Syphilis During Pregnancy

What is syphilis?

Syphilis is a serious infection usually passed from one person to another by sexual contact. If it is not treated, syphilis in adults can lead to permanent brain, nerve, and tissue damage.

If you are pregnant and have syphilis, you can pass the infection to your baby before or during birth. The infection can seriously harm the baby.

How does it occur?

The infection is caused by bacteria called Treponema pallidum. The bacteria get into the body through an opening, such as the vagina, mouth, or rectum. They can also enter through a cut or break in the skin or through blood transfusions.

If syphilis happens during pregnancy and it is not treated, the baby has a very high chance of getting infected with the disease. The infection can reach the baby through the placenta.

What are the symptoms?

Symptoms may start 10 days to 3 months after you are infected. Possible symptoms include:

• A smooth, red, painless sore (called a chancre). The first sore is usually found at the site of the initial infection, which is most commonly in or near the vagina or vulva.
• A pink or red, bumpy, scaling skin rash that does not itch and may come and go. The rash may include spots on the palms of your hands and soles of your feet. You can easily infect other people with this rash.
• Brown sores about the size of a penny.
• Swollen lymph glands.
• Flulike symptoms, such as fever, body aches, sore throat, headaches, tiredness, and loss of appetite.
• Hair loss in clumps.
• Gray or pink patches of fatty tissue in damp areas of the body (also highly infectious).
• Flat wartlike growths in the genital or anal area.

After the first stages of the disease, there is often a latent period, when the infection is silent. During the latent period you don’t have any symptoms even though you have not been treated for the disease. This latent period may last for just a few years or for many years.

In more advanced stages, the disease can cause tumors on the skin and bones. It can also affect your brain, blood vessels, heart, and other organs. It can lead to severe heart disease, brain damage, paralysis, and death.

Some babies infected with syphilis are born early (prematurely). Many infected babies have no symptoms at birth and symptoms start weeks or months later. Problems in newborns with syphilis may include:

• swelling of different parts of the body
• slow growth
• birth defects (for example, problems with the eyes or nerves)
• hearing problems
• bone problems with pain
• blisterlike rash
• yellowish skin (jaundice)
• anemia
• teeth problems
• flattened nose

Severe infections of the baby before birth can cause a stillbirth.

How is it diagnosed?

All women have a blood test for syphilis at their first prenatal visit. If your screening test suggests you might have syphilis, you will have another, more specific blood test to confirm the diagnosis.

If your healthcare provider thinks you may be infected, he or she will look for sores on your skin and in your vagina, cervix, and rectum. Scrapings from sores may be examined under a microscope to look for bacteria. In very special cases, you may have a spinal tap to see if the infection has spread to your spine and brain.

If you are diagnosed with syphilis, your newborn baby will be examined and have blood tests and possibly X-rays.

How is it treated?

Penicillin is the best treatment for syphilis in pregnancy. If you are allergic to penicillin, your healthcare provider may ask you to have a special procedure to stop your allergy so you can then take penicillin.

Treatment for syphilis before the 16th to 18th weeks of pregnancy usually keeps babies from getting syphilis. Treatment later than this in your pregnancy may lessen your baby's infection, but your baby may still be born with some problems caused by syphilis.

A baby born with syphilis will be treated with penicillin.

Cases of syphilis are required by law to be reported to the local health department. You must tell the proper authorities about all the people with whom you have had sexual contact.

Even if you have been treated for syphilis, you can get syphilis again if you are exposed again.

How long will the effects last?

If you are treated soon after you got infected, the baby may have no problems at all and you will probably be cured. The antibiotics used to treat syphilis are very effective if treatment plans are followed closely. However, if you do not get early treatment or you are infected during the second half of your pregnancy, the baby may develop severe problems. Some babies infected during pregnancy do not survive because of the complications of infection.

Expect to have monthly blood tests after your treatment to be sure the treatment is effective.

How can I take care of myself?

Follow your healthcare provider's instructions and take all of your medicine as prescribed. Be sure to tell your provider if you are allergic to penicillin or other medicines.

What can I do to help prevent syphilis?

If you have syphilis, you can help prevent spread of the infection if you:

• Get treatment right away to stop spread of the disease to your baby.
• Don’t expose others to your body fluids and open sores.
• Tell anyone with whom you have had sexual contact in the last 3 months about your infection. Your sexual contacts need to be treated even if they don't have any symptoms. Don’t have sex until you and your sexual contacts have finished all of the medicine and your provider says it's OK.
• Wash your hands after you use the toilet and before you touch food, dishes, or utensils.

You can lower your risk of getting syphilis from someone else if you:

• Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.
• Have just 1 sexual partner who is not sexually active with anyone else. Make sure your partner has been tested for syphilis and other infections.