One of the frequent pathologies administered by a venereologist and gynecologist is syphilis and pregnancy. Every year, an increasing indicator of this combining factor is recorded among women in the position when they are registered for monitoring control of the entire gestation period.
Even for ordinary patients, syphilitic infection is a danger, and for women in the situation, it doubles. Ignoring this pathology can affect both the health of the "mommy" and the health of the future baby. Only timeliness of treatment can protect against unwanted complications.
The combination of syphilitic infection with pregnancy is an aggravating factor due to high rates of perinatal pathologies and mortality.
These statistics speak for themselves:
- in almost 25% of cases, with late treatment of syphilis during pregnancy, stillborn children are noted,
- in 50% of cases, early mortality of newborn babies is recorded,
- 14% of women have spontaneous miscarriages.
These factors cause a three-time examination of future mothers for syphilis. Research data analysis carried out during the initial treatment of pregnant women to the gynecologist, at 23 and 32 weeks of pregnancy. This monitoring contributes to the prevention of placental failure and the development of complications in the perinatal period.
What is syphilis infection?
Regardless of who has this infection, whether it is an ordinary patient, or syphilis during pregnancy in women, it is a very dangerous pathology. Its pathogen - Treponema pallidum (pale treponema, spirootech) is able to adversely affect various systems of the body (reproductive, nervous, cardiovascular or musculoskeletal).
The pathogen itself is not particularly resistant to the environment, but direct contact with it significantly increases the risk of infection. Contributes to this, open sex (without the use of protective agents), including when its perverted forms.
Penetration into the body of the pathogen occurs in the presence of small dystrophic defects in the mucous coating of the vagina, the oral cavity, or in the walls of the direct intestine.
In addition to infection through sexual contact, infection can (although rarely) occur through contact with various body fluids of the patient (purulent substrate, through sperm and breast milk). Direct contact contributes to the rapid spread of the pathogen by the lymphogenous path through the body.
The development of the disease is due to several clinical stages - with the manifestation of periods of exacerbation and periods of latent clinical course with virtually no signs of the disease. The main risks of infection of women are due to the formation on the body of a rapidly disappearing rash in the form of erythema multiforme (polymorphic rash) and the initial signs of the disease, resembling a general malaise during the influenza condition.
The similarity of the initial signs of a syphilis lesion in a pregnant woman with various other pathologies leads to a delayed diagnosis, as a rule, during an already occurring pregnancy.
The primary stage of syphilis is due to the earliest stage of infection. In this period, symptoms manifest themselves in the formation of small, painless wounds in the form of ulcers. In medicine, they are called chancroid. Localization of the formations is manifested according to the route of infection - on the lips, genitals, oral mucosa, or anus.
This process continues up to one and a half months. After healing, scar tissue forms at the site of the ulcers. It seems that the disease has receded. But in reality, this suggests that the disease has passed into the phase of the latent flow. In this phase there is an active growth and reproduction of treponema and the spread of infection in all body systems. At the same time, symptoms manifest themselves:
- general malaise,
- nausea and headaches
- increase in body temperature
- swollen lymph nodes.
The disease enters the secondary stage when its first signs are ignored. Active reproduction of the infection contributes to its rapid introduction into the bloodstream. Migration of the pathogen in the body causes a more extensive defeat. The entire surface of the skin, including the hands, feet, and organs of the reproductive system, is covered with a pale rash.
Perhaps the manifestation of anagenic alopecia (rapid and uniform baldness), wart neoplasms, a noticeable deterioration in general health.
The third stage of syphilis is the last and most difficult. Syphilis in pregnant women at this stage is characterized by the defeat of many systems and organs: the nervous, endocrine, cardiovascular systems, damage to visual and auditory functions. Abnormalities in the brain can manifest as memory lapses.
Pronounced character have a rash on the skin. They are painful and there is no sign of healing. Patients are characterized by depressive states and signs of mental disorder (paranoia).
But the main feature of syphilis infection is its latent form, which does not manifest itself with specific symptoms and any signs of internal lesions. Doctors associate the latent form of the disease with uncontrolled intake of certain drugs.
It is no secret that during self-treatment, drugs of the penicillin, tetracycline, macrolipid and fluoroquinoline groups, which are capable of changing the clinical picture of the disease, its staging and smoothing of symptoms, are independently prescribed.
