The Jarisch‐Herxheimer reaction and fetal monitoring changes in pregnant women treated for syphilis
Abstract
Objective To estimate the incidence of the Jarisch-Herxheimer reaction in pregnant women undergoing treatment of syphilis and the incidence of changes in uterine activity or fetal heart rate (FHR). Methods Pregnant women of at least 24 weeks' gestation diagnosed as needing treatment of syphilis were reviewed retrospectively. Patients were admitted for their first dose of benzathine penicillin, and the FHR was recorded continuously before and for 24 hours after injection. The occurrence of the Jarisch-Herxheimer reaction was noted, and all available FHR records for this admission were reviewed. Evaluations for changes in the FHR pattern and uterine activity were made. Statistical comparisons used Student t, Fischer exact, and chi2 tests, when applicable (significance P Results We reviewed 50 charts and 31 available FHR records. The average gestational age was 30.8 weeks. We found 20 cases of probable Jarisch-Herxheimer reaction (40%). Thirteen of 31 patients (41.9%) developed regular uterine contractions, median onset, 10 hours. All resolved within 24 hours of treatment. Patients with uterine contractions had a greater mean increase in temperature (1.15F versus 0.68F, P Conclusion The incidence of Jarisch-Herxheimer reaction in treated syphilitic pregnancies is about 40%; similar proportions of patients develop regular uterine contractions and recurrent variable decelerations.
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The Jarisch-Herxheimer reaction can be associated with threatening preterm labor in pregnant person above 24 weeks of gestational age.
“This reaction can be associated with threatening preterm labor in pregnant person above 24 weeks of gestational age. 43”
From Syphilis in pregnancy: A practical guide for prenatal care providers (2025) · cites this paper as [43]
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- Authors
- Myles, T.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Myles, T
- Venue
- Obstetrics & Gynecology
- Published
- 1998-11
- Volume
- 92
- Issue
- 5
- Pages
- 859-864
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W2094578618
- Cited by
- 58
- References
- 10
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 4 · 2012: 3
- FWCI
- 0.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Historical Medical Research and Treatments
- Keywords
- Jarisch-Herxheimer reaction, maternal syphilis, fetal heart rate, uterine contraction, benzathine penicillin, gestational age, fever, fetal monitoring
- MeSH terms
- Adult, Female, Fetal Monitoring, Fever, Heart Rate, Fetal, Humans, Penicillin G Benzathine, Penicillins, Pregnancy, Pregnancy Complications, Infectious, Retrospective Studies, Statistics as Topic, Syphilis, Uterine Contraction
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