妊娠期梅毒的临床结局

摘要

目的 探讨妊娠合并梅毒的筛查、治疗及妊娠结局,降低不良妊娠结局的发生率.方法 对180例经血清学筛查并确诊为妊娠合并梅毒的临床资料进行回顾性分析,根据妊娠期是否抗梅毒治疗及治疗的早晚,将孕妇分为A组(早孕中孕开始治疗)、B组(晚孕开始治疗)、C组(未治疗),比较三组孕妇的妊娠结局.结果 除去选择性引产5例,175例妊娠合并梅毒的产妇入院即确认死胎的10例,出生1周内诊断为胎传梅毒新生儿33例.A组死胎1例,B组1例,C组8例,三组比较有显著性差异(P<0.05);A组新生儿先天梅毒10例,B组10例,C组13例,三组比较有显著性差异(P<0.05).结论 妊娠合并梅毒是导致不良妊娠结局的重要因素,妊娠期及早进行规范的抗梅毒治疗能很好改善不良妊娠结局.%Objective To investigate obstetric treatment and pregnancy outcome of syphilis infection during pregnancy. Methods In a retrospective study,we evaluated 180 pregnant women ( 20 ~35 years ) diagnosed with syphilis by serological assays. The 175 cases were divided into three groups apart from elective termination of pregnancy: A group for treating pregnant women during the first or second trimester of pregnancy; B group for pregnant women during late pregnancy; C group for untreated group. Results There were 103 cases screened and final diagnosed during the first or second trimester of pregnancy( A group ),41 cases screened and final diagnosed during the final of pregnancy( B group ) ,30 cases were not diagnosed until peripartum( C group ). Among the 175 cases, there were 1 case of fetal intrauterine death in A group, 1 case in B group,8 cases in C group;there were 10 cases of congenital syphilis in A group, while 10 cases in B group and 13 cases in C group respectively. The pregnancy outcomes were observed and compared and there were significant differences in three groups( P<0. 05 ). Conclusion Syphilis in pregnancy is a serious harmful complication to the fetus, can be well controlled through regular and earlier treatment against syphilis during pregnancy. It is also the key for improving the pregnancy outcome.