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目的探讨在不同阶段驱梅治疗后的妊娠结局,以及其对新生儿的影响。方法根据注射首剂青霉素时的孕期,将261例妊娠梅毒患者分为3组:早孕组(妊娠≤12周)92例,中孕组(妊娠13～28周)94例,晚孕组(妊娠≥29周)75例。各组均予以规范青霉素驱梅治疗,治疗结束后比较三组梅毒孕妇的妊娠结局、围产儿预后及先天性梅毒的发病率,同时根据孕妇血清快速血浆反应素环状卡片试验(RPR)滴度高低,分为RPR≤1:4组和RPR≥1:8组,观察血清RPR滴度与围产儿预后的关系。结果早孕组、中孕组和晚孕组三组梅毒孕妇的足月分娩率分别为92.83%,89.36%和53.33%;先天性梅毒发病率分别为2.17%,5.32%和28.00%。早孕组及中孕组梅毒孕妇的妊娠结局和围产儿预后均明显优于晚孕组,先天性梅毒发病率明显低于晚孕组。RPR≤1:4组159例,先天性梅毒发病率为1.26%;RPR≥1:8组102例,先天性梅毒发病率为25.49%,差异有显著性(P<0.05)。结论妊娠合并梅毒时,首剂青霉素治疗早晚和其妊娠结局、围产儿预后及先天性梅毒发病率密切相关,早期进行正规青霉素治疗可以有效防止胎儿感染梅毒,且梅毒孕妇血清RPR滴度高低是影响其妊娠结局的重要因素。
Objective To explore the outcome of pregnancy in different stages of flooding treatment and its effect on the newborn. Methods According to the pregnancy during the first injection of penicillin, 261 pregnant women with syphilis were divided into 3 groups: 92 in the early pregnancy group (≤12 weeks of pregnancy), 94 in the pregnant group (13 to 28 weeks of gestation), 94 in the pregnant group ≥29 weeks) 75 cases. All groups were given standardized penicillin-floxed treatment. After the treatment, the pregnancy outcomes, the prognosis of perinatal children and the incidence of congenital syphilis were compared among three groups of syphilis pregnant women. At the same time, according to the serum RPR titer The patients were divided into RPR≤1: 4 group and RPR≥1: 8 group. The relationship between serum RPR titer and perinatal prognosis was observed. Results The full-term delivery rates of syphilis pregnant women in the first trimester group, the second trimester group and the third trimester group were 92.83%, 89.36% and 53.33% respectively. The incidences of congenital syphilis were 2.17%, 5.32% and 28.00% respectively. The pregnancy outcomes and perinatal outcomes of syphilis pregnant women in early pregnancy group and middle pregnancy group were significantly better than those in late pregnancy group. The incidence of congenital syphilis was significantly lower than that in late pregnancy group. The incidence of congenital syphilis was 1.26% in RPR≤1: 4 group, 102 cases in RPR≥1: 8 group, the incidence of congenital syphilis was 25.49%, the difference was significant (P <0.05). Conclusion Pregnancy with syphilis, the first dose of penicillin sooner or later and its outcome of pregnancy, the prognosis of perinatal and congenital syphilis incidence is closely related to the early normal penicillin treatment can effectively prevent fetal infection with syphilis, and syphilis serum RPR titers affect the level of serum An important factor in their pregnancy outcome.