Adequate screening, detection, and treatment of syphilis during pregnancy is critical to reducing cases. The Tennessee Department of Health screening guidelines published in January 2024 include:
- All pregnancies to be tested for syphilis in the 1st trimester or at the 1st prenatal care visit.
- Rescreening for syphilis at 28-32 weeks gestation and delivery is highly encouraged by TDH for ALL patients, regardless of first-trimester test results.
- If a patient is getting a pregnancy test in an emergency department or outpatient/walk-in setting, TDH highly encourages concurrent sexually transmitted infection testing including syphilis. Cases of Congenital Syphilis can be prevented if syphilis has been detected and treated at the time the time pregnancy was diagnosed.
- If a patient has a vaginal complaint in pregnancy that requires a workup, strongly consider testing for syphilis in addition to your other testing.
- If a patient faces obstacles to care, TDH recommends starting syphilis treatment right away following a positive rapid syphilis test during pregnancy. Send for full confirmatory syphilis testing for optimal patient follow-up.
- All women who experience stillbirth after 20 weeks should be tested for syphilis.
- Infants should not leave the hospital without the serologic status of the infants’ mother having been documented at least once during pregnancy.
- Congenital syphilis should be considered in infants of mothers with evidence of syphilis infection during pregnancy, especially if syphilis is newly acquired during pregnancy.