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Chapter 8 : Syphilis and Pregnancy

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Abstract:

Untreated syphilis during pregnancy is associated with spontaneous abortion, stillbirth, nonimmune hydrops, premature delivery, and perinatal death. Syphilis in the United States is currently found among racial and ethnic minorities who live in poverty. A major contributor to the increased incidence of syphilis in the late 1980s and early 1990s was the use of crack cocaine and the exchange of illegal drugs for sex. Gestational syphilis primarily affects women who are young and unmarried and who receive inadequate or no prenatal care. A pregnant woman with syphilis can transmit the infection to her unborn infant in utero, presumably by a transplacental route or possibly during delivery by contact with a genital lesion. The effect of concurrent maternal infection with and HIV on the risk of fetal infection with and HIV remains to be elucidated. The risk of prematurity, perinatal death, and congenital infection is directly related to the stage of maternal syphilis during pregnancy. An early clue to the diagnosis of congenital syphilis is provided by examination of the placenta. The infected placenta is often large, thick, and pale; the histologic findings consist of focal villitis, endovascular and perivascular proliferation in villous vessels, and relative immaturity of the villi. Penicillin remains the drug of choice for treatment of both acquired and congenital syphilis. Prevention of syphilis among pregnant women has remained an elusive public health goal.

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8
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Figure 1

Reported cases of primary and secondary syphilis per 100,000 population in the United States, 1996 ( ).

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8
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Image of Figure 2
Figure 2

Reported cases of primary and secondary syphilis per 100,000 population by race and ethnicity in the United States, 1981 to 1996 ( ).

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8
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Figure 3

Congenital syphilis cases in infants younger than 1 year of age, 1970 to 1997 ( ). P & S, primary and secondary syphilis among women. Note: the surveillance case definition for congenital syphilis changed in 1988.

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8
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Figure 4

Algorithm for management of infants born to mothers with reactive serologic tests for syphilis.

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8
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References

