Successful management of syphilis in pregnancy

in Max Super Speciality Hospital, Shalimar Bagh

Jan 16 , 2023

A 25-year-old woman, 30 weeks pregnant, visited Max Hospital, Shalimar Bagh, for safe confinement. Upon investigations, she and her husband's VDRL test was positive, which was reconfirmed by a positive Treponema Pallidum Haemagglutination (TPHA). There was no history of fever and lymphadenopathy, sore throat, or weight loss. Ultrasound scan indicated normal pregnancy.

She was 2nd gravida with previous normal delivery and had reports that showed congenital syphilis features in the previous baby. A physician review was taken, and Injection B penicillin was given weekly for four doses. She went into labour at 40 weeks and delivered a healthy baby who was evaluated for congenital syphilis and tested negative. The husband was also treated.

All pregnant women should be screened for syphilis. Syphilis in pregnant women can cause miscarriage, stillbirth, and early neonatal death. Approximately 40% of babies born to women with untreated syphilis can be stillborn or die of infection as new-born. Syphilis can be effectively treated with a Penicillin regime initiated 30 days or more before delivery.

Their partners should also receive treatment to prevent reinfection. Infants at birth should be evaluated for congenital syphilis and treated. Infants who are not treated within the first three months are likely to develop lifelong complications such as deafness, blindness, and intellectual disability. In 99% of the cases, treatment with penicillin during pregnancy cures the mother and fetus.

The patient continued the treatment despite being positive for the second time and showed immense trust and faith during the whole course of treatment.