Syphilis in pregnancy

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Background

  • Risk of transmission to fetus
    • Primary and secondary syphilis: 70 to 100%
    • Early latent syphilis: 40%
    • Late latent syphilis: 10%

Management

  • For primary, secondary, or early latent syphilis: benzathine penicillin G 2.4 million units IM weekly for 1-2 doses
  • For late latent, latent syphilis with unknown duration, or tertiary syphilis not involving the CNS: benzathine penicillin G 2.4 million units IM weekly for 3 doses
  • For tertiary neurosyphilis, treat as usual
  • Postpartum, follow guidelines for congenital syphilis to decide whether and how to treat the neonate