It's that simple! To prevent mother-to-child transmission of syphilis, remember these tips!

1. What is syphilis?

Syphilis is a chronic, systemic sexually transmitted disease caused by Treponema pallidum. Early syphilis can manifest as chancre, rash, hair loss and other symptoms. If not treated early, it will spread throughout the body and cause irreversible damage to the cardiovascular and nervous systems. Latent syphilis infection has no symptoms or signs and requires early detection and treatment to prevent transmission.

2. What is mother-to-child transmission of syphilis?

Syphilis is mainly transmitted through sexual contact, but can also be indirectly transmitted through blood transfusions, surgery, and even clothing. Pregnant women are infected through the placenta, causing congenital syphilis. Newborns can be infected through the birth canal during delivery, through breastfeeding or contact with contaminated clothing and utensils after delivery, thus causing mother-to-child transmission, which seriously endangers health.

3. Why should pregnant women be screened for syphilis?

Treponema pallidum can enter the fetal area through the placenta at any stage of pregnancy, causing spontaneous abortion, stillbirth, non-immune fetal edema, premature birth, low birth weight and congenital syphilis.

Congenital syphilis accounts for about 30% of stillbirths, and even if they survive, the condition is more serious. The degree of harm of mother-to-child transmission of syphilis is often related to the time when the mother was infected with syphilis, the serum titer detected, and the treatment during pregnancy. Most cases of pregnancy complicated with syphilis are latent syphilis, which has no clinical manifestations and related signs and can only be detected through blood screening. It is recommended that both men and women be screened at the same time !

4. Can pregnant women with syphilis give birth to healthy babies?

Can .

Pregnant women infected with syphilis should receive testing and standardized treatment in the hospital as soon as possible, and have regular follow-up examinations after treatment; the baby should receive standardized preventive treatment in a timely manner after birth. Mother-to-child transmission of syphilis can be completely blocked . Mothers who receive standardized treatment during pregnancy can still breastfeed after giving birth.

5. How to prevent mother-to-child transmission of syphilis?

1. Before pregnancy

Women of childbearing age should reduce high-risk behaviors, do premarital medical examinations when registering for marriage, and do pre-pregnancy eugenics health examinations when planning pregnancy. Those who have high-risk behaviors are advised to go to a regular hospital for timely testing. If the test is positive, pregnancy should be postponed. Those who have been confirmed to be infected should see a doctor regularly and receive standardized treatment. Those who are planning to conceive should choose the best time for pregnancy under the guidance of a doctor.

2. Pregnancy

All pregnant women should be screened for syphilis during early pregnancy or the first prenatal checkup, preferably within the first three months of pregnancy, to clarify the infection status as soon as possible. If the infection is confirmed, they should receive standardized anti-syphilis treatment as soon as possible and have regular maternal and fetal status assessments.

Treatment principles for syphilis during pregnancy: early, adequate, and standardized treatment. Penicillin treatment is the first choice. If you are allergic to penicillin, you can choose ceftriaxone or erythromycin. Follow the doctor's advice. Tetracycline and doxycycline are contraindicated. Treatment has two purposes: one is to treat syphilis in pregnant women, and the other is to prevent or reduce congenital syphilis in infants . Treatment in early pregnancy may prevent fetal infection, and treatment in mid- and late pregnancy may cure the infected fetus before delivery.

3. Postpartum

Pregnant women infected with syphilis must undergo quantitative non-syphilis Treponema pallidum antigen serological tests before giving birth to determine the infection status of the newborn. After giving birth, pregnant women infected with syphilis should undergo regular follow-up examinations according to different syphilis stages to monitor the syphilis condition.

4. Neonatal intervention

All newborns born to pregnant women with syphilis need to receive preventive treatment. Newborns born to pregnant women with syphilis should be tested for syphilis infection immediately after birth. If congenital syphilis is confirmed, they should receive standardized treatment as soon as possible. If congenital syphilis cannot be confirmed, the need for preventive treatment should be determined based on the test results, and follow-up should be conducted every 3 months to receive syphilis infection-related tests to diagnose or exclude congenital syphilis in a timely manner.

For newborns whose mothers did not receive standardized treatment during pregnancy and who tested positive for non-syphilis Treponema pallidum, they should be treated as congenital syphilis and followed up regularly.

Newborns born to pregnant women infected with syphilis should undergo syphilis serological testing and follow-up at 3, 6, 9, 12, 15, and 18 months of age starting from birth until congenital syphilis is excluded or diagnosed in the children.

6. Can a mother with syphilis breastfeed?

Treponema pallidum is not transmitted through breast milk, and breastfeeding is not the main route of syphilis transmission . After the pregnant woman and her newborn receive standardized treatment and intervention, mothers infected with syphilis can breastfeed.

If the mother has not received regular treatment or the serum titer is still high after treatment, breastfeeding should be temporarily suspended . However, breast milk can be extracted and pasteurized or boiled before feeding. If the mother has severe nipple ulceration and bleeding or syphilis lesions, breastfeeding should be stopped.

7. Can a mother/father with syphilis take care of the baby normally?

If the parents have received standardized treatment and have been clinically cured, they can take care of their babies normally . Early syphilis is mainly transmitted through sexual intercourse, but a few are still transmitted through kissing, drinking water, and contaminated clothing, towels, diapers, etc., so you still need to pay attention to protection when taking care of your baby, develop good hygiene habits, wash and disinfect clothing and towels separately, and avoid bathing together and contact with secretions.

8. What should I do if I get pregnant again?

Blocking mother-to-child transmission is not a one-time solution. If you get pregnant again, you should also be tested before 12+6 weeks of pregnancy and start treatment as soon as possible. Testing and treatment are also required after the baby is born.

The obstetrics department of the High-tech Campus of Yiyang Central Hospital provides one free syphilis screening test to all pregnant women receiving prenatal care for the first time, and provides free penicillin treatment for syphilis infection for pregnant women.

The Neonatal Department of the High-tech Campus of Yiyang Central Hospital provides free testing and anti-syphilis or preventive treatment for babies born to mothers infected with syphilis. It provides free consultation, testing, evaluation, treatment, intervention and other one-stop services to protect the health of mothers and babies in our city.

References

Practical Neonatology, People's Medical Publishing House, 5th edition;

"Infectious Diseases", People's Medical Publishing House, 9th edition;

Hunan Medical Chat Special Author: Liu Ping from Yiyang Central Hospital

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(Edited by YT)