Syphilis is one of the most important complications of pregnancy as it is one of the most frequent causes of repeated abortion, or premature labor. The influence of syphilis upon pregnancy differs materially, and three classes of cases are distinguished, according as infection has taken place: 1—before pregnancy; 2—at the time of conception; or, 3—during pregnancy. When inoculation with the specific poison has occurred before conception the disease nearly always gives rise to abortion or premature labor, more frequently the latter. Le Pileur obtained a striking illustration of the disastrous effects of syphilis from a study of the reproductive histories of 130 women, before and after its inception, 3.8 per cent. of the children being born dead before, as compared with 78 per cent. after infection. In premature labor due to syphilis the child is usually dead when it comes into the world; less frequently it is born alive with definite manifestations of the disease. When the mother is suffering from the affection at the time of conception the offspring is always syphilitic. P. 495.
THE PRACTICE OF OBSTETRICS. In Original Contributions by American Authors. Edited by Reuben Peterson, A.B., M.D., Professor of Obstetrics and Gynecology in the University of Michigan, Ann Arbor, Mich.; Obstetrician-in-Chief to the University of Michigan Hospital. Lea Bros. and Co., Philadelphia and New York, 1907.
In marked contrast to the comparatively slight interference of pregnancy with the course of syphilis is the decidedly unfavorable influence of syphilis upon the course of pregnancy. Syphilis, more often than any other infectious disease, is responsible for a great variety of pathological changes in the fetus, placenta and uterus, and for the premature interruption of gestation. Statistics show that the fetal mortality in this disease averages 50%. This figure is lower than that given in the preceding paragraphs for some of the acute infectious diseases, but considering the prevalence of syphilis among all civilized and uncivilized races, it is obvious that the effect of this disease deserves a most careful consideration, not only from the medical, but also from the economic and sociologic point of view. Fournier gives the fetal mortality for cases in which the maternal infection occurs simultaneously with fecundation as 75%, the fetal morbidity being above 91%. Page 347. (Hugo Ehrenfest, M.D.)
A TEXT BOOK OF OBSTETRICS. Barton Cooke Hirst, M.D., Professor of Obstetrics in the University of Pennsylvania; Gynecologist to the Howard and Orthopaedic and Philadelphia Hospitals, etc. W. B. Saunders Co., Philadelphia and London, 1912.
Syphilitis as the most frequent cause of habitual death of the fetus must be excluded before another cause is sought. P. 352.
Of 657 pregnancies in syphilitic women collected by Charpentier 35% ended in abortion, and of the children that went to term a large number were stillborn. Of 100 conceptions in syphilitic women only seven children were alive a year later. P. 333.
PRACTICAL OBSTETRICS. Thomas Watts Eden, Obstetrical Physician and Lecturer on Midwifery and Gynecology, Charing Cross Hospital; Consulting Physician to Queen Charlotte’s Lying-in-Hospital; Surgeon to In-Patient Hospital for Women. 4th Edition. C. V. Mosby Co. 1915.
Of all the systematic causes of abortion however, the most important in all respects is syphilis. In all probability more abortions are due to this disease than to any other cause. P. 220.
It will be clear from this enumeration of the conditions which cause it that abortion is not an uncommon event. From some recent statistics presented by Professor Malins to the Obstetrical Society of London it appears that in this country about 16% of pregnancies terminate by abortion, i.e., one abortion occurs to every five births of viable children, and further, it appears that abortion is nearly twice as frequent among the classes from which hospital patients are drawn as among the well-to-do. Women who are the subjects of syphilis or Bright’s disease often sustain a succession of abortions without carrying any pregnancy to term. P. 221.
THE PRINCIPLES AND PRACTICE OF OBSTETRICS. Jos. B. De Lee, M.D., Professor of Obstetrics at the Northwestern University Medical School; Obstetrician to the Chicago Lying-in-Hospital and Dispensary and to Wesley and Mercy Hospitals, etc. W. B. Saunders Co. 1913.