Doctor's Blog

Syphilis and Pregnancy
June, 2009

Syphilis is caused by the spirochete Treponema pallidum, and is transmitted from partner to partner sexually. It can also be transmitted vertically from mother to fetus through the placenta or through genital lesion at time of delivery. Fetal syphilis leads to among other things, prematurity, low birth weight, and intrauterine death.

The rate of syphilis among women increased between 2005 and 2006 by 11.1%. Consequently, the rate of congenital syphilis has increased by 3.7% in the same time frame. In the 2009 issue of the Annals of Internal Medicine, the U.S. Preventive Services Task Force recommendation is to screen for syphilis at the first prenatal visit. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologist have similar recommendations.

Screening for syphilis is done through blood tests VDRL or RPR. If this blood test is positive, a more specific test FTA-ABS is used to confirm the diagnosis. Prevalence of the disease is higher in the southern U.S., metropolitan areas, and in Hispanic and African-American populations. High risk groups (including women with previous history of STD, illicit drug, and sex workers) should be screened at first prenatal visit, again at third trimester, and at delivery.

Treatment for syphilis is penicillin. There have been no cases of antibiotic resistance reported. There is limited evidence on the efficacy or safety of other antibiotics in pregnancy. Women with penicillin allergies have to be desensitized. Please see the Center for Disease Control website for more information on treatment
www.cdc.gov

For questions and/or concerns, please contact your primary care provider.

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