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[The Importance of Leprosy in Gynaecology and Midwifery.]

Abstract

After a comprehensive review of the literature on the gynaecological aspects of leprosy, the authors describe 50 female patients from the leprosarium of the Dermatological Clinic of the University of Sarajevo. The question of pre-natal infection by leprosy bacilli is of special importance. Among these 50 patients the majority (33) were classified as lepromatous, 3 as of the tuberculoid type and 14 were considered to be indeterminate. The youngest was 8 years old and the eldest 36; 6 were under the age of 12. Half of the patients were mature, between 20 and 30. All 3 tuberculoid patients gave a positive lepromin reaction. 43 patients (86%) were sterile. Pregnancy and childbirth were, surprisingly, uncomplicated. About 20% were amenorrhoeic but only in 1 patient could this be attributed to leprosy. The group with irregular oligo-menorrhoea was the largest, with 27 patients (54%), and these were all prepuberal lepra infections and were apparently all sterile.
The authors put forward the opinion that the fetus can be infected with leprosy during pregnancy and during the course of delivery.
Although no details of treatment are given, on the whole the authors are satisfied with DDS and Conteben [thiosemicarbazone] which was well tolerated by pregnant women. The preparation SU 1906-Ciba was very satisfactory, and no lepra reactions were observed. Local treatment with Etisul ointment appeared to shorten the treatment. The use of streptomycin and dihydrostreptomycin is not recommended. The authors are in favour of inoculating the newborn infants of leprotic parents with BCG vaccine.
This paper ends with a series of postulates based upon this experience: (1) they advocate sterilization during institutional treatment; (2) the pregnancy should be terminated in the first 3 months (in mid-pregnancy this should be undertaken only if there is any activation of the leprosy; during the last 3 months the antileprotic therapy should be stepped up); (3) after delivery intensive bacteriological investigations become necessary and various methods of disinfection should be undertaken; (4) the newborn child should be separated immediately from the mother and the placenta and cord should be examined for leprosy bacilli. Philip Manson-Bahr.

 

 

 

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Type
Journal Article
Author
FLEGER J
BERIC B
PRICA S

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