Congenital syphilis primary prevention

The key in reducing the incidence of congenital syphilis infection is to reduce the rates of maternal infection and adequate antenatal screening.

Primary prevention of syphilis in women of reproductive age and men who have sex with women and prevention of mother to infant transmission in infected individuals plays a important role in decreasing incidence of congenital syphilis.Effective measures for the primary prevention of congenital syphilis include reducing the risk of mother having syphilis infection and also screening during the antenatal period:^[1][2][3][4]

• Routine screening in pregnant females, individuals with high risk behaviours, and those residing in highly prevalent areas.
• Abstinence from intimate physical contact with an infected person.
• Consistent use of latex condoms.
• Limiting no of sexual partners.
• Avoid sharing sex toys.
• Practice of safe sex.

• Obtaining maternal blood for serologic testing at the first visit unless the results of a previous test during the current pregnancy are available. A second STS should be performed at the beginning of the third trimester (28 weeks).

• Providing each patient with a card identifying what test was performed, the date it was done, the result, what treatment (if any) was given, and the clinic’s name and telephone number.

• Maintaining a list, arranged by date of test and patient’s name, of the results of the STS. Entries should be maintained for 1 year after the pregnancy is terminated. Prenatal care providers are responsible for determining the serologic status of their patients. Providers either should obtain the specimen or should document that a nonreactive test was obtained earlier in the pregnancy. The patient-borne record of STS and reactive results will assist in this documentation.

• Identifying specimens from pregnant women by clearly labeling the laboratory slips prenatal. Reactive tests should be followed by the STD program as part of an ongoing surveillance activity.

• Flagging the charts of clients whose serologic tests are reactive. Charts should remain flagged until the patient returns to the clinic. If the patient does not return or respond to routine notification, the local health department should be informed and referral services requested.

• Instructing pregnant patients who may not be involved in mutually monogamous relationships to insist that their sex partners use condoms during the full term of the pregnancy.

• Providing monthly quantitative nontreponemal serologic tests for the remainder of the current pregnancy of women who have been treated for early syphilis. Women who show a fourfold rise in titer should be retreated. Treated women who do not show a fourfold decrease in titer within 3 months should be retreated. After delivery, follow-up should be conducted as outlined for nonpregnant patients.

• Testing all patients for syphilis (RPR or VDRL) 1 month after they have completed treatment for any other STD diagnosed during pregnancy.

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