妊娠梅毒192例临床分析

来源 :中华妇产科杂志 | 被引量 : 0次 | 上传用户:ancci
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目的探讨妊娠梅毒患者的临床特点和影响妊娠结局的因素。方法192例经血清学检查确诊为梅毒的孕妇,根据妊娠期是否行全疗程抗梅毒治疗,分为治疗组(93例)及未治疗组(99例)。比较两组孕妇的妊娠结局、围产儿预后及新生儿先天梅毒的发生情况。同时根据母血清快速血浆反应素环状卡片试验(RPR)滴度高低,将192例梅毒孕妇分为≤1∶8组与≥1∶16组,观察血清滴度与妊娠结局的关系。结果(1)妊娠结局治疗组足月分娩率为936%(87/93),未治疗组仅为283%(28/99)。两组比较,差异有极显著性(P<001)。治疗组早产及死胎发生率分别为54%(5/93)和11%(1/93),明显低于未治疗组的283%(28/99)和323%(32/99),且治疗组无死产及流产发生。两组比较,差异有极显著性(P<0005)。治疗组分娩正常新生儿者占630%(58/92),未治疗组仅占232%(13/56)。治疗组窒息儿、低体重儿、先天梅毒患儿发生率及新生儿死亡率明显低于未治疗组,两组比较,差异有极显著性(P<001)。(2)RPR滴度≤1∶8组114例,≥1∶16组72例。≤1∶8组足月儿占781%(89/114),明显高于≥1∶16组的361%(26/72)。≤1∶8组早产儿、先天梅毒患儿、新生儿及围产儿死亡率,分别为53%(6/114)、219%(25/114)、26%(3/114)和193%(22/114),明显低于≥1∶16组的375%(27/72)、722%(52/72)、181%(13/7 Objective To investigate the clinical characteristics of patients with syphilis and affect pregnancy outcome factors. Methods A total of 192 pregnant women with syphilis diagnosed by serological test were divided into treatment group (n = 93) and untreated group (n = 99) according to whether the whole course of treatment was anti-syphilis during pregnancy. The pregnancy outcomes, the prognosis of perinatal infants and the incidence of congenital syphilis in newborns were compared between the two groups. At the same time, 192 pregnant women with syphilis were divided into ≤1: 8 group and ≥1:16 group according to the rapid serum cardioprotein cyclic card test (RPR) titer. The relationship between serum titer and pregnancy outcome was observed. Results (1) The full-term delivery rate was 936% (87/93) in the pregnancy outcome group and only 283% (28/99) in the untreated group. The difference between the two groups was significant (P <001). The incidences of preterm and stillbirth in the treatment group were 54% (5/93) and 11% (1/93), respectively, which were significantly lower than those in the untreated group (28.3% vs 323%, 32/99) Group no stillbirth and abortion occurred. There was a significant difference between the two groups (P <0005). The treatment group gave birth to normal neonates accounted for 630% (58/92), untreated group accounted for only 232% (13/56). The incidence of asphyxia and low birth weight infants, congenital syphilis and neonatal mortality in the treatment group were significantly lower than those in the untreated group. There was a significant difference between the two groups (P <0.001). (2) RPR titer≤1: 8 group, 114 cases, ≥1: 16 group, 72 cases. ≤1: 8 full-term children accounted for 781% (89/114), significantly higher than the 361% (26/72) ≥ 1: 16 group. Mortality rates in children with ≤1: 8 prematurity, congenital syphilis, neonate and perinatal mortality were 53% (6/114), 219% (25/114), 26% (3/114), and 193% 22/114), significantly lower than 375% (27/72), 722% (52/72), 181% (13/7
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