抗梅毒治疗和梅毒TRUST滴度对妊娠结局的影响

目的:探讨抗梅毒治疗以及梅毒TRUST滴度对梅毒孕妇妊娠结局的影响。方法:回顾性分析2006年3月至2010年3月太原市传染病医院收治的妊娠梅毒患者共82例,其中26例终止妊娠,8例失访,48例完成随访。①根据结束妊娠前是否行抗梅毒治疗,将48例妊娠梅毒患者分为治疗组25例和未治疗组23例,记录各组妊娠结局情况。②将48例妊娠梅毒患者分成TRUST滴度≤1∶4和TRUST滴度1∶4两组,TRUST滴度≤1∶4组患者29例,TRUST滴度1∶4组患者19例,统计各组妊娠结局。结果:治疗组发生新生儿先天梅毒6例(24.00%),无流产,死胎和死产,不良妊娠结局发生率24.00%(6/25);未治疗组流产2例(8.70%),死胎1例(4.35%),死产1例(4.35%),新生儿先天梅毒12例(52.17%),不良妊娠结局发生率达69.57%(16/23)。未治疗组不良妊娠结局发生率明显高于治疗组(P0.05)。TRUST滴度≤1∶4组的患者7例(24.14%)产生不良妊娠结局,TRUST滴度1∶4组的患者14例(73.68%)产生不良妊娠结局,滴度高的妊娠梅毒患者不良妊娠结局发生率显著高于滴度低的妊娠梅毒患者。结论:梅毒孕妇抗梅毒治疗可预防新生儿先天梅毒,并能降低不良妊娠结局的发生率。妊娠梅毒TRUST滴度的检测有助于预测不良妊娠结局的发生情况。若妊娠梅毒TRUST滴度较高,宜终止妊娠。

Effect of Anti-Syphilis Treatment and TRUST Serum Titer on Pregnancy Outcome

Objective：To investigate the effect of anti-syphilis therapy and TRUST serum titer on pregnancy outcome of pregnant women with syphilis.Methods：① Pregnancy outcomes of 48 pregnant syphilis cases from March 2006 to March 2010 were analyzed retrospectively.48 pregnant syphilis cases were respectively divided into treated group（25 cases）and untreated group（23 cases）,pregnancy outcomes of patients were recorded and analyzed.②48 pregnant syphilis cases were respectively divided into serologic syphilis titers≤1∶4 group（29 cases）and1∶4 group（19 cases）,then pregnancy outcomes of patients were recorded and analyzed.Results：①There were 6 newborn congenital syphilis cases（24.00%）,no abortion,intrauterine fetal death（IUFD）and stillbirths in treated group,the incidence of adverse pregnancy outcomes was 24.00%.There were 2 abortion cases（8.70%）,1 IUFD case（4.35%）,1 stillbirth case（4.35%）,12 newborn congenital syphilis cases（52.17%）in untreated group,the occurrence rate of adverse pregnancy outcome was 69.57%.②7 cases among serologic syphilis titers≤1∶4 group had adverse pregnancy outcomes（24.14%）,14 cases among serologic syphilis titers1∶4 group had adverse pregnancy outcomes（73.68%）.Conclusion：The anti-syphilis treatment can prevent the appearance of new-born congenital syphilis,reduce the incidence of adverse pregnancy outcomes.TRUST titer test can help predict the preg-nancy outcomes.