Identification of Treponema pallidum in amniotic fluid and fetal blood from pregnancies complicated by congenital syphilis
Article Abstract:
Treponema pallidum (T. pallidum) is the bacterial organism that causes syphilis. During an infection, these bacteria are present in the blood and in pregnant women, they can pass through the umbilical cord and infect the developing fetus. Congenital syphilis can be difficult to diagnose because many of the infants who become infected while inside of the womb do not have any of the classical symptoms (skin ulcers and lesions) at birth. Syphilis can be diagnosed by testing blood and mucus samples for T. pallidum. A recent study reported that these bacteria could be identified in the amniotic fluid from fetuses that had died from congenital syphilis. Therefore, a study was performed to determine if congenital syphilis can be diagnosed by testing samples of amniotic fluid and fetal blood for T. pallidum. Amniocentesis was performed on two pregnant women with syphilis. The first infant was delivered at week 35 of pregnancy. Samples of amniotic fluid and fetal blood tested positive for syphilis. The infant had and enlarged spleen and liver (hepatosplenomegaly), bone and cartilage inflammation (osteochondritis), and neurosyphilis (involving the central nervous system). Both mother and infant were treated with penicillin G, but were lost to follow-up. In the second case, a blood sample from a 24-week-old fetus showed that the fetus had anemia (low red blood cell count) and thrombocytopenia (abnormally low numbers of platelets). The blood tested positive for syphilis, while the amniotic fluid tested negative. The woman was treated with benzathine penicillin G and later gave birth (week 38). At birth, the infant had normal liver function and blood cell counts. This infant did not have osteochondritis or neurosyphilis, and appeared normal at three months of age. It is concluded that the samples of amniotic fluid and fetal blood may be useful for diagnosing infections with T. pallidum. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1991
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Thyroid function in small for gestational age fetuses
Article Abstract:
Illness and poor nutrition in an infant shortly after birth can affect various aspects of thyroid gland function, including release, transport, metabolism, and actions of thyroid hormones. The response of the thyroid gland to illness and malnutrition results in beneficial adaptations, including a decrease in energy expenditure and conservation of proteins. The changes in thyroid gland function associated with malnutrition of the fetus were assessed in 49 fetuses considered small for gestational age (SGA), that is, for a specific stage of pregnancy. One study showed that SGA fetuses suffered chronic malnutrition, indicated by hypoxemia, or abnormally low blood oxygen levels; acidemia, or increased acidity of the blood; and altered carbohydrate, lipid, and amino acid metabolism. The fetuses were studied at 21 to 38 weeks' gestation. The levels of the pituitary hormone thyroid stimulating hormone (TSH), which activates the thyroid gland to release hormones; thyroxine-binding globulin, a blood protein that binds and transports the thyroid hormone thyroxine (T4); and free and total forms of the thyroid hormone triiodothyronine (T3) and T4, were measured. The results were compared to those obtained from 62 fetuses considered appropriate for their gestational age (AGA). SGA fetuses had higher TSH levels and lower total and free T4 levels than AGA fetuses. Elevated TSH levels were associated with fetal hypoxemia, whereas decreased T4 levels were associated with acidemia. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
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