Screening for Syphilis in Pregnancy

Publication Date: April 4, 2024
Last Updated: April 19, 2024

Updated ACOG Recommendation

The American College of Obstetricians and Gynecologists (ACOG) continues to endorse the Centers for Disease Control and Prevention (CDC) Sexually Transmitted Infection Treatment Guidelines, 20211. However, in the context of the rapidly increasing rates of congenital syphilis, obstetrician–gynecologists and other obstetric care professionals should screen all pregnant individuals serologically for syphilis at the first prenatal care visit, followed by universal rescreening during the third trimester and at birth, rather than use a risk-based approach to testing.

Treatment of Syphilis in Pregnancy

Benzathine penicillin G is the only known effective treatment for syphilis in pregnancy and the prevention of congenital syphilis1. Timely initiation and completion of treatment are imperative and often complicated by stigma, multiple injections, treatment shortages, reporting and follow-up requirements, and mistrust of the medical system. In patients with a known severe allergy to penicillin, desensitization followed by penicillin treatment is recommended.

Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Screening for Syphilis in Pregnancy

Authoring Organization

American College of Obstetricians and Gynecologists

Publication Month/Year

April 4, 2024

Last Updated Month/Year

April 19, 2024

Document Type

Consensus

Country of Publication

US

Document Objectives

The American College of Obstetricians and Gynecologists (ACOG) continues to endorse the Centers for Disease Control and Prevention (CDC) Sexually Transmitted Infection Treatment Guidelines, 20211. However, in the context of the rapidly increasing rates of congenital syphilis, obstetrician–gynecologists and other obstetric care professionals should screen all pregnant individuals serologically for syphilis at the first prenatal care visit, followed by universal rescreening during the third trimester and at birth, rather than use a risk-based approach to testing.

Inclusion Criteria

Female, Adolescent, Adult

Health Care Settings

Ambulatory

Intended Users

Nurse, nurse midwife, nurse practitioner, physician, physician assistant

Scope

Assessment and screening

Diseases/Conditions (MeSH)

D011247 - Pregnancy, D013587 - Syphilis

Keywords

pregnancy, Syphilis