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1. Alexander, J. M.,, J. S. Sheffield,, P. J. Sánchez,, J. Mayfield,, and G. D. Wendel. 1999. Efficacy of treatment of syphilis in pregnancy. Obstet. Gynecol. 93:58.
2. American Academy of Pediatrics. 1997. Report of the Committee on Infectious Diseases (Red Book), 24th ed., p. 504514. American Academy of Pediatrics, Elk Grove Village, Ill.
3. Andrus, J. K.,, D. W. Fleming,, D. R. Harger,, M. Y. Chin,, D. V. Bennett,, J. M. Horan,, G. Oxman,, B. Olson,, and L. R. Foster. 1990. Partner notification: can it control epidemic syphilis? Ann. Intern. Med. 112:539543.
4. Benirschke, K. 1974. Syphilis: the placenta and fetus. Am. J. Dis. Child. 128:142143.
5. Berkowitz, K.,, L. Baxi,, and H. E. Fox. 1990. False-negative screening: the prozone phenomenon, nonimmune hydrops, and diagnosis of syphilis during pregnancy. Am. J. Obstet. Gynecol. 163:975977.
6. Berry, M. C.,, and A. S. Dajani. 1992. Resurgence of congenital syphilis. Infect. Dis. Clin. North Am. 1:1929.
7. Bromberg, K.,, S. Rawstron,, and G. Tannis. 1993. Diagnosis of congenital syphilis by combining Treponema pallidum-specific IgM detection with immunofluorescent antigen detection for T. pallidum. J. Infect. Dis. 168:238242.
8. Burstain, J. M.,, E. Grimprel,, S. A. Lukehart,, M. V. Norgard,, and J. D. Radolf. 1991. Sensitive detection of Treponema pallidum by using the polymerase chain reaction. J. Clin. Microbiol. 29:6269.
9. Cates, W.,, R. B. Rothenberg,, and J. H. Blount. 1996. Syphilis control: the historic context and epidemiolic basis for interrupting sexual transmission of Treponema pallidum. Sex. Transm. Dis. 23:68.
10. Centers for Disease Control. 1989. Congenital syphilis, New York City, 1986-1988. Morbid. Mortal. Weekly Rep. 38:825829.
11. Centers for Disease Control. 1991. Alternative case-finding methods in a crackrelated syphilis epidemic—Philadelphia. Morbid. Mortal. Weekly Rep. 40:7780.
12. Centers for Disease Control. 1993. Selective screening to augment syphilis casefinding— Dallas, 1991. Morbid. Mortal. Weekly Rep. 42:424427.
13. Centers for Disease Control and Prevention. 1996a. Outbreak of primary and secondary syphilis—Baltimore City, Maryland, 1995. Morbid. Mortal. Weekly Rep. 45(8):166169.
14. Centers for Disease Control and Prevention. 1996b. Summary of notifiable diseases, United States. Morbid. Mortal. Weekly Rep. 45(53):5861.
15. Centers of Disease Control and Prevention. 1998. Guidelines for treatment of sexually transmitted diseases. Morbid. Mortal. Weekly Rep. 47(RR-1):2849.
16. Centurion-Lara, A.,, C. Castro,, J. M. Shaffer,, W. C. VanVoorhis,, C. M. Marra,, and S. A. Lukehart. 1997. Detection of Treponema pallidum by sensitive reverse transcriptase PCR. J. Clin. Microbiol. 35:13481352.
17. Chhabra, R. S.,, L. P. Brion,, M. Castro,, L. Freundlich,, and J. H. Glaser. 1993. Comparison of maternal sera, cord blood, and neonatal sera for detecting presumptive congenital syphilis: relationship with maternal treatment. Pediatrics 91:8891.
18. Cohen, D. A.,, D. Boyd,, I. Prabhudas,, and L. Mascola. 1990. The effects of case definition in maternal screening and reporting criteria on rates of congenital syphilis. Am. J. Public Health 80:316317.
19. Deguchi, M.,, H. Hosotsubo,, N. Yamashita,, T. Ohmine,, and S. Asari. 1994. Evaluation of gelatin particle agglutination method for detection of Treponema pallidum antibody. J. Jpn. Assoc. Infect. Dis. 68:12711277.
20. Dickerson, M. C.,, J. Johnston,, T. E. Delea,, A. White,, and E. Andrews. 1996. The causal role for genital ulcer disease as a risk factor for transmission of human immunodeficiency virus. Sex. Transm. Dis. 23:429440.
21. Dippel, A. L. 1976. The relationship of congenital syphilis to abortion and miscarriage, and the mechanism of intrauterine protection. Am. J. Obstet. Gynecol. 47:369.
22. Dobson, S. R. M.,, L. H. Taber,, and R. E. Baughn. 1988. Recognition of Treponema pallidum antigens by IgM and IgG antibodies in congenitally infected newborns and their mothers. J. Infect. Dis. 157:903910.
