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Cited by 5Syphilis Diagnosis and TreatmentNeonatal and Maternal InfectionsHistorical Medical Research and Treatments

Sífilis congénita con hídrops fetal: reporte de cuatro casos en un hospital general de referencia en Bogotá, Colombia entre 2016- 2020

Open access
Camacho-Montaño, Andrés Mauricio, Niño-Alba, Reinaldo, Páez-Castellanos, Edgar·2021·Revista Colombiana de Obstetricia y Ginecología
DOI 10.18597/rcog.3591PMC PMC8425360
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Abstract

Objetivo: realizar un reporte de 4 casos de hídrops fetal secundario a sífilis congénita y hacer una revisión de la literatura para responder la siguiente pregunta: ¿cuál es el esquema antibiótico utilizado en los casos de sífilis gestacional complicada con hídrops fetal? Materiales y métodos: se presentan 4 casos de sífilis congénita con hídrops fetal. La edad materna varió entre 17 y 28 años, la edad gestacional al momento del diagnóstico estuvo entre 25 y 30 semanas, dos de ellas no habían iniciado control prenatal en ese momento. En tres casos se dio tratamiento para sífilis gestacional inmediatamente con penicilina cristalina entre 6 y 12 semanas antes del parto y se formuló tratamiento a la pareja con penicilina benzatínica. Respecto a los recién nacidos, dos de ellos no tenían infección activa o secuelas, se consideró que uno de ellos tenía sífilis congénita por títulos de prueba no treponémica. En uno de los casos, la paciente no alcanza a recibir tratamiento para la sífilis gestacional antes del parto, este recién nacido tenía signos de infección activa. Se hizo una revisión de la literatura en las bases de datos Medline, LILACS y google scholar; los términos de búsqueda fueron los siguientes: “hídrops fetal”, “lues”, “syphilis – prenatal diagnosis- ultrasound - penicilina – treatment”. Se buscaron reportes y series de casos o cohortes de recién nacidos con sífilis gestacional con hídrops fetalis. Se extrajo información sobre la madre y el recién nacido respecto al tratamiento. Resultados: se identificaron 119 artículos, de estos 13 cumplieron con los criterios de inclusión, tres fueron descartados por no tener acceso al texto completo. Se incluyeron diez estudios de un total de 16 casos reportados con diagnóstico prenatal de hídrops fetal secundarios a infección congénita. De ellos, tres presentaron anemia fetal severa y requirieron transfusión intrauterina; 5 casos recibieron tratamiento intrauterino con penicilina. En cuatro casos la madre recibió penicilina benzatínica intramuscular por 3 semanas, uno recibió además penicilina cristalina endovenosa por 13 días, otro recibió penicilina cristalina endovenosa por 14 días. Un total de 11 casos no recibieron tratamiento durante la gestación; 6 de los 16 casos (37,5%) presentaron muerte perinatal. Conclusión: el retraso en acudir al control prenatal y la tardanza del diagnóstico y tratamiento de la sífilis gestacional son causas importantes de la persistencia de la sífilis congénita. Se requieren estudios aleatorizados para determinar el mejor tratamiento del feto con sífilis congénita en los 30 días previos al parto y del feto con compromiso sistémico durante la segunda mitad de la gestación.

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Cites

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  • In one case series, 43 neonates with confirmed congenital syphilis were reported; among them, 32 mothers (74%) had received benzathine penicillin G during the third trimester, and 28 were treated less than 30 days before delivery.

    “In one study 37, 43 neonates with confirmed congenital syphilis were reported. Among them, 32 mothers (74%) had received benzathine penicillin G during the third trimester; 28 were treated less than 30 days before delivery.”

    From Efectividad del tratamiento de la sífilis gestacional en el último trimestre sobre la incidencia de sífilis congénita: revisión sistemática y metanálisis (2025) · cites this paper as [37]

    The Reporte de casos section describes four cases, not 43 neonates. The Resultados > Tratamiento section reports prenatal penicillin treatment in five cases in its literature review, rather than benzathine penicillin G treatment in 32 mothers; it does not report 28 mothers treated less than 30 days before delivery. Page numbers are unavailable in our copy. (LLM, conf=0.90)

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  • In that case series, 68% (19/28) of mothers treated less than 30 days before delivery delivered within 10 days of treatment, and 50% of deliveries were preterm.

    “Of these, 68% (19/28) delivered within 10 days of treatment, and 50% of deliveries were preterm.”

    From Efectividad del tratamiento de la sífilis gestacional en el último trimestre sobre la incidencia de sífilis congénita: revisión sistemática y metanálisis (2025) · cites this paper as [37]

    The Reporte de casos table (page unavailable) lists four deliveries, two at 37 weeks and two before 37 weeks, supporting the 50% preterm figure for this case series. The paper does not report 28 treated mothers or that 19 delivered within 10 days of treatment; its Results > Tratamiento section instead describes five prenatally treated cases in the literature it reviewed. (LLM, conf=0.87)

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  • The case series scored 6/10, 7/10, and 9/10 on the Joanna Briggs Institute checklist.

    “The case series scored 6/10 (37), 7/10 (36), and 9/10 (38) on the Joanna Briggs Institute checklist”

    From Efectividad del tratamiento de la sífilis gestacional en el último trimestre sobre la incidencia de sífilis congénita: revisión sistemática y metanálisis (2025) · cites this paper as [37]

    The Reporte de casos section identifies this paper as a four-case series, but does not give it a Joanna Briggs Institute checklist score. Searches for the checklist and the cited scores found no such appraisal in our copy. Citation (37) is attached to 6/10; the other scores have separate citations. (LLM, conf=0.75)

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Cites

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Research works printed but not linked: 2

  1. [1]WHO Guideline on Syphilis Screening and Treatment for Pregnant Women Geneva World Health Organization 2017 https://www.who.int/medical_devices/diagnostics/selection_in-vitro/selection_in-vitro-meetings/00007_02_WHO_Syphilis_SandT_Pregnant.pdf 29757595
  2. [17]WHO Guidelines for the Treatment of Treponema pallidum (Syphilis) Geneva World Health Organization 2016 27631046

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Related

Authors
Camacho-Montaño, A. M., Niño-Alba, R., & Páez-Castellanos, E.
ORCID
Venue
Revista Colombiana de Obstetricia y Ginecología
Publisher
Federacion Colombiana de Obstetricia y Ginecologia
Published
2021-06-30
Volume
72
Issue
2
Pages
149-161
ISSN
  • 0034-7434 (ISSN-L)
  • 2463-0225
DOI
10.18597/rcog.3591
PMC
PMC8425360
OpenAlex
W3189900852
Cited by
5
References
34
Citations by year
2026: 1 · 2025: 3 · 2024: 1
FWCI
0.16
Type
journal article
Language
es
Open access
Licence
Locations
  • Revista Colombiana de Obstetricia y Ginecología (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Redalyc (Universidad Autónoma del Estado de México) (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Historical Medical Research and Treatments
Keywords
congenital syphilis, hydrops fetalis, maternal syphilis, penicillin therapy, benzathine penicillin, crystalline penicillin, prenatal care, delayed diagnosis, perinatal mortality, fetal anemia, intrauterine transfusion, neonatal syphilis, non-treponemal tests, Bogotá, Colombia, Latin America
MeSH terms
Colombia, Female, Hospitals, Humans, Infant, Infant, Newborn, Penicillin G Benzathine, Pregnancy, Referral and Consultation, Syphilis, Congenital, Hydrops Fetalis

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