Syphilis

Question 1

Define syphilis in pregnancy.

Answer 1

Infection with Treponema pallidum in pregnancy.

Question 2

What is the aetiology of syphilis in pregnancy?

Answer 2

Sexual transmission

Blood transfusion

Transplacental transmission from mother to fetus

Question 3

What are risk factors for syphilis in pregnancy?

Answer 3

Multiple sexual partners

Unprotected sex

Syphilis during pregnancy

Question 4

Summarise the epidemiology of syphilis in pregnancy.

Answer 4

Syphilis is a common STI

Question 5

What are symptoms of syphilis in pregnancy?

Answer 5

Anogenital ulcer

Lymphadenopathy

Diffuse rash

Fatigue

Rhinitis (congenital syphilis)

Hepatosplenomegaly (congenital syphilis)

Question 6

What are signs of syphilis in pregnancy?

Answer 6

Jaundice

Peripheral neuropathy

Areflexia

Patchy alopecia

Positive Romberg’s sign

Question 7

What investigations should be performed for syphilis in pregnancy?

Answer 7

Dark-field microscopy of swab from lesion

Serum treponemal enzyme immunoassay (EIA)

Serum Treponema pallidum particle agglutination (TPPA)

Serum Treponema pallidum haemagglutination (TPHA)

Serum fluorescent treponemal antibody absorption (FTA-ABS) test

Immunocapture assay

Line immunoassay (LIA) serological test

Serum rapid plasma reagin (RPR) test

Serum Venereal Disease Research Laboratory (VDRL) test

Question 8

What is the management for syphilis in pregnancy?

Answer 8

Benzathine benzylpenicillin or Doxycycline

Question 9

What complications are associated with syphilis in pregnancy? What is the prognosis of syphilis in pregnancy?

Answer 9

Miscarriage, stillbirth, or the baby’s death shortly after birth. Approximately 40% of babies born to women with untreated syphilis can be stillborn or die from the infection as a newborn.