Objective :
@EN To support the need to reexamine current screening procedures and in addition to prenatal and at delivery screenings for congenital syphilis, it may be inappropriate to infants born to high risk mothers such as poor prenatal care, and
inadequately
treated syphilis.
@ES Study design:
@EN We have investigated 54 congenital syphilitic infants of 22299 infants born at the St. Paul Hospital C.U.M.C from January 1981 to October 1995.
Whose 108 mothers was seropositive for syphilis not contained partly such as
1) poor prenatal care and past inappropriate treated primary syphilis and VDRL(-), VDRL titer 1:16(-)TPHA(+) in mother and VDRL(-), TPHA(+) in neonate.
2) early fetal death in intrauterine pregnancy of unknown origin and VDRL(-), VDRL titer 1:16(-) TPHA(+) in mother
3) VDRL(+), VDRL(+) titer 1: 4(+) TPHA(-) in mother and VDRL(+), TPHA(+) in the neonate.
@ES Results: 1) Reactive mothers of VDRL qualititive test are 108 cases.
2) TPHA test of the VDRL reactive 108 cases result in reactive 85(78.7%), nonreactive 23(21.3%) but other TPHA(+), VDRL titer 1:16(-), VDRL(-) of 2 cases, and other TPHA(-), VDRL titer 1 : 4(+), VDRL(+) of 1 cases not contained.
3) 54 congenital syphilitic infants(63.5%) was born to 85 syphilitic mothers.
4) 28 neonates(51.8%0 cared by prenatally and 26 neonates(48.2%) not cared prenatally in 54 congenital syphilis. And 4 babies is TPHA positive on CSF study.
@ES Conclusion : Currently recommended screening procedures associated maternal risk factors may be inadequate and may miss congenital syphilis.
Even though the risk infants were asymptomatic and seronegative at birth, serology testing at 4 to 8 weeks of age would identify the syphilitic infants. And if mothers have acquired infection in the last trimester of pregnancy, they might have
tested
negative at the time of delivery.
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