Article Text

MANAGEMENT OF INFANTS AT RISK OF CONGENITAL SYPHILIS
  1. C O Owoeye1,
  2. E J Molloy2,
  3. S Knowles3
  1. 1Neonatal Unit, National Maternity Hospital, Jolles Street, Dublin, Ireland
  2. 2Neonatology Unit, National Maternity Hospital, Holles Street, Dublin, Ireland
  3. 3Microbiology Department, National Maternity Hospital, Holles Street, Dublin, Ireland

Abstract

Introduction Congenital syphilis was rare in most affluent countries but there has been a resurgence recently in several European countries.

Aims

  • To review the incidence of positive maternal syphilis serology.

  • To assess the outcome of these pregnancies.

Aims

Methods Retrospective study over a 5-year period from Jan 2003 to Dec 2007. Positive maternal syphilis serology results were identified, biological false positive results excluded and confirmation of infection in the mothers was based on two positive treponemal antibody tests, Treponema pallidum particle agglutination (TPPA) and total treponemal antibody (IgG/IgM) enzyme immunoassay. The rapid plasma reagin (RPR) was also done. The infant records were also reviewed for syphilis tests, type and duration of treatment, systemic manifestations, follow up and outcome.

Results 40,590 women were screened and 47 mothers (1.2/1000) had positive syphilis serology. There were 39 live born infants documented in this group of which 15 (38%) were not investigated. All 24 infants with syphilis testing had a positive TPPA with 2 RPR positive Only 10 infants (26%) had follow-up to an average of 9.6±3.3 months, 3 were referred to the infectious diseases team for follow-up. No baby with congenital syphilis was identified.

Conclusions The follow-up of infants in the presence of positive maternal syphilis serology is inadequate in our hospital at present. Increased awareness of the serious preventable sequelae of congenital syphilis among healthcare professionals is vital.

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