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Syphilis in pregnancy

INTRODUCTION

Syphilis is a systemic infection caused by the spirochete Treponema pallidum, which is of particular concern during pregnancy because of the risk of transplacental infection of the fetus. Congenital infection is associated with several adverse outcomes [1-7], including:

  • Perinatal death
  • Premature delivery
  • Low birth weight
  • Congenital anomalies
  • Active congenital syphilis in the neonate
  • Long-term sequelae, such as deafness and neurologic impairment

The diagnosis, treatment, and sequelae of syphilis complicating pregnancy will be reviewed here. The pathogenesis, diagnosis, and treatment of syphilis in children and nonpregnant adults are discussed separately. (See "Pathophysiology, transmission, and natural history of syphilis" and "Pathogenesis, clinical manifestations, and treatment of early syphilis" and "Pathogenesis, clinical manifestations, and treatment of late syphilis".)

DEFINITIONS

Syphilis is an infection that occurs in different stages over time in the absence of treatment. Early syphilis is often referred to as primary, secondary, and early latent syphilis. These are the stages of syphilis that typically occur within the first year after acquisition of the infection and are classically associated with sexual transmission.

Latent syphilis is defined as asymptomatic infection, with positive serology and a negative physical examination. (See "Diagnostic testing for syphilis".) When latent infection can be documented to have occurred within one year of the acquisition of the organism, it is termed early latent syphilis. If latent infection arises after one year or the time of initial infection cannot be determined, it is defined as late latent syphilis or latent syphilis of unknown duration. (See "Pathogenesis, clinical manifestations, and treatment of early syphilis", section on 'Latent syphilis'.)

                             

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Literature review current through: Apr 2013. | This topic last updated: Mar 1, 2013.
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