Original ArticlesEfficacy of treatment for syphilis in pregnancy☆
Section snippets
Materials and methods
This was a prospective clinical trial from September 1, 1987, to August 31, 1989, including all women who delivered at Parkland Memorial Hospital in Dallas, Texas, approved by the University of Texas Southwestern Institutional Review Board. Subjects were identified through the Dallas County Hospital District prenatal system by maternal syphilis serologic screening (first prenatal visit, 28–32 weeks prenatal visit, and at delivery), the Parkland Memorial Hospital Emergency Room, or Dallas County
Results
During the 2-year study period, 28,552 women delivered at Parkland Memorial Hospital. Seven hundred forty-six had positive serologic tests for syphilis, and 298 of these were identified as having sero-fast serologic tests. Four hundred forty-eight women (1.6% of the population) had untreated syphilis, of those 340 (75.9%) received prenatal care and antepartum therapy (Table 1).
The mean age of women with untreated syphilis was 24 years, and the mean gestational age at diagnosis was 32 weeks.
Discussion
A resurgence of congenital syphilis in the 1980s led to questions about the adequacy of the CDC guidelines for treatment of maternal syphilis and prevention of neonatal infection. Several factors contributed to the increase in congenital syphilis, including increased incidence of maternal disease, failure to detect maternal disease, noncompliance with treatment recommendations, and fetal treatment failure. Lack of prenatal care leading to failure to identify and treat maternal infection
References (16)
- et al.
Use of aqueous benzathine penicillin G in the treatment of syphilis in pregnant women
Am J Obstet Gynecol
(1962) - et al.
Penicillin therapy of the syphilitic pregnant womanIts practical application to a large urban obstetrical service
Am J Obstet Gynecol
(1950) - et al.
Epidemic syphilisMaternal factors associated with congenital infection
Am J Obstet Gynecol
(1994) - et al.
Penicillin in the treatment of syphilis in pregnancy
J Veneral Dis Information
(1949) The value of penicillin alone in the prevention and treatment of congenital syphilis
Acta Derm Venereol Suppl (Stockh)
(1951)- et al.
Outcome of pregnancies of women treated with aqueous penicillin for early infectious syphilis
Arch Dermatol Syphilology
(1950) Policy guidelines for the prevention and control of congenital syphilis
MMWR Morb Mortal Wkly Rep
(1988)1998 guidelines for the treatment of sexually transmitted diseases
MMWR Morb Mortal Wkly Rep
(1983)
Cited by (159)
The Mortality of Congenital Syphilis
2023, Journal of PediatricsSyphilis in Neonates and Infants
2021, Clinics in PerinatologySyphilis Complicating Pregnancy and Congenital Syphilis
2024, New England Journal of MedicineCongenital Syphilis—An Illustrative Review
2023, Children
- ☆
Supported by grant R30/CCR 602742 from the Public Health Service and Centers for Disease Control and Prevention.