Perfil clínico e sorológico da sífilis congênita em hospital de referência no Maranhão

Abstract

ABSTRACT Introduction: Congenital syphilis causes serious damage to the newborn's life, being easily prevented when the infected pregnant woman has an early diagnosis and timely treatment. In Brazil, it presented a significant increase in the detection rate in 2015 - 6.5 cases per 1,000 live births. This study is relevant to evaluate the clinical and laboratory profile of patients with congenital syphilis treated at a tertiary referral hospital in the state of Maranhão . Methods: This is a descriptive, retrospective study, based on the collection of data in medical records of patients admitted to a referral hospital in Maranhão with diagnosis of congenital syphilis or children of mothers diagnosed with syphilis during pregnancy during the period of January -December 2016. Results: 83 cases of congenital syphilis were reported in the epidemiological surveillance service; however, there was a loss of 8.4% of the medical records, of which 76 patients were studied. The majority of pregnant women were between 20 and 29 years of age, with education of more than eight years and stable union. At least one prenatal visit was reported by 76.3% of the pregnant women. The diagnosis of syphilis was late in 34.2% of the cases (diagnosis at the time of delivery) and the treatment considered inadequate or not performed in 92.1%. In only 19.7% of the cases there was information about diagnosis and treatment of the partner. The VDRL was positive in 86.9% of the newborns and the complementary exams were performed in most cases; the treatment instituted was procaine Penicillin G (65.8%), crystalline Penicillin G (19.7%) or Ceftriaxone (9.2%); clinical and laboratory follow-up was recorded in 21% of cases. Discussion: In order to achieve control of this disease, it is necessary to ensure timely and quality prenatal care to guarantee the early diagnosis of the pregnant woman and her partner, as well as posttreatment follow-up of the patients in order to achieve a reduction in the number of cases well and the sequelae of congenital syphilis. Conclusion: In the present study, a large number ofpregnant women with late diagnosis and inadequate treatment of the disease can be observed, which has a negative impact on the control of congenital syphilis.