Syphilis is a sexually transmitted infection or STI, that is fairly uncommon in pregnancy in the United States. In 2007, about one out of every 100,000 pregnant women tested positive for syphilis. The organism responsible for syphilis is a sprirochete called 'Treponema pallidum".
Due to the increased risk of pregnancy complications, women are typically screened for syphilis during prenatal testing. If caught early, syphilis can be treated effectively with pregnancy-safe antibiotics. If left untreated, the infection can cause severe pregnancy complications.
Who is at Risk of Syphilis During Pregnancy?
STIs are passed from one partner to the other. The carrying partner may not have any symptoms of infection, but infection is passed none-the-less. Men and women with multiple or non-monogamous sexual partners are at increased risk of syphilis. If you are in a monogamous relationship, your risk of syphilis falls dramatically.
If syphilis is detected in the first or second stages, it can be cured. If the condition goes untreated and moves to the third stage, symptoms may not appear for 30 years or more. When symptoms reappear, they can cause loss of vision, loss of hearing, psychosis, heart abnormalities and death.
Testing for Syphilis
The screening test for syphilis is called the VDRL (Venereal Disease Research Laboratory) test. The VDRL is s screening test. If it's negative, then you do not have syphilis. If the VDRL is positive, that means you had a positive syphilis screen test, and another test is done to confirm if you actually do have syphilis or not. The reason another test is needed is that some people have a "false-positive" VDRL test. A "false-positive" VDRL test is a VDRL screening test thats positive, but you do not have syphilis. The test to actually diagnose syphilis is a confirmatory FTA-ABS test. If the FTA-ABS test is positive, then there is syphilis present. If the FTA-ABS is negative with a positive VDRL, then the VDRL is considered "false-positive", and your doctor may do additional tests for conditions know .n to be associated with a false-positive VDRL. Se more about the VDRL test and it's interpretation HERE.
Symptoms of Syphilis During Pregnancy
Syphilis is a progressive infection with different symptoms for each progressive stage. There are also variable symptoms from one person to another, which means there is no definitive set of symptoms that all pregnant women will suffer from when infected with syphilis. The most common symptoms a pregnant woman may experience are:
- First Stage: Painful sores at infection site - mouth, vagina, labia or anus (among other sites).
- Second Stage:
- Rash on palms or soles
- Lesions in the mouth or vagina
- Infectious warts on genitals
- Flu symptoms
- Weight loss
- Loss of hair
- Third Stages:
- Lesions on bones, skin and organs
- Loss of vision
- Loss of hearing
- Heart problems
Treatment for Syphilis in Pregnancy
If the infection is caught in the early stages, it can be treated during pregnancy with penicillin. There are other antibiotics commonly used to treat syphilis infections, but none are safe for use during pregnancy. Your partner will also likely be treated for syphilis, especially if her or she has tested positive for the infection. After the course of antibiotics is complete, pregnant women undergo a blood test to ensure the infection has cleared. An ultrasound may also be scheduled to check on the condition of the fetus. Common effects of syphilis infection on the fetus include:
- Large placenta
- Fluid in the abdomen of the fetus
- Several fetal abdominal swelling
- Large liver
- Large spleen
Symptoms at birth may include:
- Skin rash
- Lesions in or around the mouth or genitals
If the condition is not treated in the early stages, symptoms may disappear for a lengthy period of time. When symptoms reappear, the condition will likely be advanced to the point where antibiotics are useless.