pediatrics
Congenital Syphilis
Prevention of Congenital Syphilis
Pregnant women should be routinely tested for syphilis in the 1st trimester and, if they live in a community with high rates of syphilis or have any risk factors for syphilis, retested in the 3rd trimester and at delivery. In the US, most states require 1st trimester screening, and many require the later testing as well ( Prevention reference ). In 99% of cases, adequate treatment during pregnancy cures both mother and fetus. However, in some cases, syphilis treatment late in pregnancy eliminates the infection but not some signs of syphilis that appear at birth. Treatment of the mother < 4 weeks before delivery may not eradicate fetal infection. When congenital syphilis is diagnosed, other family members should be examined for physical and serologic evidence of infection. Retreatment of the mother in subsequent pregnancies is necessary only if serologic titers suggest relapse or reinfection. Women who remain seropositive after adequate treatment may have been reinfected and should be reevaluated. A mother without lesions who is seronegative but who has had venereal exposure to a person known to have syphilis should be treated, because there is a 25 to 50% chance that she acquired syphilis. 1.Centers for Disease Control and Prevention (CDC): Sexually Transmitted Diseases: State Statutory and Regulatory Language Regarding Prenatal Syphilis Screenings in the United States. 