At the same time, the infection is not completely destroyed, but takes a hidden form. This form of the disease can manifest itself "in all its glory" after many years. And all this time, the patient can be in the role of an incubator, unaware of his illness, and without a twinge of conscience "carry the disease to the masses."
When does the risk of fetal infection increase?
For the most part, women monitor their health and try to prevent the manifestation of venereal pathologies. The main contingent of women with trepanemous infection who did not treat syphilis during pregnancy is women of special status. Such women early acquire sexual skills, usually with different, "objects of love."
Children are born out of wedlock, addicted to drugs, drink and smoke. Most of them, gets on the advisory accounting, only for further registration of subsidies. And this happens, as a rule, in terms of not allowing timely prenatal diagnosis of the disease.
In such situations, in order to identify the real clinic of the disease, a detailed examination of the "mountain and mommy" and its fetus is carried out. There are real risks for the woman herself and for the child, which gives an idea of the methods of further influence on the course of pregnancy and treatment.
At the beginning, the stage of the clinical course of the future mommy is revealed. After all, the risk of infecting a child, the vastness of possible complications during a child's birth, a successful delivery process depends entirely on the stage of development of the pathological process in a woman.
The most characteristic and pronounced sign of the presence of the pathogen in the body of a woman preparing to become a mother is a significant increase in the weight of the placenta against the background of the mismatch of the fetal mass with the parameters of its period. At the same time, throughout the entire period of childbearing, other, more significant pathological disorders can develop.
It is worth paying attention to the fact that late treatment of syphilis during pregnancy, regardless of its stage, can provoke miscarriage of the fetus at different times, or lead to the death of the fetus in the womb.
The child is most at risk of infection at the stage of secondary syphilis. If women have a primary disease, or manifested at a late stage of pregnancy, infection of the child is unlikely. In such cases, in order to exclude the possibility of infection, the child is removed from the womb of the mother through planned cesarean section.
But women should be aware that intrauterine infection of the fetus can occur at the initial stage of the development of the disease. That is why, more recently, the presence of syphilis infection in pregnant women was a direct indication for medical abortion. Today, opinions about the possibility of curing pathology are divided.
Motivating by examples of the achieved cure of syphilis for the last 10 years, venereologists oppose abortion. Gynecologists on the contrary - believe that the infection during pregnancy does not pass without consequences. Even in the absence of an obvious pathological clinic throughout the gestation of the fetus, it can be realized by various anatomical and functional changes in the form:
- intrauterine violation of the formation of the cardiac, vascular and nervous systems,
- increase in the size of the internal organs (in particular the spleen and liver) of the fetus,
- skin lesions in the form of syphilitic vesicle and diffuse infiltration,
- anatomical changes in bone structures (osteochondritis),
- syphilitic rhinitis, meningitis and choreoretinitis (ocular pathologies),
- focal and diffuse alopecia.
The probability of having a child with a congenital form of syphilis is due to inadequate monitoring of pregnancy, or its absence, late diagnosis (after 32 weeks of gestation) and not cured disease before conceiving a child.
Although, the listed symptoms jointly manifest themselves in exceptional cases, it can usually be one or two pronounced signs. Despite this, women should be aware of the possible risks and decide for themselves whether to leave the pregnancy or terminate it.
An important factor for making a decision is that a child who has survived an intrauterine infection and expressed signs of syphilis can manifest themselves after 2 and 20 years after the safe birth.
Basic principles of modern diagnostics
A positive test for syphilis during pregnancy is the main indicator for the diagnosis of treponemal infection. To determine this pathology, various laboratory research techniques are directed — capillary and venous blood sampling (from the finger and vein). As well as indicators of studies of cerebrospinal fluid (CSF). Diagnostic screening is for all women who are expecting a child. Whether the infection had a history of it or not is irrelevant.
The diagnostic search includes various research methods:
An integral part of the diagnosis is a non-component test, which allows the detection of antibodies to the pathogen by immunological reactions. A large number of antibodies indicates the presence of infection, and their small titers indicate neglect of the process.
Express diagnostics can be carried out by the method of A. Wasserman. The content in the studied material of antibodies is marked with a different amount of “+”. Two advantages are characterized by a low probability of infection. Three - more, and at +, +, +, + - the presence of absolute infection. This method is not perfect, sometimes shows a dubious analysis, which requires confirmation of the pathology by other methods. For example:
- involvement in the diagnosis of the polymerase chain reaction is the most reliable method for detecting the DNA of the pathogen, which indicates infection.
