Is it credible that a pregnant woman has a positive TPPA?

The physical health of pregnant women is very important, because the health of a pregnant woman not only affects her own health, but also affects the health of the fetus. Therefore, pregnant women must have a healthy body, but pregnant women may also be infected with gynecological diseases, which means they will live together during pregnancy. Pregnancy is the period when women’s bodies are at their weakest. Is it credible that a pregnant woman’s TPPA is positive?

To determine whether a person has syphilis, it is necessary to check for a specific antibody, usually represented by TPPA, and a non-specific antibody, usually represented by RPR. If TPPA or RPR antibodies are detected in the blood during pregnancy, does it mean that you have syphilis? The answer is NO. As long as you have had syphilis, TPPA will be positive for life; if RPR is positive, it means that you are likely to be infected with syphilis.

How to determine the severity of syphilis infection?

This depends on the titer of RPR antibodies. The TPPA titer is meaningless, but the higher the RPR titer, the more severe the condition; the lower the titer, the milder the condition. In addition, changes in RPR titer can also determine the effectiveness of syphilis treatment and the outcome of the disease.

Here, we will introduce what the high and low RPR titers mean. When checking the RPR titer, first use the undiluted original serum for measurement. If the result is positive, the titer is expressed as 1:1; next, dilute the serum by half, that is, use 1/2 of the original concentration for testing. If the result is still positive, the titer is expressed as 1:2; then dilute the serum to 1/4 of the original concentration. If the result is still positive, the titer is expressed as 1:4; and so on. The higher the serum dilution factor, the more positive the test result is, which means the higher the RPR titer is. This means that if the serum is diluted many times and can still be detected positive, the more serious the syphilis infection is.

Syphilis serum antibodies may show false positives, that is, the person is not infected with syphilis, but the blood test results will show positive. This situation is more common in pregnant women. This false positive is related to changes in hormone levels and internal environment during pregnancy.

How to rule out false positives?

If syphilis antibodies are positive during pregnancy, and disappear after a period of time after pregnancy, it may be a false positive;

Or if syphilis antibodies are positive during pregnancy, but the RPR titer is very low, this may be a false positive or a previous syphilis infection;

But if the RPR titer is very high, it is very likely that you are actually infected with syphilis.

A low RPR titer does not necessarily mean a false positive. It depends on the patient's previous syphilis examination results, changes in syphilis indicators during pregnancy, and the spouse's syphilis infection status. For example, if the spouse is positive for syphilis antibodies, it cannot be assumed that the pregnant woman has a false positive. It is very likely that she has been infected before but has not been discovered.

In addition, if the pregnant woman has had syphilis before and the RPR titer is very high, after treatment, the titer drops to a certain level and remains at this level for more than two years, it can be considered serum fixation, just like when a person's skin is injured and the wound heals, leaving a scar. At this time, it cannot be considered as pregnancy syphilis and is not contagious.