Examinando por Autor "Neira Varillas, Milagros Rocío"

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Syphilis during pregnancy causing neonatal death at María Auxiliadora Hospital.
(Universidad Privada Norbert Wiener, 2017-12-07) Neira Varillas, Milagros Rocío; Rodriguez Chávez, Carlos Leonidas
Syphilis is a sexually transmitted disease caused by Treponema pallidum. This disease impacts the health of both the pregnant woman and the newborn, which is why universal screening should be performed. A case of maternal syphilis is presented, which led to neonatal death due to congenital syphilis. The clinical manifestations reported during prenatal care and the operational errors in the healthcare system related to this case are described. This clinical case presents a 29-year-old patient with syphilis during pregnancy that resulted in neonatal death due to severe congenital syphilis. The obstetric history of the case includes two previous children born through vaginal delivery. In the current pregnancy, the patient attended six prenatal check-ups at CMI José Carlos Mariátegui, evaluated by a multidisciplinary team. During the first check-up, syphilis screening was not performed due to a lack of reagents, so the patient underwent private syphilis testing. The quantitative RPR result was reactive at eight dilutions (DILS), which led to referral to the Hospital María Auxiliadora for specialized evaluation, management, and confirmation of the privately obtained result. At this tertiary care hospital, an immunochromatographic (rapid) syphilis test was conducted, which returned a non-reactive result, and no treatment was prescribed. In the ninth week of pregnancy, the patient developed a rash on her abdomen without pruritus, accompanied by a sensation of mild fever, which was diagnosed as dermatitis. Subsequent prenatal check-ups were within normal limits, and at 32 weeks of gestation, a second maternal profile was performed, in which the quantitative RPR result was reactive at 16 DILS. Three days after starting parenteral penicillin treatment, the patient returned to the emergency room with signs of preterm labor and acute fetal distress, and was immediately transferred to a tertiary care hospital where the pregnancy was concluded via emergency cesarean section.