- Various methods of Koons - direct immunofluorescence, indirect, with the inclusion of a dry compliment. Such an analysis is characterized by a high sensitivity to the pathogen, which makes it possible to identify it in the initial stage of the disease.
- The use of the passive (indirect) agglutination reaction method (sedimentation of the pathogen cells and its fragments on the surface of erythrocytes) makes it possible to detect the infection at any clinical stage. To confirm the diagnosis, the study carried out by enzyme immunoassay. A positive result indicates the presence of a syphilis pathogen, or its history.
- If the doctor suspects that the previous examination gave a false result, the examination is carried out by the method of immobilization of the strain of the pathogen.
- To detect pathology in babies infected by the mother during fetal development, they use the method of detecting antibodies in blood serum using the immunoblot method.
By the way, false positive results can provoke background pathologies in the form of diabetes, heart disease, blood vessels, infectious and skin pathologies, and women’s addiction to smoking and alcohol. Even pregnancy itself can cause false positive testing for syphilis during pregnancy.
Modern therapy methods
If it is treated to start on time, many forms of syphilis today successfully respond to therapy. The effectiveness of treatment depends on the stage of development of the pathology. With late diagnosis, therapeutic treatment is needed not only for the expectant mom, but also for her fetus.
Therapeutic treatment of syphilis in pregnant women must comply with certain rules:
- ensuring timely treatment, which will provide an opportunity to prevent congenital form of syphilis,
- selection of drugs with a minimal negative impact on the child and good tolerance in women,
- drugs should be available at a price point,
- to create an opportunity for patients to conduct therapy in the day hospital.
Course Therapy Includes:
The course of specific treatment. Assigned to pregnant women after a positive diagnosis. The treatment prescribed drugs penicillin group (procaine and crystalline sodium salt of benzylpenicillin, or a penicillin antibiotic).
If the patient has an allergic reaction to the drugs, they are replaced with erythromycin or ceftriaxone. But since Erythromycin is not able to penetrate the placenta, the child needs a penicillin drug.
For primary and secondary forms of syphilis, the treatment course should be 2-2.5 weeks long. With latent early infection and recurrence of the secondary form, the course lasts for almost a month (28 days). Late latent infection is treated with three courses of penicillin (from one to one and a half weeks).
The effectiveness of the treatment is provided by penicillin antibiotics. They are well tolerated, little toxic, actively destroy the pathogen.
The course of prophylactic treatment is prescribed to women who in previous pregnancies had serological tests with a positive titer. Therapy can be carried out according to two different methods.
In the first case, the treatment is carried out with penicillin water-soluble drugs. The doctor determines his certain concentration, which must be maintained in the body of the mother and fetus for 1.5-2 weeks. During this time it is possible to interrupt up to 5-9 cycles of reproduction of treponema. Such treatment is carried out in stationary conditions. If this is not possible, the treatment is carried out according to the second method.
A course of injections (8 per course) of bicillin – durant penicillin preparation with a long exposure period is prescribed.
- If during the passage of a specific course before pregnancy, and when it occurs, the tests are still positive, women are given the first option of a prophylactic course.
- If a specific course of treatment was prescribed in the first trimester of pregnancy, the prophylactic course with previous drugs is carried out after the 20th week of pregnancy.
- If the treatment was carried out in late periods, then the prophylactic treatment course is prescribed immediately after the specific one, or 15 days after it.
Adequate is considered a 2-time treatment course, conducted in the interval of 32 weeks of pregnancy.
A preventive treatment course (preventive) is prescribed to those pregnant who have had a sexual relationship with a syphilis partner, and the relationship does not exceed 90 days. The drugs are similar to a specific course with the addition of durant penicillin injections.
Courses of specific and prophylactic treatment should take place against the background of a combined (metabolic) therapeutic treatment. All children born from an infected mother who did not have time to complete the treatment course during the perinatal period are prescribed a therapeutic prophylactic treatment course.
Prevention and Rehabilitation
Preventive and rehabilitation measures depend on the coordinated work of physicians of various practices and specializations (therapist and dermatologist, neuropsychiatrist, oncologist, endocrinologist and immunologist) and the behavior of the patient herself. The main task lies with the gynecologist, who must provide timely diagnosis.
