梅毒的妊娠结局与职业防护

Pregnancy outcome and occupational protection in case of syphilis in pregnancy

目的了解梅毒的妊娠结局及医护人员职业暴露的特点,为改善梅毒的妊娠结局及制定职业防护措施提供临床资料。方法回顾性调查妊娠梅毒患者9例,分析妊娠梅毒患者的一般临床资料、妊娠结局及医护人员职业暴露的特点。结果外地流动人口且文化程度低的孕产妇妊娠梅毒8例占88.9%;妊娠梅毒的新生儿预后差,早产3例占33.3%,新生儿窒息6例占66.67%,其中轻度窒息5例、重度窒息1例;新生儿梅毒血清学反应阳性4例;新生儿肝肿大及新生儿皮肤黏膜损害各1例;产后诊断妊娠梅毒的孕产妇造成医护人员职业暴露3例。结论建议卫生部门加强外来孕产妇的宣传教育及产前检查工作,提高孕产妇自我保健意识,使之自觉配合医务人员进行妊娠梅毒筛查与管理,从而减少先天梅毒的发生;加强医护人员职业暴露自我防护意识,避免发生梅毒医源性感染。

OBJECTIVE To understand the pregnancy outcome and the characteristics of medical personnel occupation exposure in case of syphilis in pregnancy so as to supply clinical materials for developing pregnancy outcome and occupational protection measures. METHODS A total of 9 cases of pregnancy complicated with syphilis were retrospectively analyzed, the general clinical materials of pregnancy with syphilis were analyzed, the pregnancy outcome and the characteristics of occupational exposure of the medical personnel were observed. RESULTS Totally 8 cases of pregnancy syphilis came from rural or other areas and with low culture degree, the newborn with poor prognosis, 3 cases for premature labor, 6 cases for neonatal asphyxia, including 5 cases of mild and one case of severe asphyxia, 4 cases for serological positive reactions of newborn syphilis, one case for neonatal hepatomegaly, one case for neonatal skin mucosa damage, 3 cases for the medical personnel occupation exposure caused by postnatal diagnosis of pregnancy syphilis maternal. CONCLUSION It suggested that the health departments should strengthen the work of publicity and education, prenatal examination for population from other areas, improve the self health care knowledge of maternal, so that they can cooperate actively with medical work- ers in the screening and management of pregnancy syphilis, decreasing the probability of congenital syphilis. And medical personnel should improve their knowledge of protection from occupation exposure so as to avoid the occur- rence of iatrogenic infection of syphilis.