Syphilis in Pregnancy

Abstract

Syphilis is a sexually transmitted bacterial disease relevant to pregnancy because it has the potential to cause congenital syphilis if it occurs at any time during pregnancy. An upsurge in cases of syphilis in women and hence congenital syphilis has been reported worldwide recently. 40% of cases can result in spontaneous miscarriages, stillbirth, non-immune hydrops, fetal growth restriction and perinatal death, as well as serious sequelae in liveborn infected children. Pregnancy complications can be avoided by early detection and treatment in the antenatal period. All antenatal women should be screened for syphilis at the first antenatal visit. There is no gold standard for diagnostic test of syphilis. A combination of serological tests consisting of treponemal and a non treponemal test are used for diagnosis. Screening with non-treponemal tests such as rapid plasma reagin or venereal disease research laboratory test combined with confirmation of reactive individuals with treponemal tests such as the fluorescent treponemal antibody absorption assay is the usual cost effective approach. Those at risk should be retested in the third trimester. Treatment during pregnancy should be with penicillin depending upon the stage of the maternal infection. All neonates born to mothers who have reactive nontreponemal and treponemal test results should be evaluated.