These recommendations are available on the USPSTF Web site ( ). The USPSTF has made recommendations on screening for other sexually transmitted diseases in pregnancy, including gonorrhea, chlamydial infection, hepatitis B, herpes, and human immunodeficiency virus. To ensure that results are comparable, follow-up tests should be performed using the same nontreponemal test that was used initially to document the infection (i.e., VDRL or RPR test). Follow-up serologic tests should be obtained after treatment to document decline in titers. Most states mandate that all pregnant women be screened at some point during pregnancy, and many mandate screening at the time of delivery. For women in high-risk groups, many organizations recommend repeat serologic testing in the third trimester and at delivery. All pregnant women should be tested at their first prenatal visit. Because the CDC updates these recommendations regularly, physicians are encouraged to access the CDC Web site to obtain the most up-to-date information ( ). Evidence on the effectiveness or safety of alternative antibiotics in pregnancy is limited therefore, women who report penicillin allergies should be evaluated and, if present, desensitized and treated with penicillin. In its 2006 sexually transmitted disease treatment guidelines, the CDC recommends parenteral penicillin G benzathine for the treatment of syphilis in pregnancy. The Centers for Disease Control and Prevention (CDC) has outlined appropriate treatment of syphilis in pregnancy. These are typically followed by a confirmatory fluorescent treponemal antibody absorbed test or Treponema pallidum particle agglutination test. Nontreponemal tests commonly used for initial screening are the Venereal Disease Research Laboratory (VDRL) test or the rapid plasma reagin (RPR) test. Persons in whom sexually transmitted diseases have been diagnosed may be more likely than others to engage in high-risk behavior, which places them at increased risk of syphilis. 1 The prevalence of syphilis infection differs by region (it is higher in the southern United States and in some metropolitan areas than in the United States as a whole) and by ethnicity (it is higher in Hispanic and black populations than in the white population). Pregnant women who are at increased risk of syphilis infection include uninsured women, women living in poverty, sex workers, illicit drug users, and women living in communities with high syphilis morbidity. This recommendation applies to pregnant women.Īssessment of risk. Recommendations on screening for other STDs, and on counseling for STDs, can be found at. Women with penicillin allergies should be desensitized and treated with penicillin.Ĭonsult the CDC for the most up-to-date recommendations at. The CDC recommends treatment with parenteral penicillin G benzathine.
Prevalence is higher in the southern United States, in metropolitan areas, and in Hispanic and black populations. Women living in communities with high syphilis morbidity Most organizations recommend testing women at high risk again during the third trimester and at delivery. Test all pregnant women at the first prenatal visit. Treponemal pallidum particle agglutination test Venereal Disease Research Laboratory testįluorescent treponemal antibody absorbed test Nontreponemal tests commonly used for initial screening include:
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