Syphilis in pregnancy

When babies are born with syphilis it is called congenital syphilis.

Congenital syphilis occurs when a pregnant woman transmits the infection to the unborn baby. This can occur if syphilis in pregnancy has not been treated, or if treatment was given too late in the pregnancy.

Pregnant woman and their sexual partners

The first signs of syphilis don’t last long, so you can have it and pass it on without knowing. These symptoms can be found in the pregnant mother and/or her sexual partners.

Primary stage

Syphilis can cause people to get an ulcer or sore around their genitals or mouth, 3–12 weeks after infection. The sore can be any size or shape, is usually painless and doesn’t bleed. Even without treatment, the sore heals and disappears after a few weeks, but you are still infected. The syphilis bacteria are in the bloodstream and spread around the body.

Secondary stage

Two to six months after getting infected, people can develop a rash (on the face, palms and soles of the feet), swollen glands, warts or lumps (around genitals, anus, mouth), and hair loss.

Latent and tertiary stages

Without treatment, the latent stage is where there are no physical signs but you are still able to transmit syphilis to your unborn baby.

If someone has untreated syphilis for longer than two years it can progress to the tertiary stage which affects the brain, heart, large blood vessels, the spinal cord, skin and bones. This can lead to permanent physical and intellectual disability, and death.

Babies

Congenital syphilis can damage the baby’s vital organs including the liver, brain, spinal cord and skin (rashes, warts or lumps). It can also affect bone and muscle development.

To find out if you have syphilis you need to get a blood test.

Before you are pregnant

If you are planning to get pregnant it is recommended you have a syphilis blood test before you get pregnant.

Whilst you are pregnant

Your GP, midwife or obstetrician should offer a syphilis blood test at your first pregnancy or antenatal care check-up in your first trimester.

Two additional syphilis blood tests at 28 weeks and when the baby is born are recommended for at pregnant women:

• who have had one or more new sexual partners after her first syphilis blood test
• who have sexual partners who are:
  • men who have sex with men
  • from a high prevalence country (e.g. countries in Africa and Asia, including refugees from these countries)
• whose sexual partners have:
  • had one or more new sexual partners after the woman became pregnant
  • a sexual partner from a from high prevalence country
• who have had a sexually transmitted infection during the current pregnancy or within the previous 12 months
• who have previously had infectious syphilis in pregnancy
• who engages in intravenous substance use during pregnancy.

If you think you need more than one syphilis blood test during pregnancy, ask your GP, midwife or obstetrician.

If you are in an outbreak region

For pregnant women living in an area affected by an ongoing syphilis outbreak, four additional syphilis blood tests are recommended at 28 weeks, 36 weeks, when the baby is born and 6 weeks after the baby’s birth.

This includes the Goldfields, Kimberley, Midwest and Pilbara.

Syphilis in pregnancy is effectively treated with penicillin. The earlier the infection is found, the easier it is to treat and to protect the baby from congenital syphilis.

If treatment is given within 30 days of giving birth, the baby will also need to get treatment for syphilis after their birth.

It’s important to protect yourself, baby and sexual partners from getting syphilis by wearing a condom for all kinds of sex, including oral, vaginal and anal sex.

Condoms and regular syphilis blood tests during pregnancy are recommended if you and/or your partners:

• have had a new sexual partner
• is a man who has sex with men
• have had a sexual partner from a from high prevalence country (e.g. countries in Africa and Asia, including refugees from these countries).