Congenital syphilis is a bacterial infection that is present in babies and acquired at birth. It occurs when a mother has syphilis or traces of it during the time of being pregnant. Syphilis is a bacterial infection caused by sexual intercourse, and if early signs are left untreated, they may cause serious problems to the baby. If the infection is not treated, it may cause poor outcomes during pregnancy such as minor body abnormalities, premature births, miscarriages or even death of newborn infants. Babies who are exposed may also suffer complications such as slow development, rashes, fevers, jaundice and anemia among other health complications (Lee, 2015). Infants may also develop symptoms of latent syphilis usually accompanied by brain, eye, bone and ear damage. This essay will highlight guidelines and teachings on the local clinical practice concerning congenital syphilis.
The first step is surveillance. Surveillance is done for every infant of up to twelve months of age. At this stage, the babies are monitored and tested for a reactive non-treponemal serologic test, a positive fluorescent antibody test, and positive dark field examination. This is followed by the control stage. This involves the monitoring of early symptoms and infections of syphilis to prevent an accompanied infection of congenital syphilis to the baby (Lee, 2015). Individual programs such as disease intervention activities and STD program priorities have been set to prevent future cases of congenital syphilis occurring in infants. This stage is followed by parental care. Parental care is necessary especially during the early stage of pregnancy to avoid congenital syphilis (Lee, 2015). Additional strategies are placed such as screening of the mother to reduce the risk of transmitting syphilis to the baby. Parental care providers should also ensure that their patients are tested for syphilis and ensure they receive immediate treatment. Counseling should also commence before the parental care program begins to sensitize and educate mothers on the condition they are facing.
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After these steps have been taken, then the clinic should move on to laboratory tests. It is important that the correct standard tests are done to provide proper diagnosis of syphilis. As a result, the test should be done with careful attention to detail to ensure quality results are achieved (Patel, 2014). The standard tests carried out are; antibody screening test, a confirmatory antibody test, direct examination of lesion or tissue, FTA-ABS immunoglobulin, FTA-ABS 19S IgM and IgM capture ELISA. This stage is then followed by dealing with syphilis in pregnancy. This step includes both maternal serologies and treatment in gestation (Patel, 2014). In Maternal serologies, an STS should be done when starting parental care and during delivery. Intermediate testing should also be done during the third trimester of pregnancy for women in high-risk populations. The women also receive treatment in gestation. The treatment of choice for syphilis patients not allergic to penicillin is through the same dosage of penicillin given to non-pregnant patients (Patel, 2014). Patients that may be allergic are first desensitized by giving them a small dosage and increasing it until the body develops a tolerance for the drug. This stage is then followed by a maternal treatment follow up which includes tests and treatments until after the baby is born.
The next stage is diagnosis and evaluation of syphilis in the fetus and neonate. This assessment includes neonatal serologic tests for syphilis, microscopic evaluation of the placenta, radiography test and cerebrospinal fluid analysis (Lamprecht, 2015). After tests are done, neonatal treatment is administered then a follow-up is done for up to twelve months of age. All patients are then encouraged to have a long-term monitoring and retreatment. Penicillin treatment for congenital syphilis are the same after neonatal period, and all the patients who exhibit early signs of congenital syphilis or syphilis are advised to return for other tests.
References
Kwak, J., & Lamprecht, C. (2015). A review of the guidelines for the evaluation and treatment of congenital syphilis. Pediatric annals.
Janier, Á. Hegyi, V., Dupin, N., Unemo, M., Tiplica, G. S., Potočnik, M., & Patel, R. (2014). 2014 European guideline on the management of syphilis. Journal of the European Academy of Dermatology and Venereology.
Singh, A. E., Levett, P. N., Fonseca, K., Jayaraman, G. C., & Lee, B. E. (2015). Canadian Public Health Laboratory Network laboratory guidelines for congenital syphilis and syphilis screening in pregnant women in Canada. Canadian Journal of Infectious Diseases and Medical Microbiology, 26(Supplement A), 23A-28A.