All appointments and dosages of drugs are painted by the doctor on an individual basis. Do not self-medicate. Trust your and your child's health to specialists.
Rehabilitation measures are carried out with patients with the presence of late forms of syphilis infection. Even after the main course of therapy, in pregnant women the test for syphilis is positive. После родов пациенткам назначаются физиотерапевтические процедуры, психотропные и успокаивающие препараты, средства, нормализующие процессы метаболизма (обменные) и усиливающие фагоцитарную иммунную защиту.
Rehabilitation is carried out one year after the primary treatment. The therapeutic course is distributed for a year, it can be up to 3 months.
Ways of infection in the body
The causative agent of syphilis is a bacterium, which has the name "pale treponema", or "pale spirochete." It enters the body in the following ways:
- Unprotected intercourse. The probability of becoming infected in this case is quite high. According to studies, even with a single contact without protective equipment with a person with syphilis, the probability of becoming infected reaches 45-50%. Venereologists emphasize that you can get sick not only after the traditional intimate contact, but also during oral and anal sex.
- Household way. You can even become infected through saliva. The use of common utensils in a family where there is an infected person can lead to infection of healthy relatives. Such cases of transmission are rare, as the spirochete has a short lifespan (about 2 hours) outside the body.
- Through the blood. That is why absolutely all donors without exception are tested for syphilis.
- Through the placenta from mother to baby. The high probability of infection with this method obliges all women to donate blood for syphilis during pregnancy. A child may also get sick while passing through the birth canal (this type of infection is called vertical).
According to statistics, the largest percentage of infections occur in women who have sex with indiscriminate sex and are addicted to drugs. The incubation period of this disease can last from 10 to 85 days. There are cases of the duration of incubation in several years. At this time, a person is already a carrier of the pathogen and infects others, but he still does not know about it.
Important! A postponed and even completely cured infection does not guarantee that syphilis will not reappear. Immunity after the disease is too weak, so repeated subsequent infection is possible.
The course of the disease and the main symptoms
Recognizing the signs of the disease is not easy. There are a lot of them and they vary depending on the stage. Depending on the time of infection, syphilis in pregnant women may be at one or another stage of development.
- Primary syphilis. The very first stage after the pathogen enters the human body. For this period, characterized by the appearance of small sores. The wounds are called hard chancre; usually it is not accompanied by pain. The locations of chancre are mainly dependent on the route of infection. These can be lips, genitals, mouth, anus.
This phenomenon can last for about 1–1.5 months, after which the skin rash begins to heal and turn into scars. The patient begins to think that the disease has receded. In fact, syphilis only becomes latent. At this point, treponema actively multiply and infect the body.
Hard chancre is the initial manifestation of syphilis.
At this time, an infected person experiences symptoms such as malaise, nausea, headache, fever, and lymph nodes.
Note. Diagnosis is complicated by the fact that the manifestations of syphilis are similar to many other less dangerous diseases: flu, herpes, allergies.
- Secondary syphilis. At this stage, the disease flows if the first signs were ignored. At this time, treponemes begin to actively migrate in the body, increasingly affecting it. Microbes enter the bloodstream and spread throughout the body. A pale rash appears on the body; it can affect the entire surface of the skin, including the feet, hands, and genitals. Perhaps the appearance of warts and even hair loss. The general condition of the body is deteriorating.
- Tertiary syphilis. The hardest and last stage of the disease. At this stage, treponema affect many organs and systems: hearing, vision, nervous system, endocrine. The disease creates serious problems in the work of the heart and brain. Possible loss of memory. Skin rashes become more pronounced, ulcers hurt, do not heal. The patient becomes prone to depression and paranoia.
To determine the presence of syphilis during pregnancy will help blood test. Material can be picked up from a vein or from a finger. In addition, in some cases, a spinal fluid is taken for verification. Each woman is obliged to donate blood for antibodies to syphilis for pregnancy 3 times.
Diagnostics can take place in several stages:
- Screening tests. They pass every pregnant woman, regardless of whether she ever had this disease or not. The test is called the Wasserman reaction (RW). It gives a result within 15–20 days after the onset of the first stage of syphilis. A positive reaction is distinguished by a degree of expression and differs by the amount of the + sign. This result is called seropositive. If such a response is received, the pregnant woman undergoes additional examination.
