Asia Batool, Khatoon Akhtar Bano, Misbahul Islam Khan Sherwani, Riaz Hussain.
Syphilis screening: outcome and interventions at an antenatal clinic.
Pak J Med Res Jan ;48(3):64-7.

Background: Syphilis, a sexually transmitted disease which seemed to had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. While appropriate treatment of pregnant women often prevents such complications. Objectives: To study the frequency of syphilis in pregnant women coming to a public sector hospital and see the pregnancy outcome of positive mothers and disease transmission in neonates. Patients and Methods: This cross sectional and interventional study was conducted at PMRC Research Centre, Fatima Jinnaha Medical College, Lahore among pregnant women attending Sir Ganga Ram hospital for antenatal care. Blood samples from 2000 women were collected after taking consent from them. The blood was tested for syphilis by using Treponema pallidum haemagglutination assay. Infected mothers were administered intramuscularly with 2.4 million units of benzathine benzylpenicillin (penicillin G) after testing for hypersensitivity and followed for delivery outcomes such as abortion, miscarriage, intrauterine growth restriction, low birth weight, preterm delivery and still birth. Neonates born to infected women were examined for signs of congenital syphilis including non immune hydrops, jaundice, skin rash, pseudo paralysis and running nose along with blood test for either infection. Medical and reproductive histories were also obtained from women and recorded on a proforma. Results: The treponemal antibodies were detected in 9(0.45%) pregnant women. The highest positivity was obtained among age group of 21-26 years. There was no statistically significant difference of acquiring infection among women of different age, education, and socioeconomic backgrounds. Women in third trimester were significantly more infected with syphilis. Out of 9 couples 3 refused treatment, 1 received only one dose of penicillin, 2 received two doses while only three couples completed all doses. Delivery outcome included one abortion, two preterm deliveries and none of the neonate had sign of congenital syphilis. Only one couple consented for blood sampling of their neonate which was positive for syphilis and was referred to pediatrician. Conclusions: Only 9(0.45%) of pregnant women were infected with syphilis, which can seriously complicate pregnancy and result in spontaneous abortion, and preterm delivery. Screening for syphilis in pregnant women is recommended to detect infected woman who requires treatment to prevent further transmission of this disease to new born.

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