Syphilis and Pregnancy

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Syphilis is a major health concern for pregnant women as it can have profoundly negative effects on the unborn child. When syphilis is present within the uterus of the pregnant mother, congenital syphilis may occur within the child once it is born. This is a very serious and potentially life threatening condition and can also be spread to the child via the placenta. The contraction of syphilis in unborn children may affect their development, therefore leading to developmental problems and disabilities once both. In the worst case scenario, a foetus with syphilis may die whilst still in the womb causing a still birth to occur, which is then known as a syphilitic stillbirth.

Symptoms in newborn children with congenital syphilis

There are certain symptoms to look out for in infants that may be affected by congenital syphilis. If a child is of a low body weight or struggles to gain weight in the first few months of life, then this can be an early manifestation of the infection. The inability to gain weight or grow is considered to be a failure of the newborn to thrive. Furthermore, your baby may be more irritable than what is usually expected of a newborn infant.  Many of the symptoms that also may be experience are similar to that seen within a cold or flu, such as a fever and having watery fluid leaking from the nose.  A rash or lesions may appear, quite often on the palms, soles of feet and the face, although if this does occur, it is vital that you seek medical assistance straight away in case of bacterial meningitis in the child.  There is also a chance that the child will develop a severe and potentially life threatening pneumonia, characterised by difficulty in breathing and wheezy coughing.

Symptoms in older infants, children and adults

In older children, a different set of symptoms is usually present. The teeth of the child are usually seen to be different to those of other children, appearing more peg shaped and notched.  Furthermore, bone pain, joint swelling and refusal to move limbs may occur due to problems within the skeleton caused by the infection. This is especially prominent in the lower limbs therefore potentially resulting in some form of abnormality. Hearing is often also reduced or completely absent, resulting in deafness of the child. Furthermore, eye sight may be affected with children becoming potentially blind. Neurological problems are also a possibility, such as seizures that may be debilitating to the child.  More obvious physical symptoms such as scarring around the mouth, genitals and anus as well gray mucus patches also on the anus and genitals may also be an indicator to if this is present within your child.

If left untreated within the child, complications in later life may occur. These can happen up to 40 years after contracting syphilis at birth. The central nervous system may be affected, leading to problems in motion, memory and various other bodily functions. In addition, the skeletal system may become affected as well as teeth, eyes and the skin.  Therefore, it is of the upmost importance to identify syphilis in young children as quickly as possible to prevent such complications from occurring.

How is congenital syphilis diagnosed?

Before an infant is discharged from hospital with its mother, tests should be done to ensure that the child does not have syphilis. This now routinely occurs within hospitals. If suspected at birth, tests may be done on the placenta to see whether it has been infected with the Treponema pallidum bacterium that causes syphilis. In addition, tests will be conducted on the newborn child.  The child may have to undergo a bone x-ray to see if there are any problems there. In addition, an eye examination is usually conducted and only if necessary, a lumbar puncture will be conducted where fluid is taken from the spine to be examined under a dark field microscope for any bacteria present within the sample.  To perform a lumbar puncture, or spinal tab as it can also be known as, a needle is places between two of the vertebrae of the back allowing for the removal of cerebrospinal fluid. This is fluid that bathes the brain and spinal cord to protect them from any potential damage. Only a small sample is removed, so there is no danger posed to the child although there may be a few minor side effects such as back discomfort therefore resulting in your child irritable for a few days after the procedure.  If infection is found, it is very easily treated using penicillin injections the same as the condition would be treated in adults.

The prognosis is far better for the unborn child if the condition is treated early on in the woman’s pregnancy. If you suspect you have syphilis and may be pregnant, it is crucial you get tested for it immediately at a local sexual health (GUM) clinic or at your GP.

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