Nursing assistance in Congenital Syphilis: A bibliographic review Asistencia de Enfermería en Sífilis Congénita: Una revisión bibliográfica

— Syphilis is a sexually transmitted infection caused by Treponema pallidum tracked by the VDRL non-treponema test and should be treated as early as possible. The objective of the research is to analyze the role of nurses in assisting patients with congenital syphilis. The methodology is a narrative review study with an exploratory, observational, retrospective study approached in 15 articles in the databases (PUBMED, LILACS, BVS, SciELO, REBEN) between 2010 and 2020. Results: Since pregnant and infected women if their sexual partners are diagnosed during prenatal care and treated in time, congenital syphilis can be prevented. About two-thirds of children living with congenital syphilis are asymptomatic. The diagnosis of these diseases is relatively easy and of low cost, therefore, it should


I. INTRODUCTION
In Brazil, the number of reported cases of syphilis in pregnancy is increasing every year. Worldwide, syphilis still affects many pregnant women (DOMINGUES & LEAL, 2016).
Syphilis is a systemic and sexually transmitted infection caused by infection by the Gram-negative bacteria Treponema pallidum. Despite the existence of effective and low-cost treatments, it is still a serious public health problem in Brazil. Considering that it is an easy pathology to treat and that other more complex infectious diseases have been controlled (CARVALHO & BRITO, 2014).
The congenital form of syphilis (or congenital syphilis, SC) occurs when Treponema pallidum is transmitted by the placenta (or vertically). According to reports, the transmission of CS occurs from an infected mother (untreated or undertreated), and transmission can occur at any stage of pregnancy or during childbirth (CAMPOS et al., 2012).
Estimates of the number of cases of congenital syphilis are even more inaccurate. In the absence of treatment, the rate of vertical transmission of syphilis is high, reaching a value close to 100% in the most recent form of the disease. However, timely diagnosis and treatment are very effective and vertical transmission can be reduced in up to 97%  The legitimacy and relevance of the research, in addition to emphasizing the purpose of comprehensive evidence, which can assist nurses in making decisions about the effective implementation of the tool, promoting the adherence of health professionals and integrating it into practice. This study justifies the dysfunction, which leads to the lack of preventive habits to prevent infectious diseases, highlights the importance of guiding syphilis problems in adolescents, young people and pregnant women and warns that it is a sexually transmitted infection (STI) related to sexually transmitted diseases communicable diseases. And that when diagnosed, your treatment should be as early as possible.
The objective of the research is to analyze the role of nurses in assisting patients with congenital syphilis.

II. MATERIALS AND METHODS
The present work is a narrative review of the literature carried out through a bibliographic review focused on describing the role of nurses in assisting patients with congenital syphilis.
The bibliographic research had the following question: What is the role of nurses in assisting patients with congenital syphilis? Articles that sought to explain the role of the nurse in assisting the patient with congenital syphilis from scientific articles in Portuguese, English and Spanish were selected. The translator available on the website https: // was used to translate the articles into another language. translate.google.com/.
The organization of this review took place between the months of June and December 2020, thus providing guidance for researchers in relation to the subject addressed, so that they can formulate hypotheses in an attempt to solve frequent problems related to the assistance provided in previous studies.
For data collection, the bases (PUBMED, LILACS, BVS, SciELO, REBEN) were used, searching for keywords such as: Women's Health; Syphilis; Nursing care. 15 scientific articles containing publications between the years 2010 and 2020 were analyzed, which dealt with the chosen theme.

III. RESULTS AND DISCUSSION
The nurse is one of the most important primary care professionals. Your participation is not only essential for disease prevention, but also for the comfort provided to children and their families during treatment -this can be a factor in determining clinical outcomes. Nursing starts even before delivery, when the nurse must guide the pregnant woman about the characteristics of this phase to ensure safety and tranquility during pregnancy. Topics covered include methods to prevent sexually transmitted infections (SECAD, 2019).
As long as infected pregnant women and their sexual partners are diagnosed during prenatal care and treated in time, congenital syphilis can be prevented. It is worth mentioning that despite the increase in prenatal coverage, the effectiveness of the operation is still low and the average number of cases in the period proves Prenatal care is the responsibility of the nurse at the basic health unit, and when pregnant women test positive for syphilis, it is up to them to start treatment with benzathine penicillin as soon as possible as recommended by the Ministry of Health. Sexual partners should also be tested and treated to prevent pregnant women from being infected again. Adequate treatment is for pregnant women, The nurse must pay attention to treatment with any medication other than penicillin; incomplete treatment; less time than recommended; error due to insufficient clinical stage of the disease; performed within 30 days before birth; without previous treatment documents; after the correct treatment, the titer does not decrease; untreated partner, inappropriate treatment or no information (BRASIL, 2016).
All confirmed or suspected NB infections must be treated and monitored properly. Crystalline penicillin is the drug of choice and 50,000 IU / kg / dose should be taken, 12/12 in the 1st week; and 8 / 8h, after 7 days. If normal cerebrospinal fluid is checked, procaine penicillin can be used 50,000 IU / kg / dose, single daily dose, 10 days. As this medication has a low permeability to cerebrospinal fluid, benzathine penicillin is used in cases where the infection is unlikely at a dose of 50,000UI / kg / day, single dose (FEITOSA, ROCHA & COSTA, 2016; EBSERH, 2019).
If treatment is interrupted for more than 24 hours, treatment must be restarted. After starting penicillin treatment, standard exposure precautions for up to 24 hours should be developed for all cases of congenital syphilis. It is up to the nurse to carry out the monitoring of every newborn with a mother with syphilis must be followed for at least two years. The non-treponeme test (VDRL) should be performed at 1, 3, 6, 12 and 18 months of age until two consecutive negative results occur at least 30 days apart (FEITOSA, ROCHA & COSTA, 2016; SBP, 2016).
The role of nurses in the development of strategies for the prevention of congenital syphilis is extremely important, including guidance on condom use, reduction in the number of sexual partners, nursing consultations with help and guidance, early diagnosis, treatment of patients and search for preventive measures to reduce the rates. Drug users and other preventive measures to improve quality of life. Pregnant and congenital women with syphilis must be notified for epidemiological surveillance, and the form must be completed and sent to the epidemiological surveillance service. This warning is very important to control the case (RAMPAZIO, SOUZA & CARVALHO, 2019).

IV. CONCLUSION
The nurse is and always will be a professional with prominence in the attendance of basic health units, because the role that is delegated to him and of extreme importance in the care and prevention of patients. It is up to the health secretaries to delegate training to nurses working in the consultation and treatment of congenital syphilis.
Carry out, in partnership with the local population, orientation campaigns regarding the disease, and seek to resolve all doubts and curiosity, providing guidance on the use of condoms and seeking care in case of presenting any symptoms.
The nurse must pay more attention to the role of screening during prenatal care, carry out the treatment in a qualified and correct way both from the partner to avoid recontamination and from the pregnant woman to avoid aggravating the case.