DOC for syphilis in pregnancy:
Ans. is c, i.e PenicillinRef. Williams 23/e, p 1238Syphilis in PregnancyCongenital syphilis:Transmission of T pallidum across the placenta from a syphilitic woman to her fetus may occur at any gestational age.Untreated infection leads to fetal loss in 40% cases, IUD, stillbirth and abortions, (stillbirths being more common than abortions)Early Congenital SyphilisLate Congenital SyphilisResidual Stigmata* Appears within first 2 years of life, M/C time is 2-10 weeks age* Appears after 2 years of life* Subclinical in most of the cases* Hutchinson's teeth (Centrally notched widely spaced peg shaped upper central incisor)* Earliest manifestation--rhinitis/ snuffles* Features--interstitial keratitis* Eighth nerve deafness* Mulberry molars* M/C bone changes-- osteochondritis* Recurrent arthropathy * Periostitis* B/L knee effusion k/a Clutton's joint * Mucocutaneous lesion* Asymptomatic neurosyphilis * Hepatosplenomegaly* Lymphadenopathy* Gummatous periostitis Diagnosis of congenital syphilis innonates:Presence of antetrioponemal IgM antibodies in neonates is diagnostic of congenital syphilis (IgG antibodies are not specific for neonatal infection and may be the result of transplacental transmission from a mother who has been adequately treated).VDRL and RPR tests are used for rapid screening. A VDRL titre in neonates 4 times greater than the maternal titre is consistent with congenital syphilis.In asymptomatic infants:If mother has been treated with penicillin in 1st/2nd trimester--No treatment for infantIf mother has not been treated/received treatment with penicillin in third trimester - Treat infant with penicillinSYPHILIS TREATMENT during pregnancy Ref. Williams 23/e, p 1238Syphilis therapy during pregnancy is given to eradicate maternal infection and to prevent congenital syphilis.Parenteral penicillin G remains the preferred treatment for all stages of syphilis during pregnancy.There are no proven alternative therapies for syphilis during pregnancy. Erythromycin may be curative for mother, but because of limited transplacental passage, it does not prevent all congenital diseases.Women with H/O penicillin allergy, first penicillin desensitization should be done and then followed by penicillin injection.Bullous leisons on the body of the infant and presence of periostitis suggest the diagnosis of congenital syphilis. The only option related to syphilis is VDRL. Therefore, it is the answer.
Erythromycin
Azithromycin
Penicillin
Cephalosporin/ceftriaxone
Medical & Surgical Illness Complication Pregnancy