Abstract
A sixteen-year-old unmarried primigravida was referred from General hospital Hambantota to Teaching hospital, Ragama for specialized management of foetal anaemia and ascites at 32 weeks of gestation. She was diagnosed as secondary syphilis with condylomata lata lesions and had a VDRL titre of R:16 and treated with one dose of intramuscular Benzathine penicillin two days prior to transfer. Ultrasound scan was suggestive of foetal hydrops. Foetal anaemia was suspected and intrauterine transfusion of packed red cells performed successfully. Foetal blood was drawn during the procedure for VDRL and haemoglobin for the diagnosis of congenital syphilis and anaemia respectively. Despite maternal antibiotic treatment and intrauterine management of foetal complications, intrauterine death occurred at 33 weeks of gestation. Sri Lanka Journal of Sexual Health and HIV Medicine Vol.1 2015: 37-40
Highlights
Syphilis is a sexually transmitted infection and remains a global problem with an estimated two million pregnant women getting infected each year
Syphilis is caused by Treponema pallidum subspecies pallidium and acquired by sexual contact with the important exception of congenital syphilis, where the infant acquires the infection by transplacental transmission of T. pallidum
We present a case of congenital syphilis that was diagnosed prenatally during the 3rd trimester of pregnancy which was associated with foetal anaemia and ascites
Summary
Syphilis is a sexually transmitted infection and remains a global problem with an estimated two million pregnant women getting infected each year. In Asia-Pacific region, approximately 69% of pregnant women with syphilis experience adverse pregnancy outcomes. Syphilis is caused by Treponema pallidum subspecies pallidium and acquired by sexual contact with the important exception of congenital syphilis, where the infant acquires the infection by transplacental transmission of T. pallidum. Transmission to sexual contacts requires exposure to moist mucosal or cutaneous lesions of primary or secondary syphilis. Person may be able to transmit syphilis through sexual exposure during the first year or two of untreated infection (2). Syphilis is a systemic disease, treponemes spread via the blood stream during the incubation period and women may transmit infection to their foetus in utero. We present a case of congenital syphilis that was diagnosed prenatally during the 3rd trimester of pregnancy which was associated with foetal anaemia and ascites
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