Hani Lusyana; Lina Damayanti; Agus Walujo

doi:10.15562/ism.v12i2.1009

Kematian janin dalam kandungan pada ibu hamil dengan infeksi sifilis laten: laporan kasus

Hani Lusyana ,

Lina Damayanti ,

Agus Walujo ,

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DOI: https://doi.org/10.15562/ism.v12i2.1009 |
Published: 2021-08-21

Abstract

Background: Pregnant women and newborns are a group that is prone to contracting sexually transmitted infections, although they do not directly engage in high-risk sexual behavior. One that has an unexpected impact on pregnant women and newborns is syphilis by the bacterium Treponema pallidum. Transmission of syphilis from mother to fetus is usually worse when the infection in pregnant women is not detected or not appropriately treated early in pregnancy. This case report aims to evaluate fetal death in the womb in pregnant women with latent syphilis infection

Case Presentation: A 19-year-old pregnant woman aged 31-32 weeks diagnosed with late postpartum spontaneous Intrauterine Fetal Death (IUFD) with early latent syphilis. The diagnosis of syphilis was made based on the Veneral Disease Research Laboratory (VDRL) serological test (1:64), Treponema Pallidum Hemagglutination Assay (TPHA) (1:1,280), and without any mucocutaneous complaints. The patient received Benzathine Penicillin G 2.4 million IU single dose intramuscularly. The diagnosis of IUFD was made one day after the administration of therapy and the baby was born with multiple congenital abnormalities.

Conclusion: Undiagnosed and adequately treated syphilis in pregnant women can result in perinatal death caused by multiple congenital abnormalities.

Latar Belakang: Ibu hamil dan bayi baru lahir merupakan kelompok rawan tertular infeksi menular seksual, walaupun tidak secara langsung berperilaku seksual resiko tinggi. Salah satu yang memiliki dampak kelahiran yang tidak diharapkan pada ibu hamil dan bayi baru lahir adalah Sifilis oleh bakteri Treponema pallidum. Transmisi sifilis dari ibu ke janin biasanya berakibat buruk ketika infeksi pada ibu hamil tidak terdeteksi atau tidak diobati secara benar di awal kehamilan. Laporan kasus ini bertujuan mengevaluasi kematian janin dalam kandungan pada ibu hamil dengan infeksi sifilis laten

Presentasi Kasus: Seorang wanita hamil berusia 19 tahun usia kehamilan 31-32 minggu dengan diagnosis akhir postpartum spontan Intrauterine Fetal Death (IUFD) dengan sifilis laten dini. Diagnosis sifilis ditegakkan berdasarkan tes serologis Veneral Disease Research Laboratory (VDRL) (1:64), Treponema Pallidum Hemagglutination Assay (TPHA) (1:1.280), dan tanpa adanya keluhan mukokutaneus. Pasien mendapatkan terapi Benzatin Penisilin G 2.4 juta IU single dose secara intramuskular. Diagnosis IUFD ditegakkan satu hari setelah pemberian terapi dan bayi yang dilahirkan memiliki kelainan kongenital multipel.

Kesimpulan: Sifilis pada ibu hamil yang tidak terdiagnosis dan diterapi dengan adekuat dapat mengakibatkan terjadinya kematian perinatal yang disebabkan oleh kelainan kongenital multipel.

