Syphilis during pregnancy

Pregnancy can be a very fun and exciting time for mothers-to-be and families, but with that excitement comes many sources of stress, such as your own health. It is important to tell your doctor about any pre-existing health conditions or illnesses. Syphilis during pregnancy is serious, but the good news is that there are things you can do to reduce or avoid any problems for your growing baby.

Can syphilis harm my developing baby?

Syphilis is a contagious infection caused by the bacterium Treponema pallidum, which is transmitted primarily through sexual contact. However, if you are a pregnant woman with syphilis, congenital syphilis is also possible (if the baby becomes infected). Congenital syphilis occurs as a result of transplacental transmission of bacteria to the child (bacteria can cross the placenta).

Transmission is possible at any stage of pregnancy and can lead to fetal death or multiple organ problems. It can also affect the ears, eyes, liver, bone marrow, skin, bones, and heart of the fetus. Syphilis also increases the risk of stillbirth. If the fetus survives to birth, risks include preterm birth, low birth weight, congenital syphilis infection, or neonatal death.

However, if you have syphilis or think you have it, there are some precautions you can take during pregnancy to reduce the risk of passing it on to your developing baby.

How to get tested for syphilis during pregnancy?

If you suspect that you may have syphilis during pregnancy, it is extremely important to get tested. Depending on the results, you and your doctor may be able to take the necessary precautions for your prenatal health.

What are the symptoms of syphilis?

Syphilis infection has four different stages, each with different symptoms. The first symptoms will appear between 10 and 90 days after the initial infection (average 21 days).

Some signs of syphilis include:

Primary syphilis: development of one or more papules that progress to a clear, painless sore (similar to a painful chancre) usually located on the genitals. An ulcer often heals four to six weeks after it appears.
Secondary syphilis: two to ten weeks after the wound has healed (or sometimes during the healing process), a rash may appear that can cover the entire body (red or brownish rough patches); sores in the mouth, vagina, or anus; grayish or white warty growths; heat; swollen lymph nodes; Headache; weight loss; and/or sore throat and other flu-like symptoms such as fatigue.
Latent syphilis: 1-2 months after the onset of secondary syphilis, symptoms may disappear for several years.
Advanced or tertiary syphilis: You may have neurological and cardiovascular problems, as well as problems with other organs. The symptoms depend on the affected organ.
Neurosyphilis and ocular syphilis: These can become a problem at any stage of a syphilis infection if the bacteria enters the nervous system or the eyes, respectively. Possible symptoms of neurosyphilis include headaches, movement or coordination problems, behavioral changes, paralysis, dementia, and/or sensory disturbances. Possible symptoms of eye syphilis include changes in vision, visual field loss and/or blindness.

Antibiotics are used to treat syphilis during pregnancy

The good news is that syphilis is easily treated with antibiotics (penicillin G is the only approved treatment). The treatment will rid your body of the infection, but cannot repair the organ/tissue damage that has already occurred. However, it is important to act as early as possible if you even remotely suspect that you may have contracted syphilis before or during pregnancy.

If syphilis is not treated during pregnancy, what are the risks?

The rate of fetal infection during pregnancy in the case of untreated syphilis approaches 100%, resulting in 40% fetal mortality in infected children. According to the World Health Organization, the rate of adverse pregnancy outcomes in women with syphilis is 52% higher than in women without syphilis.

In surviving but infected children, early signs of syphilis may occur in the first 2 years, and late signs in the first 2 decades of life. If detected early, syphilis is easily treated with the right antibiotics, and you can continue to have a safe and happy pregnancy as long as you continue treatment and receive regular care.

How can syphilis affect or change my prenatal care?

If you have confirmed syphilis and are treated regularly, this may reduce the chance of your child developing congenital syphilis. But you'll also want to take other precautions to keep yourself and your baby healthy.

Make sure your doctor knows you have syphilis.
Get early prenatal care.
Get regular check-ups and ultrasounds. It is required by law at the start of antenatal care in all states, as it is considered absolutely necessary to detect syphilis in infants. This is very important for the safety of your child. If a baby has syphilis from a mother, early detection and treatment are key to reducing the risk of stillbirth and the long-term consequences of syphilis.
Continue your regular testing regimen unless your doctor recommends a different treatment. Conventional treatment for syphilis before pregnancy is also considered effective and safe during pregnancy.
With proper maternal treatment and good prenatal care, your baby's chances of contracting syphilis are extremely low. However, mothers infected with syphilis are strongly advised to test their babies regularly until the test is unambiguously negative.