Abnormal Development - Syphilis

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Notice - Mark Hill
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Introduction

The spirochete bacteria treponema pallidum, the cause of syphillis.

The variety of bacterial infections that can occur during pregnancy is as variable as the potential developmental effects, from virtually insignificant to major developmental, abortive or fatal in outcome. Some bacteria are common and are part of the normal genital tract flora (Lactobacillus sp), while other bacterial infections are less common or even rare and initially infect/transmit by air or fluids through the different epithelia (genital tract, lungs, gastrointestinal tract).

Environmental Links: Introduction | low folic acid | iodine deficiency | Nutrition | Drugs | Australian Drug Categories | USA Drug Categories | thalidomide | herbal drugs | Illegal Drugs | smoking | Fetal Alcohol Syndrome | TORCH | viral infection | bacterial infection | fungal infection | zoonotic infection | toxoplasmosis | Malaria | maternal diabetes | maternal hypertension | maternal hyperthermia | Maternal Inflammation | Maternal Obesity | hypoxia | biological toxins | chemicals | heavy metals | air pollution | radiation | Prenatal Diagnosis | Neonatal Diagnosis | International Classification of Diseases | Fetal Origins Hypothesis

Some Recent Findings

  • Antibiotics during pregnancy[1] "Macrolides or clindamycin during the second trimester of pregnancy to women at risk of preterm births can lower the risk, a new systematic review and meta-analysis by Canadian researchers indicates. But the study also found that giving metronidazole alone in the second trimester is linked with a greater risk of preterm birth in the high risk population. The study's authors, from the University of Montreal and Laval University, Quebec, say that delivery before 37 weeks' gestation complicates between 7% and 11% of all pregnancies, is the leading cause of perinatal morbidity and mortality, and is responsible for high healthcare costs"
  • Optimal timing of ampicillin administration to pregnant women for establishing bactericidal levels in the prophylaxis of Group B Streptococcus [2] "Bactericidal levels of ampicillin in the cord blood are rapidly achieved within 30 minutes of administration of ampicillin to the mother. The increase in the ratio of cord to maternal serum ampicillin levels is directly related to time, suggesting a decrease in the clearance of ampicillin in the newborns as compared to the mothers. The cord blood ampicillin concentration exceeds the maternal concentration and both continue to be above the minimal bactericidal concentrations at 5.6 hours after administration."


Syphilis

Treponema-pallidum.jpg
Treponema pallidum (scanning EM, Image CDC)
The bacterium Treponema pallidum causes syphilis which is a sexually transmitted disease (STD). Infection can lead to congenital infection with abortion, prematurity, neonatal death or multiple system abnormalities. (More? [syphilis.htm Abnormal Development - Syphilis])

Links: CDC (USA) Fact Sheet - Syphilis | CDC (USA) Fact Sheet - STD and Pregnancy NCBI Bookshelf Medical Microbiology - Syphilis Search |

Gram Stain

Bacterial staining procedure named after Hans Christian Gram (1853 - 1938). Generally divides bacteria into either:

Gram-positive bacteria purple crystal violet stain is trapped by layer of peptidoglycan (forms outer layer of the cell).

Gram-negative bacteria outer membrane prevents stain from reaching peptidoglycan layer in the periplasm, outer membrane then permeabilized and pink safranin counterstain is trapped by peptidoglycan layer.


Lactobacillus (gram-positive rods among squamous epithelial cells and neutrophils in vaginal smear, Image CDC)

Links: Medical Microbiology | American Society for Microbiology

Australian NHMRC Recommendations

The Australian NHMRC (1988) recommends neonates be assessed for follow-up care under the following conditions.

(see the NHMRC WWW Page)
  • Birthweight less than 1500g or gestational age less than 32 weeks
  • Small-for-gestational-age neonates
  • Perinatal asphyxia
  • Apgar score less than 3 at 5 minutes
  • clinical evidence of neurological dysfunction
  • delay in onset of spontaneous respiration for more than 5 minutes and requiring mechanical ventilation
  • Clinical evidence of central nervous system abnormalities ie., seizures, hypotonia
  • Hyperbilirubinaemia of greater than 350umol/l in full term neonates
  • Genetic, dysmorphic or metabolic disorders or a family history of serious genetic disorder
  • Perinatal or serious neonatal infection including children of mothers who are HIV positive
  • Psychosocial problems eg., infants of drug-addicted or alcoholic mothers.

References

  1. <pubmed>19250368</pubmed>| Journal of Obstetrics and Gynaecology of Canada 2007;29:35-44)." (text from BMJ 2007;334(7587):224
  2. <pubmed>16458647</pubmed>

Reviews

<pubmed>16374219</pubmed> <pubmed>15784499</pubmed> <pubmed>15861401</pubmed> <pubmed>10816189</pubmed> <pubmed>6293753</pubmed>

Articles

<pubmed>16458647</pubmed> <pubmed>10456962</pubmed>

Search Pubmed

Search PubMed: Abnormal Embryology Syphillis | Abnormal Development Syphillis

External Links

External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation.

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Cite this page: Hill, M.A. (2020, October 27) Embryology Abnormal Development - Syphilis. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Syphilis

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© Dr Mark Hill 2020, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G