摘要
目的探讨妊娠期合并梅毒螺旋体感染的患者在妊娠期间进行规范驱梅治疗对妊娠结局及新生儿血清学转归的影响。方法回顾性分析2009年1月至2014年2月在南京中医药大学附属南京医院妇产科收治的192例妊娠合并梅毒螺旋体感染孕妇的临床资料,所有患者经梅毒快速血浆反应试验(RPR)和梅毒螺旋体颗粒凝集试验(TPPA)筛查,根据孕妇孕期是否接受规范驱梅治疗,分为治疗组162例和未治疗组30例,对所有活产新生儿完成12个月的血清学RPR跟踪随访,比较妊娠期规范驱梅治疗对妊娠结局和分娩新生儿血清RPR转阴率的影响。结果治疗组与未治疗组孕母足月活产率(91.4%vs40.0%)、死胎死产率(0.6%vs10.0%)、畸形引产率(1.2%vs16.7%)、子代先天性梅毒率(0.6%vs13.3%)组间比较差异均有统计学意义(P<0.05)。治疗组与未治疗组子代血清RPR累积转阴率在9个月(96.2%vs75.0%)和12个月(97.4%vs80.0%)差异均有统计学意义(P<0.01)。结论妊娠期梅毒螺旋体的筛查及规范驱梅治疗能显著降低妊娠不良结局的发生,降低子代感染先天梅毒的风险,其影响可持续至出生后12个月。
Objective To explore the impact of antisyphilitic treatment on pregnancy with syphilis and the transformation of rapid plasma regain(RPR)of the offspring.Methods In the total puerpera admitted in the hospital from January 2009 to February 2014,after screening with RPR of syphilis and treponema pallidum particle agglutination(TPPA),192 puerperal were recruited in the research and were separated into two groups-162 in the treated group and 30 in the untreated group.All live born neonates were followed up for 12 months and were retrospectively compared the effect of antisyphilitic treatment on the outcome of pregnancy and the rate of RPR negatively transformation of offspring.Results In the treated group and the untreated group,the rate of term birth was 91.4% vs 40.0%;the rate of fetal death/still births was 0.6% vs 10.0%;the rate of congenital malformation was 1.2% vs 16.7%;and the rate of congenital syphilis was 0.6% vs 13.3%;there were significant differences between the two groups(P<0.05).The rate of negative conversion in RPR of offspring at 6 months(96.2% vs 75.0%)and 9 months(97.4% vs 80.0%)after birth of the two groups were significantly different(P<0.01).Conclusion The syphilitic screening and antisyphilitic treatment during pregnancy could decrease the rate of harmful outcomes and neonatal infection of syphilis, which could ensure the quality of both maternal and neonatal health for 12 months.
作者
陈艳
韩国荣
王根菊
王翠敏
CHEN Yan;HAN Guo-rong;WANG Gen-ju;WANG Cui-min(Department of Gynaecology and Obstetrics,Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing 210003,Jiangsu,China)
出处
《东南国防医药》
2019年第4期348-351,共4页
Military Medical Journal of Southeast China
基金
国家重大传染病防治科技专项课题(2017ZX10201201-001-002)
关键词
妊娠合并梅毒感染
驱梅治疗
结局
新生儿
pregnancy with syphilis
antisyphilitic treatment
outcome
neonate