References

Arando Lasagabaster M, Otero Guerra L. Syphilis. Sífilis. Enferm Infecc Microbiol Clin (Engl Ed). 2019;37(6):398-404.
Dupin N. Syphilis. Rev Med Interne. 2016;37(11):735-742.
Rac MW, Revell PA, Eppes CS. Syphilis during pregnancy: a preventable threat to maternal-fetal health. Am J Obstet Gynecol. 2017;216(4):352-363.
Plagens-Rotman K, Przybylska R, Gerke K, Piskorz-Szymendera M, Tomaszewska M, Sadowska-Przytocka A, et al. Syphilis and a pregnant woman: a real danger for the woman and the child. Postepy Dermatol Alergol. 2019;36(1):119-124.
Mattei PL, Beachkofsky TM, Gilson RT, Wisco OJ. Syphilis: a reemerging infection. Am Fam Physician. 2012;86(5):433-440.
Tsai S, Sun MY, Kuller JA, Rhee EHJ, Dotters-Katz S. Syphilis in Pregnancy. Obstet Gynecol Surv. 2019;74(9):557-564.
Su JR, Brooks LC, Davis DW, Torrone EA, Weinstock HS, Kamb ML. Congenital syphilis: trends in mortality and morbidity in the United States, 1999 through 2013. Am J Obstet Gynecol. 2016;214(3):381.e1-381.e3819.
Pedoman Nasional Tatalaksana Infeksi Menular Seksual. Jakarta: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. 2015.
Trivedi S, Taylor M, Kamb ML, Chou D. Evaluating coverage of maternal syphilis screening and treatment within antenatal care to guide service improvements for prevention of congenital syphilis in Countdown 2030 Countries. J Glob Health. 2020;10(1):010504.
Brown DL, Frank JE. Diagnosis and management of syphilis. Am Fam Physician. 2003;68(2):283-290.
Nathan L, Bohman VR, Sanchez PJ, Leos NK, Twickler DM, Wendel GD Jr. In utero infection with Treponema pallidum in early pregnancy. Prenat Diagn. 1997;17(2):119-123.
Rac MW, Bryant SN, McIntire DD, Cantey JB, Twickler DM, Wendel GD Jr, et al. Progression of ultrasound findings of fetal syphilis after maternal treatment. Am J Obstet Gynecol. 2014 Oct;211(4):426.e1-6.
Hawkes SJ, Gomez GB, Broutet N. Early antenatal care: does it make a difference to outcomes of pregnancy associated with syphilis? A systematic review and meta-analysis. PLoS One. 2013;8(2):e56713.
Jamal S, Agarwal S. IUFD incidence, causes and complications: a retrospective study done at a tertiary care centre in greater Noida, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;6(12):5483-5487.
Krüger C, Malleyeck I. Congenital syphilis: still a serious, under-diagnosed threat for children in resource-poor countries. World J Pediatr. 2010;6(2):125-131.
Ostrander B, Bale JF. Congenital and perinatal infections. Handb Clin Neurol. 2019;162:133-153.

[1] Arando Lasagabaster M, Otero Guerra L. Syphilis. Sífilis. Enferm Infecc Microbiol Clin (Engl Ed). 2019;37(6):398-404.

[2] Dupin N. Syphilis. Rev Med Interne. 2016;37(11):735-742.

[3] Rac MW, Revell PA, Eppes CS. Syphilis during pregnancy: a preventable threat to maternal-fetal health. Am J Obstet Gynecol. 2017;216(4):352-363.

[4] Plagens-Rotman K, Przybylska R, Gerke K, Piskorz-Szymendera M, Tomaszewska M, Sadowska-Przytocka A, et al. Syphilis and a pregnant woman: a real danger for the woman and the child. Postepy Dermatol Alergol. 2019;36(1):119-124.

[5] Mattei PL, Beachkofsky TM, Gilson RT, Wisco OJ. Syphilis: a reemerging infection. Am Fam Physician. 2012;86(5):433-440.

[6] Tsai S, Sun MY, Kuller JA, Rhee EHJ, Dotters-Katz S. Syphilis in Pregnancy. Obstet Gynecol Surv. 2019;74(9):557-564.

[7] Su JR, Brooks LC, Davis DW, Torrone EA, Weinstock HS, Kamb ML. Congenital syphilis: trends in mortality and morbidity in the United States, 1999 through 2013. Am J Obstet Gynecol. 2016;214(3):381.e1-381.e3819.

[8] Pedoman Nasional Tatalaksana Infeksi Menular Seksual. Jakarta: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. 2015.

[9] Trivedi S, Taylor M, Kamb ML, Chou D. Evaluating coverage of maternal syphilis screening and treatment within antenatal care to guide service improvements for prevention of congenital syphilis in Countdown 2030 Countries. J Glob Health. 2020;10(1):010504.

[10] Brown DL, Frank JE. Diagnosis and management of syphilis. Am Fam Physician. 2003;68(2):283-290.

[11] Nathan L, Bohman VR, Sanchez PJ, Leos NK, Twickler DM, Wendel GD Jr. In utero infection with Treponema pallidum in early pregnancy. Prenat Diagn. 1997;17(2):119-123.

[12] Rac MW, Bryant SN, McIntire DD, Cantey JB, Twickler DM, Wendel GD Jr, et al. Progression of ultrasound findings of fetal syphilis after maternal treatment. Am J Obstet Gynecol. 2014 Oct;211(4):426.e1-6.

[13] Hawkes SJ, Gomez GB, Broutet N. Early antenatal care: does it make a difference to outcomes of pregnancy associated with syphilis? A systematic review and meta-analysis. PLoS One. 2013;8(2):e56713.

[14] Jamal S, Agarwal S. IUFD incidence, causes and complications: a retrospective study done at a tertiary care centre in greater Noida, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;6(12):5483-5487.

[15] Krüger C, Malleyeck I. Congenital syphilis: still a serious, under-diagnosed threat for children in resource-poor countries. World J Pediatr. 2010;6(2):125-131.

[16] Ostrander B, Bale JF. Congenital and perinatal infections. Handb Clin Neurol. 2019;162:133-153.

Kematian janin dalam kandungan pada ibu hamil dengan infeksi sifilis laten: laporan kasus

Abstract

References

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