Document 0832
 DOCN  M9650832
 TI    Lues-lues: maternal and fetal considerations of syphilis.
 DT    9605
 AU    Ray JG; Department of Medicine, McMaster University, Hamilton, Ontario,;
       Canada.
 SO    Obstet Gynecol Surv. 1995 Dec;50(12):845-50. Unique Identifier :
       AIDSLINE MED/96164290
 AB    Although syphilis occurs infrequently among Canadian and American women,
       global antenatal screening is still warranted. The reason is that
       congenitally acquired syphilis is serious, yet largely preventable.
       Those women at highest risk for the disease seem to be crack and cocaine
       users, as well as those without antenatal care. These women should be
       screened for syphilis during the first and early-third trimesters,
       whenever possible, or at the time of delivery. HIV testing should be
       routinely recommended. Syphilis is diagnosed using microscopy and/or
       serologic testing. Although nontreponemal serology (VDRL and RPR) is
       acceptable as the initial screening test, sensitivity and specificity
       for syphilis vary between 60 and 75 percent and 84 and 99 percent,
       respectively. These are also many causes of false-positive test results.
       Treponemal serology (FTA-ABS and MHA-TP) are used to confirm
       nontreponemal tests. The only acceptable treatment of syphilis during
       pregnancy is penicillin. For those with disease of less than 1 year's
       duration, it is suggested that two doses of benzathine penicillin G (2.4
       million units I.M.) be administered 1 week apart. Disease of greater or
       unknown duration requires a longer, modified regimen. Serious adverse
       reactions to therapy are rare, and penicillin-allergic mothers can be
       skin tested, followed by desensitization if required. Exactly how HIV
       infection modifies the detection and treatment of syphilis in pregnancy
       is unclear. Treatment of HIV-infected women with syphilis is presently
       no different than non-HIV patients, unless invasion of the central
       nervous system is suspected.
 DE    Female  Fetus/DRUG EFFECTS  Human  HIV Infections/DIAGNOSIS  Infant,
       Newborn  *Mass Screening  Penicillins/THERAPEUTIC USE  Pregnancy
       *Pregnancy Complications, Infectious/DIAGNOSIS/PHYSIOPATHOLOGY/  THERAPY
       Syphilis/DIAGNOSIS/PHYSIOPATHOLOGY/THERAPY  Syphilis Serodiagnosis
       Syphilis, Congenital/*PREVENTION & CONTROL  JOURNAL ARTICLE  REVIEW
       REVIEW LITERATURE

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