Syphilis treatment journey in pregnancy

Overview

Syphilis is a sexually transmitted infection (STI) caused by bacteria. If you have syphilis while pregnant, you can pass it to your baby during pregnancy or birth. This can cause serious health problems for your baby. The good news is that syphilis is treatable with antibiotics, and early treatment can protect your baby.

Syphilis is less common than some other STIs, but the number of cases has been rising in recent years. In pregnancy, it is important to test for syphilis early so treatment can be given if needed.

Syphilis can affect anyone who is sexually active. Pregnant women with untreated syphilis are at risk of passing the infection to their baby.

Symptoms

Common symptoms

• Painless sores (called chancres) on the genitals, mouth, or rectum
• Rash that may appear on the palms of the hands or soles of the feet
• Flu-like symptoms such as fever, headache, sore throat, and tiredness
• Swollen lymph nodes
• Hair loss in patches
• Weight loss

Symptoms in children

• In a newborn (congenital syphilis): rash, fever, poor feeding, irritability, and failure to gain weight
• Swollen liver and spleen
• Bone deformities or abnormal bone growth
• Late signs: hearing loss, vision problems, and developmental delays

Symptoms in older adults

• The symptoms of syphilis are the same in older adults as in younger adults. However, older adults may be less likely to notice early signs because they may not think they are at risk.

Causes

Main causes

• Syphilis is caused by a bacteria called Treponema pallidum.
• The bacteria enter the body through tiny cuts or mucous membranes during sexual contact with an infected person.
• During pregnancy, the bacteria can cross the placenta and infect the unborn baby.

Risk factors

• Having unprotected sex with multiple partners
• Having a partner who has syphilis or other STIs
• Living in areas where syphilis is more common
• Not getting regular STI testing during pregnancy

When to see a doctor

See a doctor urgently if:

• If you are pregnant and notice any symptoms of syphilis (sores, rash, flu-like signs).
• If you have had unprotected sex with someone who might have syphilis.
• If you have a rash or sores that do not go away.

Book a routine appointment if:

• All pregnant women are offered a syphilis test as part of routine antenatal screening. Make sure you attend all your prenatal appointments.

Diagnosis

Syphilis is diagnosed with a simple blood test. Sometimes a swab is taken from a sore to look for the bacteria under a microscope.

Tests that may be done

• Blood test to look for antibodies to the syphilis bacteria
• If you have a sore, a swab of fluid from the sore can be tested
• If you are diagnosed, your healthcare provider may also test for other STIs

What to expect at your appointment

The test is quick and usually done at your first antenatal appointment or if you have symptoms. You may need a follow-up blood test after treatment to make sure the infection is gone. Your partner may also be advised to get tested and treated.

Treatment

Syphilis in pregnancy is treated with antibiotics. Treatment is very effective at preventing the infection from passing to your baby, especially if started early in pregnancy. You will be given a course of antibiotics, usually as an injection. It is important to complete the full course, even if you feel better. You will be monitored with follow-up blood tests to confirm the infection has cleared.

Self-care at home

• Take all antibiotics exactly as prescribed – do not skip doses.
• Tell your doctor if you have any side effects from the medication.
• Avoid sexual contact until both you and your partner have completed treatment and follow-up tests show the infection is cured.
• Use condoms to reduce the risk of getting syphilis again.

Medical treatments

The main treatment for syphilis is a course of antibiotics given by injection. The type and length of treatment depend on the stage of syphilis and how far along you are in your pregnancy. Your healthcare provider will decide the best treatment plan for you. Treatment is safe for your baby.

When is surgery considered?

Surgery is not used to treat syphilis.

Living with this condition

If you are being treated for syphilis during pregnancy, you will have regular check-ups to monitor your health and your baby's health. You may need follow-up blood tests for up to a year to make sure the infection does not return. Most women go on to have a healthy pregnancy and baby.

Lifestyle tips

• Attend all prenatal appointments and follow-up visits.
• Make sure your partner is also tested and treated to prevent reinfection.
• Avoid alcohol and drugs during pregnancy, as they can affect your baby's health.
• Eat a balanced diet and take prenatal vitamins as recommended.

Diet and exercise

A healthy diet with plenty of fruits, vegetables, whole grains, and lean protein supports your immune system. Gentle exercise, like walking or prenatal yoga, is safe for most pregnant women. Talk to your doctor before starting any new exercise.

Mental health and emotional wellbeing

A diagnosis of syphilis during pregnancy can be distressing. You may feel worried, ashamed, or anxious. These feelings are normal. Remember that syphilis is a treatable infection, and getting treatment is the best thing you can do for your baby. Talk to your healthcare provider, partner, or a counselor about how you feel.

Prevention

Yes, syphilis can be prevented. Using condoms during sex reduces the risk. If you are sexually active, regular STI testing helps catch infections early. During pregnancy, routine screening for syphilis is offered to all women so that treatment can be given if needed.

Vaccines

There is no vaccine for syphilis.

Screening programmes

Routine blood tests for syphilis are part of standard antenatal care. If you are at higher risk, your doctor may recommend additional tests later in pregnancy.

Complications

If left untreated

• Untreated syphilis in pregnancy can cause miscarriage, stillbirth, or premature birth.
• The baby can be born with congenital syphilis, which can cause severe lifelong health problems such as bone deformities, blindness, deafness, and intellectual disability.
• In the mother, untreated syphilis can progress to later stages that damage the heart, brain, and other organs.

Long-term outlook

With early diagnosis and proper treatment, the outlook is excellent. Treatment during pregnancy prevents nearly all harm to the baby. After treatment, you and your baby can have a healthy future. It is important to complete all follow-up care to make sure the infection is completely cured.

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