Intravenous Penicillin for Antenatal Syphilotherapy

• Main Authors: Henry L. Galan (Author), Paul M. Yandell (Author), Alfred B. Knight (Author)
• Format: Book
• Published: Hindawi Limited, 1993-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1064-7449; 1098-0997; 10.1155/S1064744993000031
• Keywords: Gynecology and obstetrics; RG1-991; Infectious and parasitic diseases; RC109-216
• Source: Infectious Diseases in Obstetrics and Gynecology, Vol 1, Iss 1, Pp 7-11 (1993)

A 21 year old woman (G2 P0101) of 24 weeks gestation presented with syphilis of unknown duration. Sonography revealed fetal hydrops and placental thickening. Weekly intramuscular injections of 2.4 million U Bicillin for 3 weeks was initiated as recommended by the Centers for Disease Control. Repeat sonogram 1 week after starting treatment revealed increased ascites and a new pericardial effusion. Due to the worsening fetal condition, therapy was altered and the patient was admitted for IV penicillin. She received a continuous infusion of 18 million U penicillin G daily for 10 days. Serial sonograms showed improvement offetal ascites and pericardial effusion with 10 days of IV therapy, and complete resolution of hydrops was noted within 3 weeks. The fetus was born at term with no stigmata of congenital syphilis on newborn exam, and laboratory tests suggested adequate treatment in utero.