23. Dorfman, D. H.,, and J. H. Glaser. 1990. Congenital syphilis presenting in infants after the newborn period. N. Engl. J. Med. 323:12991302.
24. Fenton, L. J.,, and J. L. Irwin. 1976. Congenital syphilis after maternal treatment with erythromycin. Obstet. Gynecol. 47:492494.
25. Finelli, L.,, E. M. Crayne,, and K. C. Spitalny. 1998. Treatment of infants with reactive syphilis serology, New Jersey: 1992 to 1996. Pediatrics 102:e27.
26. Fiumara, N. J.,, W. L. Fleming,, J. G. Downing,, and F. L. Good. 1952. The incidence of prenatal syphilis at the Boston City Hospital. N. Engl. J. Med. 247:4852.
27. Fojaco, R. M.,, G. T. Hensley,, and L. Moskowitz. 1989. Congenital syphilis and necrotizing funisitis. JAMA 12:17881780.
28. Genest, D. R.,, S. R. Choi-Hong,, J. E. Tate,, F. Qureshi,, S. M. Jacques,, and C. Crum. 1996. Diagnosis of congenital syphilis from placental examination: comparison of histopathology, steiner stain, and polymerase chain reaction for Treponema pallidum DNA. Hum. Pathol. 27:366372.
29. Grimprel, E.,, P. J. Sánchez,, G. D. Wendel,, J. M. Burstain,, G. H. McCracken, Jr.,, J. D. Radolf,, and M. V. Norgard. 1991. Use of polymerase chain reaction and rabbit infectivity testing to detect Treponema pallidum in amniotic fluids, fetal and neonatal sera, and cerebrospinal fluid. J. Clin. Microbiol. 29:17111718.
30. Hallak, M.,, J. F. Peipert,, A. Ludomirsky,, and J. Byers. 1992. Nonimmune hydrops fetalis and fetal congenital syphilis: a case report. J. Reprod. Med. 37:173176.
31. Harter, C. A.,, and K. Benirschke. 1976. Fetal syphilis in the first trimester. Am. J. Obstet. Gynecol. 124:705711.
32. Hashiasaki, P.,, G. G. Wertzberger,, G. L. Conrad,, and C. R. Nichols. 1983. Erythromycin failure in the treatment of syphilis in a pregnant woman. Sex. Transm. Dis. 10:3638.
33. Hay, P. E.,, J. R. Clarke,, R. A. Strugnell,, D. Taylor-Robinson,, and D. Goldmeier. 1990. Use of the polymerase chain reaction to detect DNA sequences specific to pathogenic treponemes in cerebrospinal fluid. FEMS Microbiol. Lett. 68:233238.
34. Hill, L. M.,, and J. B. Maloney. 1991. An unusual constellation of sonographic findings associated with congenital syphilis. Obstet. Gynecol. 78:895897.
35. Hira, S. K.,, G. J. Bhat,, D. Chikamata,, B. Nkowane,, G. Tembo,, P. L. Perine,, and A. Meheus. 1990. Syphilis intervention in pregnancy: Zambian demonstration project. Genitourin. Med. 66:159164.
36. How, J. H. Y.,, and J. D. P. Bowditch. 1994. Syphilis in pregnancy: experience from a rural aboriginal community. Aust. N. Z. J. Obstet. Gynaecol. 34:383389.
37. Ikeda, M. K.,, and H. B. Jenson. 1990. Evaluation and treatment of congenital syphilis. J. Pediatr. 117:843852.
38. Ingall, D.,, P. J. Sánchez,, and D. Musher,. 1995. Syphilis, p. 529564. In J. S. Remington, and J. D. Klein (ed.), Infectious Disease of the Fetus and Newborn, 4th ed. The W. B. Saunders Co., Philadelphia, Pa.
39. Ingraham, N. R. 1951. The value of penicillin alone in the prevention and treatment of congenital syphilis. Acta Dermato-Venereol. 31(Suppl. 24):6088.
40. Jacques, S. M.,, and F. Qureshi. 1992. Necrotizing funisitis: a study of 45 cases. Hum. Pathol. 23:12781283.
41. Kaufman, R. E.,, O. G. Jones,, J. H. Blount,, and P. J. Wiesner. 1977. Questionnaire survey of reported early congenital syphilis: problems in diagnosis, prevention and treatment. Sex. Transm. Dis. 4:135139.
42. Klein, V. R.,, S. M. Cox,, M. D. Mitchell,, and G. D. Wendel, Jr. 1990. The Jarisch-Herxheimer reaction complicating syphilotherapy in pregnancy. Obstet. Gynecol. 75:375380.
43. Larsen, S. A.,, E. A. Hambie,, D. E. Pettit,, M. W. Perryman,, and S. J. Kraus. 1981. Specificity, sensitivity, and reproducibility among the fluorescent treponemal antibody-absorption test, the microhemagglutination assay for Treponema pallidum antibodies, and the hemagglutination treponemal test for syphilis. J. Clin. Microbiol. 14:441445.
44. Larsen, S. A.,, B. M. Steiner,, and A. H. Rudolph. 1995. Laboratory diagnosis and interpretation of tests for syphilis. Clin. Microbiol. Rev. 8:121.
