Sexual Health | Pregnancy and children | Antenatal Screening for Syphilis

Antenatal Screening for Syphilis
Session Overview
Description
This session describes the antenatal screening programme for syphilis in the UK and the rationale underlying this. We will discuss national and global epidemiology of syphilis, as well as testing and treatment strategies. We will briefly examine the consequences of antenatal syphilis infection.

Learning Objectives
By the end of this session you will be able to:

• Describe the epidemiology of syphilis in pregnancy and its burden in the UK and globally
• Describe the antenatal syphilis screening programme in the UK
• List the treatment options for syphilis in pregnancy
• Recognise the consequences of untreated syphilis in pregnancy
• Explain the follow-up of pregnant women treated for syphilis

Prerequisites
Before commencing this session you should complete sessions:

• Module 1/STIs in Pregnancy (260-0102)
• Module 2/Diagnosing Syphilis (260-0023)
• Module 4/Early Infectious Syphilis (260-0052)
• Module 4/Diagnosis and Management of Late Syphilis (260-0054)
• Module 4/Positive Treponemal Serology in Asymptomatic Patient (260-0053)
• Module 4/HIV in Syphilis (260-0055)
• Module 16/Epidemiology and Control of STIs and HIV Globally (260-0181)

Syphilis is an infection caused by the spirochete Treponema pallidum. This can be spread both through sexual contact as well as vertically from mother to child.

T pallidum readily crosses the placenta and vertical transmission can occur at any stage in pregnancy. The risk of transmission is highest in early maternal syphilis infection and is associated with a higher RPR titre (> 1:8). Although foetal infection usually occurs late in pregnancy, it has been demonstrated as early as 8–9 weeks of gestation.

Foetal infection can lead to miscarriage, stillbirth, neonatal death and the musculoskeletal, developmental and neurological complications of congenital syphilis.

Antenatal screening and maternal syphilis treatment are therefore required to decrease the impact of mother to child syphilis transmission.