Sífilis materna e congênita: ainda um desafio

Abstract

This descriptive study collected socio-demographic, obstetric, and diagnostic and treatment-related data from pregnant and postpartum women and their partners, for the 67 pregnant or postpartum women reported with syphilis to the National System of Diseases of Notification, users of public maternity hospitals in the Federal District of Brazil from 2009 to 2010. Data on clinical and laboratory follow-up of the newborn were obtained from the hospital patient charts, compulsory notification forms, and Infant Health Cards. Of the pregnant women, 41.8% were adequately treated; the main reason for inadequate treatment was the absence (83.6%) or inadequate treatment of the partner (88.1%). More than a third required repeat treatment at the maternity hospital due to lack of documentation of treatment during the prenatal period. Of the newborns diagnosed with congenital syphilis, 48% received radiographic investigation, 42% received a spinal tap, and 36% failed to receive any kind of intervention. Thus, the quality of prenatal care was insufficient to guarantee the control of congenital syphilis and achieve the goal of reducing incidence of the disease.

Evaluation of preventative and control measures for congenital syphilis in State of Mato Grosso

“…The marked temporal variation in the incidence of congenital syphilis throughout the study suggests the existence of underreporting, which is also noted in other municipalities 22,23 ; the underreporting might be compounded by the diffi culty of determining a clinical diagnosis of this disease in newborns. It is noteworthy that underreporting of health information could be considered to be an indirect indicator of poor quality of health care.…”

Gestational and congenital syphilis: maternal, neonatal characteristics and outcome of cases

“…1,8,10,[14][15][16] The identified proportion of gestational syphilis (1.39%) is also above the national prevalence (1.02%), as well assouthern Brazil prevalence (1.10%), 17 which reinforces the need to strengthen epidemiological surveillance in all points of the network, actions thatadd up to the national agenda, as already determined by the Health Pact in 2006. 10 Even with the acknowledged efficacy of diagnosis, treatment and prevention of transmission, 5 the proportion of pregnant women infected with syphilis without therapeutic actions and intervention on risk factors remains high, resulting in abortion, prematurity, neonatal deathand congenital malformations. 4,10 As presentedin this study, only 67.5% of pregnant women have made treatment.…”

“…10 Even with the acknowledged efficacy of diagnosis, treatment and prevention of transmission, 5 the proportion of pregnant women infected with syphilis without therapeutic actions and intervention on risk factors remains high, resulting in abortion, prematurity, neonatal deathand congenital malformations. 4,10 As presentedin this study, only 67.5% of pregnant women have made treatment.…”

“…[8][9][10][11][12][13][14][15][16][17][18]19 In this regard, it was found that the majority of pregnant women (55%) studied did only oneVDRL test, indicating non-compliance with the Protocol of attention to prenatal care.…”

“…9 Knowing the characteristics of pregnant women and children with syphilis is important because from the epidemiological data, public policies are formulated to control syphilis, and compulsory notification is a fundamental tool. 10 Even with the evidence put in the literature for decades about the problems that syphilis can cause to pregnant women, newborns and the health system, comprehensive studies that relate variables from diagnosis to treatment are scarce on the national scene. Given the importance of the theme, it was plotted as an objective to describe the occurrence of gestational and congenital syphilis in a municipality in second maternal characteristics, neonatal diseases and outcome of cases.…”