout pregnancy in the second trimester from 20 to 24 weeks, after which the woman is carefully observed and tested for syphilis - this allows birth healthy child.

Pregnancy after syphilis is fully possible, but with careful observation and, from time to time, preventive treatment for the woman.

Prevention of syphilis during pregnancy is planning a pregnancy with a preliminary full examination of the future parents. If, under such conditions, one of the spouses is diagnosed with syphilis, the diagnosis of the disease is clarified, a thorough examination of the spouse is carried out, based on the results of which the couple or one of the spouses is prescribed treatment. Pregnancy after treatment for syphilis Treatment of syphilis, a labor-intensive process, is recommended after two to three years.

Is it possible to give birth to a healthy child after cured syphilis?

creator | 12/15/2008, 22:06:29

• 1. | 16.12.2008, 00:03:38

I heard. that at the end of cured syphilis. in addition, after 10 years or more. a sick child may appear. Because this disease deforms something in the genes. Don't know. Is this true? A family with three children lived next door to us, all of them were idiots in the medical sense. They talked. that this is because dad had syphilis. But that was in the distant past. Go to the doctors - including a geneticist - and get advice.

And how is the baby? I have the same situation! At the moment I’m very afraid of 30 weeks

And I have the same problem (((I was sick about 15 years ago. I was completely cured, I worked at a food company for 13 years, donated blood every year, everything was OK. And during B I showed a + reaction. I couldn’t save the pregnancy, but I managed to hang around in the CVD. Now I don’t know what to do, we are planning to get pregnant again, go to the hospital again. Then the doctor said that she would inject something at 20 weeks, but I categorically don’t want to have Syphilis a hundred years ago, and even then, it was recognized. at a time when the tests were still negative.

This disease has been known for quite a long time, since the end of the 15th century. Refers to chronic venereal diseases.

The cause of syphilis is Treponema pallidum, which, having penetrated the human body, begins to actively multiply and spreads through the circulatory system to all organs and systems.

That is why this disease requires long-term therapy, and often, even after a seemingly complete recovery, tests to identify it can show a positive result.

How can a woman become infected with syphilis?

Mostly, infection with the causative agent of syphilis occurs through sexual contact. Moreover, in the case of one-time unprotected sexual intercourse, the probability of contracting syphilis is about 30%.

However, we should not forget about the contact and household route of transmission of syphilis.

So, for example, you can become infected through contact with wet things of a sick person, or through saliva from kissing, common objects (for example, through cutlery).

Pregnancy after syphilis

Since the disease has a high probability of transmitting the pathogen from mother to child, a pregnant woman with a history of syphilis will undergo constant monitoring throughout the entire gestational period.

History of syphilis and pregnancy

If the expectant mother undergoes a full course of therapeutic treatment and passes all the necessary tests that confirm that the disease has been defeated, her chance of a healthy pregnancy will increase significantly.

However, married couples who have completed all the necessary procedures and studies should still wait to plan a pregnancy for at least the next year or two.

After all, it will take time for the body to recover after antibiotic therapy.

How does pregnancy proceed after cured syphilis?

There are several options for the course of the gestational period in a woman with a history of syphilis.
For example:

1. If pregnancy occurs after a long period of time after infection and 2.5-3 years after successful completion of the course of treatment, the woman has never had a positive test result. In this case, of course, there is a chance of infection of the fetus, but it is small. To reduce it, the expectant mother will undergo preventive treatment during pregnancy. Most likely this will happen at 20-24 weeks, when medications can penetrate the placental barrier. In addition, once a trimester you will need to take the necessary package of tests to detect syphilis, which will also be taken from the newborn.
2. If a woman becomes pregnant after completing a full course of therapy, but positive reactions remain in the tests. Here the probability of an unfavorable outcome is slightly greater than in the first case. However, if a pregnant woman undergoes proper monitoring and undergoes preventive treatment at 20-24 weeks, the risk of infection of the child will be minimal. During the entire gestational period, she will have to undergo the necessary tests regularly (once every 3 months). After delivery, the newborn will also undergo a preventive examination to detect this disease.
3. If pregnancy occurs after infection, but the expectant mother has not received therapeutic treatment. In this case, the pregnant woman must go to the hospital for treatment. Then she will undergo regular tests, and at 20-24 weeks, to reduce intrauterine infection of the fetus, she will undergo mandatory preventive therapy. If, despite the measures taken, infection occurs, the outcome will most likely be disastrous. The child, although he will survive, will be born with various lesions of the skin, eyes and internal organs.