45. Lee, W. K.,, D. A. Schwartz,, J. R. Rice,, and S. A. Larsen. 1994. Syphilitic endometritis causing first trimester abortion: a potential infectious cause of fetal morbidity in early gestation. SouthIMed. J. 87:12591261.
46. Lewis, L. L.,, L. H. Taber,, and R. E. Baughn. 1990. Evaluation of immunoglobulin M Western blot analysis in the diagnosis of congenital syphilis. J. Clin. Microbiol. 28:296302.
47. Lindstrand, A.,, S. Bergström,, A. Bugalho,, G. Zanconato,, A. M. Helgesson,, and B. Hedersted. 1993. Prevalence of syphilis infection in Mozambican women with second trimester miscarriage and women attending antenatal care in second trimester. Genitourin. Med. 69:431433.
48. Lucas, M. J.,, S. K. Theriot,, and G. D. Wendel. 1991. Doppler systolic-diastolic ratios in pregnancies complicated by syphilis. Obstet. Gynecol. 77:217222.
49. Lukehart, S. A.,, E. W. HookIII,, S. A. Baker-Zander,, A. C. Collier,, C. W. Critchlow,, and H. H. Handsfield. 1988. Invasion of the central nervous system by Treponema pallidum: implications for diagnoses and therapy. Ann. Intern. Med. 109:855862.
50. Mascola, L.,, R. Pelosi,, and C. E. Alexander. 1984. Inadequate treatment of syphilis in pregnancy. Am. J. Obstet. Gynecol. 150:945947.
51. Mascola, L.,, R. Pelosi,, J. H. Blount,, C. E. Alexander,, and W. Cates, Jr. 1985. Congenital syphilis revisited. Am. J. Dis. Child. 139:575580.
52. McKown, R. R.,, and P. S. Kapernick. 1988. Syphilis in pregnancy. South. Med. J. 81: 447451.
53. Nakashima, A. K.,, R. T. Rolfs,, M. L. Flock,, P. Kilmarx,, and J. R. Greenspan. 1996. Epidemiology of syphilis in the United States, 1941-1993. Sex. Transm. Dis. 23:1623.
54. Nathan, L.,, R. E. Bawdon,, E. Sidawi,, R. W. Stettler,, D. M. McIntire,, and G. D. Wendel, Jr. 1993. Penicillin levels following the administration of benzathine penicillin G in pregnancy. Obstet. Gynecol. 82:338342.
55. Nathan, L.,, D. M. Twickler,, M. T. Peters,, P. J. Sánchez,, and G. D. Wendel. 1993. Fetal syphilis: correlation of sonographic findings and rabbit infectivity testing of amniotic fluid. J. Ultrasound Med. 2:97101.
56. Nathan, L.,, V. R. Bohman,, P. J. Sánchez,, N. K. Leos,, D. M. Twickler,, and G. D. Wendel. 1997. In utero infection with Treponema pallidum in early pregnancy. Prenat. Diag. 17(2):119123.
57. Noordhoek, G. T.,, E. C. Wolters,, M. E. J. DeJonge,, and J. D. A. Van Embden. 1991. Detection by polymerase chain reaction of Treponema pallidum DNA in cerebrospinal fluid from neurosyphilis patients before and after antibiotic treatment. J. Clin. Microbiol. 29:19761984.
58. Norgard, M. V. 1993. Clinical and diagnostic issues of acquired and congenital syphilis encompassed in the current syphilis epidemic. Curr. Opin. Infect. Dis. 6:916.
59. Orle, K. A.,, C. A. Gates,, D. H. Martin,, B. A. Body,, and J. B. Weiss. 1996. Simultaneous PCR detection of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus types 1 and 2 from genital ulcers. J. Clin. Microbiol. 34:4954.
60. Pereyra, N.,, A. Parisi,, and G. Baptista. 1997. Situación de la sífilis congénita en un municipio del gran Buenos Aires tres años de evaluación 1994-97, San Isidro, p. 187. In Program and Abstracts of the XI Latin American Congress on Sexually Transmitted Diseases/V Pan-American Congress on AIDS.
61. Petzoldt, D. 1975. Effect of spectinomycin on T. pallidum in incubating syphilis. Br. J. Vener. Dis. 51:305306.
62. Philipson, A.,, L. D. Sabath,, and D. Charles. 1973. Transplacental passage of erythromycin and clindamycin. N. Engl. J. Med. 288:12191221.
63. Pollack, H.,, W. Borkowsky,, and K. Kransinski. 1990. Maternal syphilis is associated with enhanced perinatal HIV transmission, abstr. 1274. In Program and Abstracts of the 30th Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, D.C.
64. Qureshi, F.,, S. M. Jacques,, and M. P. Reyes. 1993. Placental histopathology in syphilis. Hum. Pathol. 23:779784.
65. Radolf, J. D.,, P. J. Sánchez,, K. F. Schulz,, and F. K. Murphy,. 1999. Congenital syphilis, p. 11651189. In K. K. Holmes,, P. F. Sparling,, P.-A. Mårdh,, S. M. Lemon,, W. E. Stamm,, P. Piot,, and J. N. Wasserheit (ed.), Sexually Transmitted Diseases, 3rd ed. McGraw-Hill, New York, N.Y.
