Managing congenital syphilis again? The more things change ..

PURPOSE OF REVIEW: Untreated syphilis may have profound adverse effects on pregnancy outcome, resulting in spontaneous abortion, stillbirth, premature delivery or perinatal death, or can result in significant morbidity during infancy, childhood or adolescence. In this article, we review current strategies for the management of maternal and congenital syphilis nationally and in resource-poor settings.

RECENT FINDINGS: Since 1998, a dramatic increase in syphilis diagnoses has been documented among women of child-bearing age in the UK and elsewhere. The low prevalence of congenital syphilis in many developed countries may have led to complacency, hindering modern-day management of this historically important condition. Follow-up studies indicate that present antenotal and postnatal interventions could be improved. This conclusion extends to resource-poor settings endemic for syphilis in which rapid diagnostic techniques are currently being validated.

SUMMARY: A stringent follow-up of pregnant women with syphilis before delivery and a proactive approach to identifying and treating exposed neonates born to such patients are needed.