congenital syphilis Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):453-463
To assess the knowledge and compliance of health professionals regarding the diagnostic and treatment practices for syphilis in patients admitted for childbirth in public maternity hospitals in the city of Teresina, in the state of Piauí, Northeastern Brazil.
A cross-sectional study was performed in 2015 with obstetricians and nurses working in the public maternity hospitals in Teresina (n = 159) using a selfadministered questionnaire, with 5% of losses and 10% of refusals. The study used 21 evaluation criteria: 13 of them were related to knowledge (5 on serological tests and 8 on treatment adequacy); 8 were related to practices (3 on diagnosis, 4 on treatment, and 1 on post-test counseling). The knowledge of and compliance to the practices was estimated as the proportion of health professionals’ answers that were in agreement with Brazilian Ministry of Health protocols.
The obstetricians were in agreement with twocriteria concerning the knowledge of serological tests, one for diagnostic practices, and one for treatment practice. Among nurses, no single match between actual procedures and guidelines was observed.
Low compliance with the protocols results in missed opportunities for the diagnosis and treatment of pregnant and postpartum women and their partners. Strategies for training and integrating the various professional groups, improved data recording on prenatal cards, and greater accountability of the hospital team in managing the women’s partners are needed to overcome the barriers identified in the study and to interrupt the syphilis transmission chain.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):453-463
To assess the knowledge and compliance of health professionals regarding the diagnostic and treatment practices for syphilis in patients admitted for childbirth in public maternity hospitals in the city of Teresina, in the state of Piauí, Northeastern Brazil.
A cross-sectional study was performed in 2015 with obstetricians and nurses working in the public maternity hospitals in Teresina (n = 159) using a selfadministered questionnaire, with 5% of losses and 10% of refusals. The study used 21 evaluation criteria: 13 of them were related to knowledge (5 on serological tests and 8 on treatment adequacy); 8 were related to practices (3 on diagnosis, 4 on treatment, and 1 on post-test counseling). The knowledge of and compliance to the practices was estimated as the proportion of health professionals’ answers that were in agreement with Brazilian Ministry of Health protocols.
The obstetricians were in agreement with twocriteria concerning the knowledge of serological tests, one for diagnostic practices, and one for treatment practice. Among nurses, no single match between actual procedures and guidelines was observed.
Low compliance with the protocols results in missed opportunities for the diagnosis and treatment of pregnant and postpartum women and their partners. Strategies for training and integrating the various professional groups, improved data recording on prenatal cards, and greater accountability of the hospital team in managing the women’s partners are needed to overcome the barriers identified in the study and to interrupt the syphilis transmission chain.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(6):265-272
To evaluate maternal-fetal surveillance and follow-up of infants at risk for congenital syphilis (CS).
Retrospective cohort study in a Portuguese Tertiary Referral Hospital. The main inclusion criterion was a positive syphilis serology. The study included all pregnant women that delivered in our hospital between January 2004 and December 2013. The neonates were classified according to their probability of infection based on the Centers for Disease Control and Prevention guidelines.
Among the 27 pregnancies at risk for CS, 48.2% (n = 13) of the women had a diagnosis during the 1st trimester, and the median gestational age at the end of the treatment was 28 weeks. Inadequate treatment was noted in 44.4% (n = 12) of the women. Adverse pregnancy outcomes were observed in 30.8% of the cases (n = 8), 5 of which had been adequately treated. We found 2 (7.7%) cases with “proven or highly probable CS,” 10 (38.5%) with “possible CS,” 12 (46.1%) with “less likely CS,” and 2 (7.7%) with “unlikely CS.”Among the infants, the treatment was successful, except for 1 neurosyphilis case.
This study highlights many of the difficulties/concerns encountered in the maternal-neonatal management of syphilis. We highlight the importance of assuring the early detection of the infection as a way of guaranteeing the timely treatment, as well as a good compliance to the treatment and follow-up through a more efficient pregnant women surveillance network.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(6):265-272
To evaluate maternal-fetal surveillance and follow-up of infants at risk for congenital syphilis (CS).
Retrospective cohort study in a Portuguese Tertiary Referral Hospital. The main inclusion criterion was a positive syphilis serology. The study included all pregnant women that delivered in our hospital between January 2004 and December 2013. The neonates were classified according to their probability of infection based on the Centers for Disease Control and Prevention guidelines.
Among the 27 pregnancies at risk for CS, 48.2% (n = 13) of the women had a diagnosis during the 1st trimester, and the median gestational age at the end of the treatment was 28 weeks. Inadequate treatment was noted in 44.4% (n = 12) of the women. Adverse pregnancy outcomes were observed in 30.8% of the cases (n = 8), 5 of which had been adequately treated. We found 2 (7.7%) cases with “proven or highly probable CS,” 10 (38.5%) with “possible CS,” 12 (46.1%) with “less likely CS,” and 2 (7.7%) with “unlikely CS.”Among the infants, the treatment was successful, except for 1 neurosyphilis case.
