dr_hemantkalia
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A 42 yr old woman, G4,P3 at 38 weeks gestation, comes to the labor room with contractions . She had a history of syphilis adequately treated 4 yrs ago. Pt. hypersensitive to penicillin. Her prenatal course was unremarkable, including n screening.BP-140/90, cervix -4cm dilated & 100% effaced. she is admitted . which of the following IV med she is req to be given during labor and delivery to prevent neonatal complication.
1. Hydralazine
2. labetelol
3. penicillin
4. erythromycin
5. none of the above
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| Ouli Maty
Forum Elite
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I don't think she should receive anything given that her syphilis was adequately treated, no abnormally at sreening .and she doesn't have any risk factor for GBS, wich would have warranted to give her Eryt since she is hypersensitive to penicillin.
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deep breathing...
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| dr_hemantkalia
Forum Newbie
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the ans is 5 erythromicin.....well i read that statement"syphilis adequately treated so no need to give prophylaxis"in the explanation of q-30 kaplan q book....but it forced me to check my textbook and it said"irrespective of the serology report.T/t should be repeated in subsequent pregnancies"pg311 Textbook of obs by DUTTA 5th ed......so i thought of sharing this thought.....although in the kaplan q...there is a history of DM-1..so the preferred ans in that q is insulin
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| Ouli Maty
Forum Elite
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Thank you for the info.
If you have to treat Syphilis again why don't you give Penic after desensitization instead of Erythro? I believe that's what Kaplan notes says.
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deep breathing...
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| dpk
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you are right Maty erythro is not going to prevent neonatal complication becoz of poor penetration through placenta...
i think she doesnot requires any meds.
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