- The following tests are more susceptible to treponema, and therefore give a clearer picture of the course of the disease.
- immunofluorescence reaction - is more sensitive to pathogens.
- The reaction of immobilization of pale treponemas - is used when a false positive result is suspected.
- Immunoassay can determine the stage of the disease.
- The reaction of passive agglutination may show the prescription of infection in the body.
A false positive result can be obtained if a woman has such diseases as:
- drug and / or alcohol addiction,
- syphilis, which was cured before,
- cardiovascular pathology,
- infectious diseases,
- connective tissue disease.
Pregnancy itself can cause a false positive blood test for syphilis.
Syphilis - the reason for abortion?
Important! According to the order of the Ministry of Health, syphilis is an indication for termination of pregnancy when detected for up to 28 weeks. On this mandatory gynecologist must warn the expectant mother. At the same time, he is obliged to acquaint her with possible complications and problems.
However, modern medicine has reached such a level that when an infection is found in a woman, pregnancy can be continued. Thanks to the latest pharmaceutical developments, congenital syphilis in a child can be prevented. There is no absolute guarantee that the fetus will not be infected, but the chances are quite high. In any case, when this problem occurs, the expectant mother is under strict control and undergoes additional procedures.
Timely diagnosis significantly increases the chances of having a healthy baby in a mother with syphilis.
Treatment depends entirely on the stage of detection of the problem. Usually, the infection is detected in the early stages. In the case of late detection of a problem, not only the expectant mother needs therapy, but also the fetus.
Important! No one has the right to force a woman with syphilis to have an abortion. This right is reserved for it by current legislation. Abort or not - the subjective choice of each woman.
In the case of pregnancy after syphilis, which was completely cured, the woman gives birth to a healthy child. It does not even need a preventive program: pregnancy with cured syphilis occurs without deviation from the norm.
The danger for the unborn child and what measures to take
Syphilis during pregnancy increases the risk of giving birth to dead babies, and also increases the likelihood of miscarriage. With this disease, miscarriages often occur. Syphilis in a pregnant woman, if left untreated, will lead to rapid fetal death or the birth of a disabled child.
An infant who has received an infection from the mother suffers from congenital syphilis. Typically, treponema affects the fetus in the middle of the first trimester, when the active link of the mother and baby through the placenta begins. The infection penetrates through the membranes.
Treponema destroys all organs and systems of the fetus. Possible manifestations of congenital syphilis:
- skin rashes,
- destruction of bones, joints,
- damage to the liver, heart,
- changing the shape of the nose, skull, teeth curvature,
- serious brain defects.
The probability of having a child with congenital syphilis increases in the following cases:
- inadequate management of pregnancy or lack thereof,
- late diagnosis, for a period of more than 32 weeks,
- syphilis not cured before pregnancy.
Important! In a child who has survived syphilis infection in the womb, the presence of an infection can occur 2 years after birth. In some cases, the disease manifests itself after 20 years.
Children born to a mother who was sick or had syphilis before are under the supervision of a doctor and undergo the following tests:
- in a maternity hospital: examination of cord blood, examination of a neonatologist, start of treatment,
- children's department: continuation of treatment, laboratory tests (blood, X-ray of tubular bones, examination by an ophthalmologist, a neurologist),
- dermatovenerologic dispensary: control and conclusion (deregistration).
Features of pregnancy in syphilis
Responsibility for how to treat syphilis during pregnancy lies with the obstetrician-gynecologist, who leads the process. After confirming positive results for the presence of infection, the pregnant woman should undergo special treatment in the dermato-venereal hospital. Here she receives a course of antibiotic therapy. Used mainly penicillin group drugs. Treatment of syphilis during pregnancy is carried out with the following drugs:
- penicillin novocaine salt,
- penicillin sodium,
If a woman is intolerant of penicillins, Erythromycin, Ceftriaxone, etc. are used.
Important! Only a doctor can prescribe penicillin dosage. The drug has side effects in the form of early contractions, dizziness, pain in muscles and joints.
Additionally, a general strengthening therapy with the use of vitamins and vitamin-like remedies is carried out:
- folic acid,
- vitamin E,
- lipoic acid
- pyridoxal phosphate,
- potassium orotat.
Treatment will be effective if you have time to start it before 32 weeks of pregnancy.
