Title Primaljska skrb novorođenčeta s infekcijom Treponema pallidum Title (english) Midwifery care of a newborn with Treponema pallidum infection Author Ana Karaman Mentor Svjetlana Karabuva (mentor)Committee member Anet Papazovska Cherepnalkovski (predsjednik povjerenstva)Committee member Vanja Kaliterna (član povjerenstva)Committee member Svjetlana Karabuva (član povjerenstva)Granter University of Split Defense date and country 2021-07-22, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Sažetak: Uvod. Sifilis je zarazna bolest uzrokovana spiralnom bakterijom zvanom Treponema pallidum.
Infekcija se najčešće prenosi spolnim putem, no može se prenijeti i transplacentarno.
Cilj. Cilj ovog rada je opisati mikrobiološka obilježja uzročnika, kliničku sliku, dijagnostičke postupke i
načine liječenja u odraslih osoba, trudnica, novorođenčadi i odabranih skupina, te istaknuti ulogu primalje
u skrbi za oboljelu trudnicu.
Rasprava. Treponema pallidum je Gram neodređena spiroheta
... More složene antigenske strukture koja se može
vizualizirati mikroskopiranjem u tamnom polju, no klinički gledano najvažniju ulogu u dijagnosticiranju
sifilisa imaju serološki testovi; netreponemski (VDRL, RPR) i treponemski (IFA, TPHA, TPI).Klinička
slika sifilisa dijeli se na tri stadija; primarni, sekundarni i tercijarni. Također, uobičajeno je govoriti i o
ranom i kasnom stadiju sifilisa. Kongenitalni sifilis nastaje transplacentarnim prijenosom, uobičajeno
između 16. i 28. tjedna gestacije. Osim transplacentarno, novorođenče može akvirirati infekciju i u
kontaktu s lezijom u vaginalnom kanalu ili dojenjem. U slučaju transplacentarnog prijenosa infekcije,
mogu nastati različiti neželjeni ishodi trudnoće. Pri porođaju u novorođenčeta se ne moraju uočavati
kliničke manifestacije bolesti.Lijek izbora za liječenje sifilisa je penicilin, a duljina liječenja i način
primanja terapije ovise o stadiju bolesti i specifičnosti bolesnika. Uspješnost liječenja potrebno je pratiti
klinički i serološki.Primaljska skrb očituje se u edukaciji trudnice o simptomima, prijenosu i načinu
zaštite od spolno prenosivih bolesti. U trudnica s potvrđenom dijagnozom sifilisa, primalja sudjeluje u
primjeni liječenja koje je ordinirao liječnik specijalist. Primalja bi trebala uočiti rane znakove
kongenitalnog sifilisa, te pravovremeno prepoznati čimbenike koji doprinose povećanom riziku za lošije
ishode u novorođenčeta.
Zaključak. Kongenitalni sifilis može se prevenirati rutinskim probirom trudnica na sifilis. Sve trudnice
trebale bi prvi prvom pregledu biti podvrgnute istom, a dodatno testiranje trebalo bi obaviti između 28. i
32. tjedna gestacije. U slučaju postojanja dodatnih čimbenika rizika, testiranje bi trebalo ponoviti
neposredno prije ili po porodu. Liječenje kongenitalnog sifilisa uključuje i timski rad specijalista
infektologije, neonatologije, pedijatrije, ginekologije i opstetricije, te sestrinskog i primaljskog osoblja. Less Abstract (english) Summary: Introduction. Sypfilis is an infectious disease caused by spirochetal bacteria named
Treponema pallidum. Infection is usually sexually transsmited, but could be also transplacentary
transmitted.
Aim. The aim of this work is to describe the microbiological features, clinical presentation, diagnostic
tools and available treatment in adults, pregnant women, newborns and other specific groups of patients.
Also, the goal of this work is to point out the role of midwifery care.
... More Discussion. Treponema pallidum is a Gram neutral spirohetal bacteria with complex antigene structure
that can be visualized by microscopy in the dark field. From the clinical aspect, serological tests are the
most important diagnostic tools in confirming the diagnosis. There are non-treponemal (VDRL, RPR) and
treponemal tests (IFA, TPHA, TPI).Cliniacl presentation of syphilis in traditionally divided into three
stages; primary, secondary and tertiary. Also, syphilis is divided into early and late onset. Congenital
syphilis appears after transplacental transmission usually between 16th and 28th gestation week. Besides
transplacentary, newborn may aquire this infection in direct contact with vaginal channel or while
breastfeeding. In casese of transplacentar transmission, various unfavorable pregnancy outcomes may
occur. At birth, newborns may not show the cliniacl manifestations of acute illness. Penicillin is the
medication of choice. The regime and the duration of the therapy are prescribed depending of the stage of
illness and the patient specificity. Effectivness of therapy should be monitored with clinical and serologic
features.Midwifery care is based on the education about symptoms, ways of transmission and protection
against sexually transmitted diseases. In pregnant women with syphilis, midwife participates in treatment
procedures proscribed by the specialists doctors. Midwife should be trained to recognize the early signs of
congenital syphilis, and to promptly notice the factors that contribute to the increased risk for negative
outcomes in newborns.
Conclusion. Congenital syphilis is preventable when routine serological tests are made on time in
pregnant women. All pregnant women should underwent serological testing at the first visit, and
additional testing is recommended to be done between 28th
and 32th gestation week. In case of other risk
factors, re-testing should be made near delivery or at delivery. Complete treatment process of congenital
syphilis is a result of multidisciplinary work of specialities in infectology, neonatology, gynecology and
obstetrics, and nursing and midewifery staff. Less Keywords
Ključne riječi: Treponema pallidum
kongenitalni sifilis
novorođenče
trudnica
primaljska skrb.
Keywords (english)
Key Words: Treponema pallidum
congenital syphilis
newborn
pregnant woman
midwifery care.
Language croatian URN:NBN urn:nbn:hr:176:468529 Study programme Title: Midwifery (university/undergraduate) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2021-07-22 18:35:45