Preventive measures during the gestational period after syphilis.

• A pregnant woman who has had syphilis must undergo the necessary tests at 20-24 weeks.

1. Analysis for chlamydia, trichomoniasis, herpes;
2. Analysis for syphilis, HIV, hepatitis B, C;
3. Tank culture for sensitivity to antibacterial agents;
4. PCR swab.

• If a woman has completed a course of therapy, but tests for the disease are still positive, in addition to undergoing the standard tests in this case, she will be moved to an isolated delivery room or to an observation department during childbirth;
• In the case when the tests for the disease are negative and the expectant mother is no longer registered with a venereologist, the gestational period and childbirth will not be different for her from other women.

What complications may arise with conception, pregnancy and childbirth after suffering from syphilis?

Due to the fact that the development of medicine is progressing by leaps and bounds, today there are practically no cases where cured syphilis somehow affected the reproductive function of a woman or the health of her newborn child.

A much greater danger is posed by the situation when the expectant mother becomes infected with syphilis during the gestational period.

In this case, the likelihood of a late miscarriage or stillbirth is much higher.

As for conception, unlike trichomoniasis, chlamydia and gonorrhea, cured syphilis does not affect conception in any way.

This is explained by the fact that syphilis does not cause blockage of the fallopian tubes and the development of chronic inflammation in the female reproductive organs.

However, it is worth keeping in mind that in medical practice there are still cases when, even several years later, after undergoing a full special course of therapy, women, due to illness, give birth to children with various health problems.

That is why both the gestational period and delivery of an expectant mother who has cured this disease should take place under especially close regular monitoring.

What is the probability of infection of the unborn child by a mother who was cured of syphilis before pregnancy?

The risk of infection of the fetus in a woman who has had syphilis depends on several factors. So, for example:

• If she was infected with syphilis more than 3 years ago, underwent a full course of therapeutic treatment, and her tests for syphilis (MR/MP) at the end of treatment were negative, during the gestational period she will need to undergo only one test (MR):

1. if it is negative, then the probability of infection of the fetus is very low (approximately zero). A woman expecting the birth of a child during the gestational period will not need to undergo additional preventive treatment;
2. If during the gestational period the test result is positive or doubtful, the woman will be offered to undergo preventive therapy.

• If the expectant mother had syphilis less than 3 years ago, also underwent a course of treatment, and at the end of therapy her tests for syphilis (MR/RS) were negative, during the gestation period she will have to undergo one test (MR):

1. if its result is negative, the expectant mother will not need to undergo preventive therapy;
2. if the result is positive or doubtful, the woman will be asked to undergo preventive treatment, since in this case the risk of infection of the unborn child is more likely.

• If the expectant mother had syphilis less than 3 years ago, has completed the course of the necessary therapeutic treatment, but her test results are still positive, she will be asked to undergo a course of treatment during the gestational period in order to reduce the likelihood of the child becoming infected.

A child whose mother has had syphilis is monitored by doctors especially carefully.

In a child without signs of congenital syphilis, during the first year of life, blood is taken every three months for analysis to identify the disease.

Moreover, the first time is immediately after birth from the umbilical cord. Here, antibodies to the pathogen that the child received from the mother can be detected. Next, the amount of antibodies should gradually decrease.

If this does not happen or the number of antibodies increases, the child is infected. In this case, he is treated in a hospital setting.

Such therapy can be carried out immediately after the baby is born if he has signs of a congenital form of the disease.