66. Rawstron, S. A.,, and K. Bromberg. 1991. Comparison of maternal and newborn serologic tests for syphilis. Am. J. Dis. Child. 145:13831388.
67. Rawstron, S. A.,, S. Jenkins,, S. Blanchard,, P.-W. Li,, and K. Bromberg. 1993. Maternal and congenital syphilis in Brooklyn, NY: epidemiology, transmission, and diagnosis. Am. J. Dis. Child. 147:727731.
68. Reyes, M. P.,, N. Hunt,, E. M. Ostrea, Jr.,, and D. George. 1993. Maternal/congenital syphilis in a large tertiary-care urban hospital. Clin. Infect. Dis. 17:10411046.
69. Ricci, J. M.,, R. M. Fojaco,, and J. O'Sullivan. 1989. Congenital syphilis: the University of Miami/Jackson Memorial Medical Center experience, 1986-1988. Obstet. Gynecol. 74:687693.
70. Risser, W. L.,, and L.-Y. Hwang. 1996. Problems in the current case definitions of congenital syphilis. J. Pediatr. 129:499505.
71. Rolfs, R. T.,, M. Goldberg,, and R. G. Sharrar. 1990. Risk factors for syphilis: cocaine use and prostitution. Am. J. Public Health 80:853857.
72. Russell, P.,, and G. Altshuler. 1974. Placental abnormalities of congenital syphilis: a neglected aid to diagnosis. Am. J. Dis. Child. 128:160163.
73. Sánchez, P. J. 1992. Congenital syphilis. Adv. Pediatr. Infect. Dis. 7:161180.
74. Sánchez, P. J. 1998. Laboratory tests for congenital syphilis. Pediatr. Infect. Dis. J. 17: 7071.
75. Sánchez, P. J.,, and G. D. Wendel. 1997. Syphilis in pregnancy. Clin. Perinatol. 24:7190.
76. Sánchez, P. J.,, G. H. McCracken,, G. D. Wendel,, K. Olsen,, N. Threlkeld,, and M. V. Norgard. 1989. Molecular analysis of the fetal IgM response to Treponema pallidum antigens: implications for improved serodiagnosis of congenital syphilis. J. Infect. Dis. 159:508517.
77. Sánchez, P. J.,, G. D. Wendel,, G. H. McCracken,, and M. V. Norgard. 1990. Congenital syphilis and HIV infection. Pediatr. Res. 27:276A. (Abstract.)
78. Sánchez, P. J.,, G. D. Wendel,, M. Hal,, J. Mayfield,, and M. Eason. 1991a. Congenital syphilis: the Dallas experience. Pediatr. Res. 29:286A. V
79. Sánchez, P. J.,, G. D. Wendel,, and M. V. Norgard. 1991b. Congenital syphilis associated with negative results of maternal serologic tests at delivery. Am J. Dis. Child. 145:967969.
80. Sánchez, P. J.,, G. D. Wendel,, and M. V. Norgard. 1992. IgM antibody to Treponema pallidum in cerebrospinal fluid of infants with congenital syphilis. Am. J. Dis. Child. 146:11711175.
81. Sánchez, P. J.,, G. D. Wendel,, E. Grimprel,, M. Goldberg,, M. Hall,, O. Arencibia-Mireles,, J. D. Radolf,, and M. V. Norgard. 1993. Evaluation of molecular methodologies and rabbit infectivity testing for the diagnosis of congenital syphilis and neonatal central nervous system invasion by Treponema pallidum. J. Infect. Dis. 167:148157.
82. Sánchez, P. J.,, G. D. Wendel,, F. Zeray,, N. K. Leos,, and J. Mayfield. 1994. Serologic follow-up in congenital syphilis: what "s the point? abstr. L22, p. 182. In Abstracts of the 34th Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, D.C.
83. Satin, A. J.,, D. M. Twickler,, and G. D. Wendel, Jr. 1992. Congenital syphilis associated with dilation of fetal small bowel: a case report. J. Ultrasound Med. 11:4952.
84. Schmid, G. P. 1996. Serologic screening for syphilis. Rationale, cost, and realpolitik. Sex. Transm. Dis. 23:4550.
85. Schmitz, J. L.,, K. S. Gertis,, C. Mauney,, L. V. Stamm,, and J. D. Folds. 1994. Laboratory diagnosis of congenital syphilis by immunoglobulin M (IgM) and IgA immunoblotting. Clin. Diagn. Lab. Immunol. 1:3237.
86. Schulz, K. F.,, W. Cates, Jr.,, and P. R. O'Mara. 1987. Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa. Genitourin. Med. 63: 320325.
87. Sheffield, J. S.,, J. Alexander,, D. D. McIntire,, P. Sanchez,, and G. Wendel, Jr. 1998. Serologic response after antepartum secondary syphilis treatment with one vs. two doses of benzathine penicillin G. Am. J. Obstet. Gynecol. 178:5210, abstr. 757.
88. Silverstein, A. M. 1962. Congenital syphilis and the timing of immunogenesis in the human fetus. Nature 194:196197.