It is possible to recover from syphilis during pregnancy if a problem is detected in the early stages in 2-3 months, while the later stages can be treated for more than one year.
An infected woman during her entire pregnancy will be observed not only by an obstetrician-gynecologist, but also by a dermatovenerologist. The gynecologist will monitor and correct possible deviations from the normal gestation process, and the dermatovenereologist will monitor the dynamics of the treatment.
Why is it so important to be tested for syphilis
Syphilis in both men and women does not immediately manifest. It can be felt in 3-4 weeks after infection. That leads to irreversible processes. If you do not recognize syphilis in time, it can lead to infertility. If a woman is pregnant, then this is a big threat to the fetus.
Currently, according to statistics, syphilis is spreading very quickly and the number of infected in the last 10 years has increased 5 times. That is why the survey is a must.
Analysis for syphilis at home
When an analysis is prescribed
Usually, the analysis is prescribed by doctors:
- when a woman becomes registered with a female consultation during pregnancy,
- during a planned operation,
- before admission hospital
- if there was contact with an infected,
- assigned to a child if the mother is infected,
- with the manifestation of symptoms that are characteristic of this disease.
Also, this analysis is planned for the passage of compulsory medical examination for work for certain types of professions:
- related to the food industry,
- medical workers,
- employees of preschool institutions, schools, etc.
An analysis of syphilis is mandatory for convicts, military personnel, and blood donors.
Also, each person can, if desired, take an analysis. To do this, you need to contact the clinic at the place of residence.
Dear women and men, it is not shameful to be tested for syphilis, but safe for your health and life. Remember that your diagnosis is a medical secret.
How to pass
For analysis of syphilis, blood is taken from a vein. But also for analysis, if necessary, you can use the CSF (cerebrospinal fluid), a smear from an ulcer, sperm. Since they mainly take blood from a vein, we will tell you how to prepare correctly for an accurate result.
Recommend the day before the test to limit the use of fatty foods and fried. And for 5-6 days to completely eliminate alcohol and smoking. Completely from the food should refuse no less than 8 hours before the analysis (the blood is surrendered strictly on the toast). You can, if necessary, drink a little ordinary water. It is desirable to exclude taking pills (except for vital, in this case, you must notify the doctor).
If you take the test again after you have completed the course of treatment, the test is done no earlier than two weeks after the end of the treatment.
Women are not recommended to take the analysis during menstruation.
If you have only undergone an x-ray or physiotherapy, it is recommended that you take the test after a couple of days.
As we said, blood is taken from a vein. Many patients faint when they see blood. If you know this fact behind you, be sure to warn the lab technician who takes blood about it.
Syphilis blood is taken from a vein
Delivery of the test for syphilis during pregnancy, especially the result
During pregnancy, syphilis is a very big threat to the fetus, namely:
- preterm labor
- infection of the child in utero.
The analysis is prescribed as planned 4 times. The first one during the woman’s consultation is in consultation with the purpose of registration, then at 1, 2, 3 screening. When analyzing blood is taken from a vein.
Screening is a comprehensive survey of pregnant women. During the screening for biochemical examination, venous blood is taken and ultrasound of the fetus is done.
There is no special preparation for analysis during pregnancy; all recommendations are absolutely the same for everyone. Dear pregnant women, it is worth knowing that, if the result is weakly positive, then there is no reason to worry. This is not rare, as the woman's body is rebuilt, thereby forming antibodies, which are protection for the fetus. Be sure to retake the analysis.
For pregnant women use a screening diagnostic method, such as - RMP. If the RPM gives a weakly positive result, then the second study is definitely prescribed - ELISA.
Syphilis is considered to be one of the most difficult diseases in terms of its dynamics. That is why no test can give you an absolute guarantee that the result is reliable.
In order to increase the accuracy of the result, it is necessary to strictly adhere to all the rules when passing the analysis. You also need to know the causes and factors that can directly affect the result of the analysis.
During the incubation period, not all tests can reveal the disease. Also, the result may be false positive. In such cases, conduct a complex of surveys for accurate statement of a positive diagnosis or its denial.
False Positive Syphilis Analysis and Interpretation
Not rarely does a false positive result. But this is not a reason to make a diagnosis right away. Since this result has many influencing factors. This occurs when the patient at the time of delivery of the analysis had an acute period of illness. These diseases include:
- heart attack
- vaccination (within 31 days).