This study highlights many of the difficulties/concerns encountered in the maternal-neonatal management of syphilis. We highlight the importance of assuring the early detection of the infection as a way of guaranteeing the timely treatment, as well as a good compliance to the treatment and follow-up through a more efficient pregnant women surveillance network.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(4):183-188
The purpose of this study was to evaluate the perinatal outcomes in pregnant women who use illicit drugs.
A retrospective observational study of patients who, at the time of delivery, were sent to or who spontaneously sought a public maternity hospital in the eastern area of São Paulo city. We compared the perinatal outcomes of two distinct groups of pregnant women - illicit drugs users and non-users - that gave birth in the same period and analyzed the obstetric and neonatal variables. We used Student's t-test to calculate the averages among the groups, and the Chi-square test or Fisher's exact test to compare categorical data from each group.
We analyzed 166 women (83 users and 83 non-users) in both groups with a mean of age of 26 years. Ninety-five percent of the drug users would use crack or pure cocaine alone or associated with other psychoactive substances during pregnancy. Approximately half of the users group made no prenatal visit, compared with 2.4% in the non-users group (p < 0.001). Low birth weight (2,620 g versus 3,333 g on average, p < 0.001) and maternal syphilis (15.7% versus 0%, p < 0.001) were associated with the use of these illicit drugs.
The use of illicit drugs, mainly crack cocaine, represents an important perinatal risk. Any medical intervention in this population should combine adherence to prenatal care with strategies for reducing maternal exposure to illicit drugs.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(4):183-188
The purpose of this study was to evaluate the perinatal outcomes in pregnant women who use illicit drugs.
A retrospective observational study of patients who, at the time of delivery, were sent to or who spontaneously sought a public maternity hospital in the eastern area of São Paulo city. We compared the perinatal outcomes of two distinct groups of pregnant women - illicit drugs users and non-users - that gave birth in the same period and analyzed the obstetric and neonatal variables. We used Student's t-test to calculate the averages among the groups, and the Chi-square test or Fisher's exact test to compare categorical data from each group.
We analyzed 166 women (83 users and 83 non-users) in both groups with a mean of age of 26 years. Ninety-five percent of the drug users would use crack or pure cocaine alone or associated with other psychoactive substances during pregnancy. Approximately half of the users group made no prenatal visit, compared with 2.4% in the non-users group (p < 0.001). Low birth weight (2,620 g versus 3,333 g on average, p < 0.001) and maternal syphilis (15.7% versus 0%, p < 0.001) were associated with the use of these illicit drugs.
The use of illicit drugs, mainly crack cocaine, represents an important perinatal risk. Any medical intervention in this population should combine adherence to prenatal care with strategies for reducing maternal exposure to illicit drugs.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):647-652
DOI 10.1590/S0100-72032001001000006
Purpose: to study the prevalence of congenital syphilis in a universitary hospital of the south of Brazil, emphasizing its role as a prenatal care marker. Patients and Method: a descriptive study of the congenital syphilis cases which occurred at the Hospital Geral (HG-UCS) from June 1st, 2000 to May 31st, 2001, based on the diagnosis criteria proposed by the Center for Disease Control and Prevention (CDC, 1998). Results: The prevalence of congenital syphilis was 1.5 (27 cases in 1739 births). The coefficient of congenital syphilis observed was 15.5/1000 newborns. Twenty-three pregnant women (85.2%) received prenatal care; however, the maternal infection with syphilis was diagnosed before the delivery in only 16 (69.6%) cases. Only 4 pregnant women reported an appropriate prenatal treatment of syphilis. In 8 (29.6%) cases an association of maternal syphilis with other sexually transmissible diseases was observed. The coefficient of perinatal mortality was 1.15/1000 births (two perinatal deaths). Conclusions: The authors reaffirm the importance of congenital syphilis as an indicator of perinatal health, since it is a disease that may be completely prevented by prenatal care. In addition, a high prevalence of congenital syphilis allows one to question the quality of the prenatal care, which was available to the studied group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):647-652
DOI 10.1590/S0100-72032001001000006
Purpose: to study the prevalence of congenital syphilis in a universitary hospital of the south of Brazil, emphasizing its role as a prenatal care marker. Patients and Method: a descriptive study of the congenital syphilis cases which occurred at the Hospital Geral (HG-UCS) from June 1st, 2000 to May 31st, 2001, based on the diagnosis criteria proposed by the Center for Disease Control and Prevention (CDC, 1998). Results: The prevalence of congenital syphilis was 1.5 (27 cases in 1739 births). The coefficient of congenital syphilis observed was 15.5/1000 newborns. Twenty-three pregnant women (85.2%) received prenatal care; however, the maternal infection with syphilis was diagnosed before the delivery in only 16 (69.6%) cases. Only 4 pregnant women reported an appropriate prenatal treatment of syphilis. In 8 (29.6%) cases an association of maternal syphilis with other sexually transmissible diseases was observed. The coefficient of perinatal mortality was 1.15/1000 births (two perinatal deaths). Conclusions: The authors reaffirm the importance of congenital syphilis as an indicator of perinatal health, since it is a disease that may be completely prevented by prenatal care. In addition, a high prevalence of congenital syphilis allows one to question the quality of the prenatal care, which was available to the studied group.