A syphilis screening survey on HIV-positive and HIV-negative pregnant women, with placental histopathological evaluation of reactive cases, in a hospital in Uyo, Southern Nigeria

Authors : Uchechukwu Brian EZİAGU, Chinedu Onwuka NDUKWE, Ikwo KUDAMNYA, Ntiense Macaulay UTUK, Ajayi Oyedele OYEWUMİ, Eberechukwu Desmond EZİAGU, Inemesit Edet BASSEY

Pages : 1-13

Doi:10.5798/dicletip.1266601

View : 22 | Download : 19

Publication Date : 2023-03-19

Article Type : Research Paper

Abstract :Objectives: Veneral Disease Research Laboratory insert ignore into journalissuearticles values(VDRL); test is an important screening tool for syphilis in pregnancy insert ignore into journalissuearticles values(because of adverse pregnancy outcomes, particularly congenital syphilis {CS}); and can be combined with the placental histopathological examination in the diagnosis of CS. Thus, we aimed to compare VDRL test results from HIV-positive/HIV-negative pregnant women with relevant historical data and perinatal/placental histopathological findings. Methods: A prospective hospital-based cross-sectional survey of VDRL tests for two study groups insert ignore into journalissuearticles values(HIV-positive {tests} and HIV-negative {controls} pregnant women); at ante-natal care insert ignore into journalissuearticles values(ANC);/delivery. A convenient sampling method was used. Relevant insert ignore into journalissuearticles values(maternal/fetal); historical data were extracted from their case notes, and placentas of reactive VDRL cases were histopathologically examined. Results: We surveyed 145 pregnant women insert ignore into journalissuearticles values(49 tests and 96 controls);. The VDRL tests, for both groups, were not strongly associated with maternal age insert ignore into journalissuearticles values(p-value = 0.097);, booking for ANC insert ignore into journalissuearticles values(p-value = 0.770);, gravidity insert ignore into journalissuearticles values(p-value = 0.331);, and HIV/AIDS stage insert ignore into journalissuearticles values(for tests only);. Notably, one subject from the tests had a reactive VDRL test, and she was in HIV/AIDS clinical stage 2, her baby had microcephaly insert ignore into journalissuearticles values(fetal head circumference of 31 cm);, low birth weight insert ignore into journalissuearticles values(of 2.4 kilograms);, and intermediate APGAR score. Histopathological examination of her placenta showed avascular villi, large hypercellular villi, and obliterative vasculopathy with an onion-skinning pattern in the placental disk. Conclusions: The obstetrical, fetal, and placental histopathological features of the reactive VDRL case were consistent with CS and syphilitic placentitis. Hence placental histopathological evaluation can play a critical role in the diagnosis of maternal/congenital syphilis.
Keywords : VDRL test, HIV positive, pregnant women, Syphilis, Placenta, Histopathology