89. Sison, C. G.,, E. M. Ostrea, Jr.,, M. P. Reyes,, and V. Salari. 1997. The resurgence of congenital syphilis: a cocaine-related problem. J. Pediatr. 130:289292.
90. South, M. A.,, D. H. Short,, and J. M. Knox. 1964. Failures of erythromycin estolate therapy in utero syphilis. JAMA 190:7071.
91. Southwick, K.,, S. Blanco,, A. Santander,, G. Seonae,, M. Estenssoro,, F. Torrico,, W. Brady,, V. Pope,, J. Lewis,, M. Fears,, and W. Levine. 1997. Rapid assessment of maternal and congenital syphilis in Bolivia, 1996, p. 96. In Program and Abstracts of the International Congress of Sexually Transmitted Diseases.
92. Stoll, B. J.,, F. K. Lee,, S. Larsen,, E. Hale,, D. Schwartz,, R. J. Rice,, R. Ashby,, R. Holmes,, and A. J. Nahmias. 1993. Clinical and serologic evaluation of neonates for congenital syphilis: a continuing diagnostic dilemma. J. Infect. Dis. 167:10931099.
93. Taber, L.,, and B. Baughn. 1991. Long-term follow-up of infants born of mothers with past or active infection with Treponema pallidum, p. 155, abstr. 337. In Program and Abstracts of the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, D.C.
94. Theus, S. A.,, D. A. Harrich,, R. Gaynor,, J. D. Radolf,, and M. V. Norgard. 1998. Treponema pallidum, lipoproteins, and synthetic lipoprotein analogues induce human immunodeficiency virus type 1 gene expression in monocytes via NF-kB activation. J. Infect. Dis. 177:941950.
95. Wasserheit, J. N. 1992. Epidemiological synergy. Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases. Sex. Transm. Dis. 19:6171.
96. Watts, T. E.,, S. A. Larsen,, and S. T. Brown. 1984. A case-control study of stillbirths at a teaching hospital in Zambia, 1979-80: serological investigations for selected infectious agents. Bull. W. H. O. 62:803808.
97. Webber, M. P.,, G. Lambert,, D. A. Bateman,, and W. A. Hauser. 1993. Maternal risk factors for congenital syphilis: a case-control study. Am. J. Epidemiol. 137:415422.
98. Wendel, G. D. 1988. Gestational and congenital syphilis. Clin. Perinatol. 15:287303.
99. Wendel, G. D., Jr.,, B. J. Stark,, R. B. Jamison,, R. D. Molina,, and T. J. Sullivan. 1985. Penicillin allergy and desensitization in serious infections during pregnancy. N. Engl. J. Med. 312:12291232.
100. Wendel, G. D.,, M. C. Maberry,, J. T. Christmas,, M. S. Goldberg,, and M. V. Norgard. 1989. Examination of amniotic fluid in diagnosing congenital syphilis with fetal death. Obstet. Gynecol. 74:967970.
101. Wendel, G. D.,, P. J. Sánchez,, M. T. Peters,, T. W. Harstad,, L. L. Potter,, and M. V. Norgard. 1991. Identification of Treponema pallidum in amniotic fluid and fetal blood from pregnancies complicated by congenital syphilis. Obstet. Gynecol. 78: 890895.
102. Wicher, K.,, G. T. Noordhoek,, F. Abbruscato,, and V. Wicher. 1992. Detection of Treponema pallidum in early syphilis by DNA amplification. J. Clin. Microbiol. 40: 497500.
103. Zenker, P. N.,, and S. M. Berman. 1991. Congenital syphilis: trends and recommendations for evaluation and management. J. Pediatr. Infect. Dis. 10:516522.
104. Zoechling, N.,, E. M. Schluepen,, H. P. Soyer,, H. Kerl,, and M. Volkenandt. 1997. Molecular detection of Treponema pallidum in secondary and tertiary syphilis. Br. J. Dermatol. 136:683686.

Tables

Generic image for table
Table 1

Surveillance case definition for congenital syphilis

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8
Generic image for table
Table 2

Syphilis in pregnancy: outcome by stage of infection

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8
Generic image for table
Table 3

Clinical findings and their frequencies in infants with early congenital syphilis

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8
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Table 4

Clinical findings in late congenital syphilis

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8
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Table 5

Treatment guidelines for acquired syphilis during pregnancy

Citation: Sánchez P. 1999. Syphilis and Pregnancy, p 125-150. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch8

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