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Maternal syphilis: Pathophysiology
and treatment.
Bulletin of the World Health Organization 2004;82(6):433-438.
Berman SM.
Abstract
Despite the long history of medical interest in syphilis and its effects on
pregnancy outcome, many fundamental questions about the pathophysiology and
treatment of syphilis during pregnancy remain unanswered. However, understanding
has been advanced by recent scientific reports such as those which delineate
the complete sequence of the genome of the syphilis spirochaete, provide
a more precise description of fetal and neonate infection by use of rabbit
infectivity tests and describe the gestational age distribution of fetal
death secondary to syphilis. It appears that fetal syphilitic involvement
progresses in a rather predictable fashion, and although there is disagreement
about the optimal prenatal treatment regimen, programmatic efforts to prevent
fetal death must provide seropositive pregnant women with a recommended treatment
early in pregnancy, and certainly before the third trimester.