Clinical and epidemiological features of congenital syphilis with antenatal fetal asphyxia

Syphilis is a systemic venereal disease that causes skin, mucous membranes, internal organs and musculoskeletal system lesions, and damages the fetus in the womb. The fetus is infected in the 16^th–20^th weeks of pregnancy, mostly transplacentally. The outcomes of congenital syphilis are miscarriages, stillbirths, premature births, the birth of a child with active and latent course of syphilis, and the birth of a healthy child.

A clinical case of untreated congenital syphilis with antenatal fetal asphyxia is presented. First of all, the attention is drawn to the aggravated obstetric anamnesis: the first and second pregnancies ended in intrauterine fetal asphyxia and therefore a non-developing pregnancy. In the 8^th–9^th weeks of the current pregnancy antibodies to Treponema pallidium were detected – IgG, M, titer 1:1280, and a consultation with a dermatovenereologist was recommended. However, during the entire pregnancy period, no dermatovenereological examination, tests or treatment measures were carried out. Concomitant trichomoniasis and acute respiratory viral infections in a mild form were revealed and sanitized twice. At 27 weeks of pregnancy, antenatal fetal asphyxia was determined by ultrasound examination. The autopsy of the fetus revealed intrauterine pneumonia, and the postmortem examination of the placenta – pronounced dystrophic changes specific to congenital syphilis.

This case demonstrates that ignoring the dermatovenereological therapeutic and diagnostic measures which were required, contributed to the disease progression and resulted in the development of antenatal fetal asphyxia. Timely detection and correction of all existing changes are necessary for a favorable course of pregnancy.