Syphilis in Pregnancy

Syphilis is a sexually transmitted infection (STI). If you’re pregnant and have syphilis, it can cause severe problems for you and your baby. Without treatment, it can cause premature birth, miscarriage, stillbirth, and infant death. But syphilis is preventable. And it’s usually easy to cure with medicine if treated early. That’s why early testing and treatment are so important.

What causes syphilis in pregnancy?

Syphilis is an STI that’s caused by a germ (bacteria). It can cause painless, infected sores. Syphilis is spread through sexual contact with someone who has the disease. You can also get syphilis by touching or kissing an infected sore. These sores are often hard to see. You may not know they are there. A syphilis sore can be found on a person’s sex organs or in the anus, rectum, or vagina. A sore can also be on someone’s lips or in their mouth.

Once a pregnant person is infected, syphilis can infect their unborn baby. It does this by passing through the placenta. The placenta is the temporary organ that develops in the birth parent’s uterus during pregnancy. It passes nutrients and oxygen from the birth parent to the baby.

In most cases, syphilis is spread from the birth parent to the baby during pregnancy. But a baby can also be infected during a vaginal birth. This can happen if a baby has contact with a birth parent’s syphilis sore during delivery. This is called congenital syphilis.

Symptoms of syphilis in pregnancy

It’s possible to have syphilis and not know it. That’s why it’s so important to get tested. In many cases, there are no symptoms. Or the symptoms may be very mild. Symptoms can also go away on their own. But even if symptoms go away without treatment, the infection is still there. The only way to get rid of syphilis is to get treatment with medicine.

Syphilis symptoms occur in stages. With each stage, the symptoms get worse. The stages are:

Primary syphilis. A painless, infected sore is first seen on the infection site. This site is often the vagina, vulva, or penis. A sore may not be noticed if it’s on the vagina or the cervix. Even without treatment, these sores will go away on their own in 3 to 6 weeks. But without treatment, syphilis will still progress to the next stage.

Secondary syphilis. A rash appears at this stage. It’s often on the palms of the hands and the bottom of the feet (soles). You may also have:

  • Fever
  • No appetite
  • Headache
  • Weight loss
  • Hair loss
  • Muscle pain
  • Lack of energy (fatigue)
  • Swollen lymph nodes

Latent stage. Symptoms go away in this stage. But you still have the infection.

Late syphilis. If you don’t get treated, syphilis can cause problems for you years later, such as:

  • Vision problems, including blindness
  • Tumors
  • Paralysis
  • Damage to the brain, nervous system, and other organs

Some of the symptoms of syphilis can be caused by other health conditions. Always see your healthcare provider for testing and a diagnosis.

Diagnosing syphilis in pregnancy

Pregnant people are tested early in their pregnancy for syphilis and other STIs using a blood test. Your healthcare provider will also ask you about your sex history. This includes asking about your partners and if you use birth control. You may also have another blood test for syphilis and other STIs in your third trimester, and again after your baby is born.

It’s important to have your partner get tested and treated for syphilis too. If they don’t, you will keep getting reinfected.

Treatment for syphilis in pregnancy

It’s vital to get treated for syphilis as soon as possible. In most cases, early treatment during pregnancy can cure both you and your baby. Your partner also must be tested and treated right away.

The antibiotic penicillin is the preferred treatment for syphilis. It’s also safe to use when pregnant. Other medicines may not be safe to take during pregnancy. Or they may not work as well.

Penicillin is usually given as a shot (injection). People who have primary or secondary stage syphilis may only need 1 shot. People in latent or later stages may need additional shots.

If you have a penicillin allergy

If you’re allergic to penicillin, your healthcare provider will help you to safely build up a tolerance to the medicine. This is called penicillin desensitization. It’s done to prevent an allergic reaction. You’ll be given low doses of penicillin. The doses will slowly become a little higher. This will be done in a healthcare provider’s office. You’ll be closely watched by your provider or by an allergy specialist.

How can I prevent syphilis in pregnancy?

To prevent syphilis, be sure to have safe sex. Only have sex with 1 person who doesn’t have other sex partners. And always use a condom when you have sex.

It’s also important to go to all your prenatal checkups, even if you think you and your baby are fine.

If you think you may have syphilis, talk with your provider right away. It’s important to get tested and treated as soon as possible. With treatment, most problems can be prevented for you and your baby.