I'm pregnant. Do I need to g​​et tested for syphilis?​

Yes. All pregnant women are routinely offered testing for syphilis during pregnancy. Syphilis can be diagnosed with a blood test. You should get tested at least twice during pregnancy. If you are at higher risk, you should be offered additional testing in late pregnancy and at birth.

Can syphili​s harm my baby?

Yes. Without treatment, having syphilis while pregnant can cause:

• loss of your baby early in pregnancy (miscarriage)
  
• your baby to be born early (premature birth)
• death of your baby in the womb (stillbirth) or death soon after.

Babies with congenital syphilis can show symptoms at different times. Some early signs in your baby at birth or shortly after birth include:

• low birth weight
• runny nose (“snuffles")
  
• rashes
• swollen lymph nodes
• painful joints or bones

If not treated, some symptoms might not show up until later in childhood, like:

• bone and teeth problems
• vision or hearing issues
• learning or intellectual difficulties.

What increases my risk of harm from syphilis?

You may be at higher risk of harm from syphilis if you:

• miss your pregnancy care appointments
• have had syphilis before
• had another sexually transmissible infection in the past year
• use drugs, especially methamphetamine ('ice') or inject drugs
• have more than one sexual partner
• have a male partner who also has sex with men.

Talk to your GP, midwife or obstetrician (pregnancy doctor) if you are unsure about when to get tested.

How can I protect my baby during  pregnancy?

You can help protect your unborn baby by:

• going to all your planned pregnancy care appointments and having all your tests. Your doctor needs your test results to make sure you and your baby receive the right care
• using condoms or avoiding unprotected sex with new partners
• avoiding sex with anyone who has sores or ulcers on their genitals
• not having sex with someone being treatedfor syphilis until their treatment is finished and symptoms are gone
• talking to your doctor, midwife, Aboriginal health worker or obstetrician you have any worries or don't understand your tests or treatment.

Syphilis can be safely and effectively treated during pregnancy. The earlier the infection is treated, the lower the risk that your baby will be affected by syphilis.

How is syphilis in pregnancy treated?

Syphilis in pregnancy is treated with antibiotics (usually penicillin) given by injection. The number of injections will vary depending on the stage of infection. Some women may need weekly injections for up to three weeks. Treatment with penicillin is safe for your baby. If you are allergic to penicillin, speak to your doctor about treatment options.

After treatment, you will need regular blood tests to check that the treatment has worked. Don't have sex until the treatment course is finished and your symptoms have gone away.

How do I know if my baby has congenital syphilis?

A paediatrician (a doctor who cares for babies and children) will examine your baby shortly after birth. They will check for signs of syphilis infection. Your baby will need a syphilis blood test at birth and again at 3 months and 6 months of age.

My baby was born with congenital syphilis. Can they be treated?

Yes. Babies who have congenital syphilis need to be treated right away to reduce the chance of serious health problems. Your doctor will talk with you about what treatment is best for your baby. Sometimes your baby will need to stay in hospital to have antibiotic treatment.

After you and your baby leave hospital, attend all your baby's follow-up appointments to check that your baby's treatment has worked.

Do my sexual partners need to know?

After infection, a syphilis test can take 3 months to show a positive result. Because of this, your recent sexual partners should be treated even if they test negative. Don't have sex with any recent sexual partner until both of you have completed treatment.

If you're not sure how to talk to your partners, ask your doctor, midwife or Aboriginal health worker for advice. They can help you reach out to them, either directly or anonymously, if you are uncomfortable doing it yourself.

Further Information

• Sexual Health Infolink   (SHIL) for free and confidential sexual health help including a confidential telephone help line available from Monday to Friday 9am to 5:30pm on 1800 451 624.
• Having a baby book  gives you information about how to look after yourself and your baby in pregnancy and how to make informed decisions about your care.
• MotherSafe  at Royal Hospital for Women in Randwick for free telephone counselling and advice on infection risks during pregnancy. Available Monday to Friday, 9am to 5pm, by calling (02) 9382 6539 (Sydney) or 1800 647 848 (regional NSW).
• Multicultural HIV and Hepatitis Service for support and information about HIV and other blood-borne viruses to people from culturally and linguistically diverse communities by calling (02) 9515 1234 or 1800 108 098 (free call – outside Sydney).
• Pregnancy, Birth & Baby Helpline  1800 882 436 (free call) for free, confidential, professional information and counselling for women, their partners and families about conception, pregnancy, birthing and postnatal care.
• Let Them Know for advice and assistance with confidential and anonymous contact tracing for all sexual partners.
• Better to Know  for Aboriginal and Torres Strait Islander people to access information about common STIs and where to get tested. The site also offers a way to tell sexual partners without them knowing who you are.
• Mental Health Line  for free mental health support. Staffed by trained professionals, it offers advice, brief assessments, and referrals to appropriate mental health services. Available 24/7 by calling 1800 011 511.

This factsheet title has been reproduced with permission from Western Sydney Local Health District.