Syphilis in pregnancy

Congenital syphilis is showing a rising trend globally. Materno-fetal transmission of syphilis can be prevented by ensuring early diagnosis and prompt treatment of infected pregnant women. The risk of transmission from mother to child is directly related to the quantity of Treponema pallidum in the maternal circulation. Maximum number of the organisms is seen in early syphilis. Hence, early syphilis in mother (in comparison to late syphilis) places the baby at a higher risk for congenital syphilis. Amniocentesis and cordocentesis may help in the prenatal detection of congenital syphilis. Ultrasonography and Doppler studies supported by serological tests, and polymerase chain reaction, and dark field microscopic examination of the specimen from suspected lesions of early syphilis of mother may help to diagnose congenital syphilis prenatally. Benzathine penicillin G in appropriate dose is the ideal drug for syphilis in pregnancy, except for neurosyphilis for which the drug of choice remains crystalline penicillin.