- oncology (mainly with lymphatic tissue),
- Hepatitis of all types
- liver disease,
- enterovirus infection,
- gouty arthritis
- age-related changes of the body.
All these diseases in the course of their disease form proteins, the so-called antibodies. In the study of blood for syphilis (RW), this is what gives a reaction to these proteins, which shows a positive result.
Often there is a false positive result, when a person turned himself for the first time, without consulting a doctor and without proper preparation.
If before delivery of the analysis drugs and alcohol were taken for more than one month.
Often there is a false positive result during pregnancy.
Another factor is the age of more than 70 years. The older we get, the more pronounced the oxidation-reduction reactions occur in the body, which provokes a false-positive result.
If you decide to take an analysis of syphilis yourself, then carefully read the rules of preparation. If the analysis came positive you should not panic. Each qualified doctor will give you an additional examination to confirm the result or vice versa.
The content of antibodies to the synthetic peptide Tz 41 (23 - 51) in the comparison groups
Содержание антител к синтетическому пептиду Тз 41 (23 — 51) в группах сравнения
* Примечание: р — достоверность различий показателей в группах у пациентов с ЛПР и РСС
Классификация методов лабораторной диагностики сифилиса
For many years, syphilis was considered an incurable disease, but Wasserman discovered a method for diagnosing a disease. This is how the methods for diagnosing ELISA and RIBT were discovered - microscopic examination. At the reception of the doctor according to your complaints, it is possible to assume the presence of syphilis, but to confirm the preliminary diagnosis, screening is carried out - diagnostics or as it is called serodiagnosis.
Wasserman reaction (RW) belongs to the group of complement fixation reactions
(A. P. Wassermann, German bacteriologist, 1866-1925 - immunological reaction used in the diagnosis of syphilis)
Wasserman reaction (RW) belongs to the group of complement fixation reactions
All diagnostic methods are divided into:
- indirect (otherwise they are called indirect).
Direct methods are divided:
- SST - dark-field microscopy (using a light microscope to examine treponema pallidum). They are very poorly susceptible to staining. Disadvantages of this method: a qualified laboratory technician is required for proper introductory work. High probability of a false positive result. This diagnostic method is not expensive - it is considered the cheapest.
- RIF-Tr - direct immunofluorescence reaction (microscopic examination by staining with fluorescent antibodies). This method is practically no different from TPM, but it is much more expensive and that is why it is practically not used.
- PCR is a polymerase chain reaction (it detects the DNA of pale treponema, it is considered much more effective, since it shows not only living, but also dead treponema, even if their units). PCR does not require the professionalism of a laboratory technician, it is fully automated. But for screening for syphilis, it is not suitable. False negative results are common. It is expensive and rarely used.
Indirect methods (serological tests) are methods based on the detection of antibodies that are produced by the body in response to infection. Serological tests include a range of surveys. The basis of the diagnosis of syphilis - serological methods. They can be divided into:
- Non-treponemal (otherwise non-specific) are used to determine how the disease progresses and for the selection of drugs. Using them detect IgG and IgM. Positive results are considered to be 1: 2, 1: 4, 1:80, etc.
- Treponemal (specific) - these include the Wasserman reaction.
ELISA (enzyme-linked immunosorbent assay) - this method uses rabbit testicular treponemas, which are placed in the patient's blood serum. But he has one significant drawback, he does not show a positive result in the early period of the disease.
RIF (immunofluorescence reaction) - usually titers are very high and a positive result indicates a 100% presence of syphilis in the body. Gives the opportunity to detect the disease in the early stages.
RIBT (reaction of immobilization of pale treponemas) is considered an expensive diagnostic method. A positive result shows no earlier than the second stage of the disease. It is used for the defeat of the internal organs or for suspected congenital syphilis.
RGPA (reaction of indirect hemagglutination) is the most commonly used diagnostic method. It is used for people in contact with patients and after false positive results. Allows you to find out the duration of the disease.
Nelson's test - use both blood, and sperm, vaginal contents, slime, a smear from chancre.
RPR, RPR - fast plasma reagin test. Tests are considered to be simple in their work. It is often used for emergency diagnostics.
RMP - microprecipitation reaction or microreaction. RMP becomes positive one month after the appearance of a hard chancre. For its use is used blood from a finger.