Sífilis e gestação: estudo comparativo de dois períodos (2006 e 2011) em população de puérperas

Abstract

Introduction: In 2005, syphilis in pregnant women was included in the list of diseases of compulsory notification, in an attempt to control the vertical transmission. Objectives: to compare two different periods in order to identify congenital syphilis (CS) as a prenatal assistance factor characterizing populations of puerperas in 2006 and 2011, regarding the socio-demographic data; to check the frequency of syphilis, other sexually transmitted diseases (STD) and prenatal infections in the populations evaluated as well as the syphilitic infection-related characteristics. Materials and methods: this is a retrospective and prospective comparative cross-sectional observational study of CS cases during two periods, in four maternity hospitals in Campo Grande MS. The diagnosis was based on the criteria proposed by the Ministry of Health. The examinations conducted during the prenatal period or at the moment of hospitalization were checked. Results: The prevalence of CS observed was 2,3% (12/512) in 2006 and 0,58% (3/512) in 2011. In 2006, 75% (9/512) of the pregnant women with a positive diagnosis reported prenatal care, whereas the entire group of pregnant women (3/512) was assisted in 2011. In 2006, 20% (3/512) and in 2011, 13% (2/512) of the infected pregnant women were given adequate treatment. In 2006, 33% (5/512) and in 2011, 7% (1/512) of the partners were treated. In 2006, 33% (5/512) and in 2011, 13% (2/512) of the children were monitored. Neither group presented concomitant contamination of syphilis with other STD, but there was an increase in the incidence of other infectious diseases during the prenatal period in 2011, especially toxoplasmosis, rubella and Cytomegalovirus. Conclusion: the data found in the study reaffirm that congenital syphilis rates should be used as a reference for the quality of perinatal care, since it can be a completely preventable disease when adequately assisted. In both periods, socio-demographic data showed lack of knowledge about the importance of syphilis prevention, in addition to the attention and care that should occur when filling in the pregnant card, as the information can help improve prenatal care. There was a significant increase in the identification of other infectious diseases during prenatal care in 2011, when compared to 2006. Chlamydial infection was high in both periods assessed. Even though the syphilis infection rate was smaller in the second period, there was no significant improvement in prenatal care, considering that the index recommended by the Ministry of Health (one case per 1000 live births) was not achieved. In neither period was there an adequate treatment of the patients or their partners; nor were the children monitored, although the disease was identified before the birth in 33% (5/512) of the cases in 2006 and 13% (2/512) in the second period.