Congenital Syphilis: Causes and Prevention

Congenital syphilis is an infection that occurs when Treponema pallidum, the bacterium causing syphilis, is transmitted from an infected mother to her baby during pregnancy.

Understanding the causes, transmission, and prevention methods is crucial for healthcare providers, expectant mothers, and public health officials.

This vertical transmission can lead to severe health issues for the infant, including developmental delays, neurological problems, and even death if not promptly diagnosed and treated.

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Causes of Congenital Syphilis

Maternal Infection

The primary cause of congenital syphilis is the maternal infection with Treponema pallidum. Pregnant women with untreated or inadequately treated syphilis can transmit the infection to their unborn children. The risk of transmission is highest during the primary and secondary stages of maternal syphilis but can occur at any stage of the disease.

Lack of Prenatal Care

Another significant factor contributing to the incidence of congenital syphilis is the lack of adequate prenatal care. Regular prenatal visits and syphilis screenings are essential for early diagnosis and treatment, thereby reducing the risk of transmission to the fetus.

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Transmission of Congenital Syphilis

In Utero Transmission

Congenital syphilis is primarily transmitted in utero. The Treponema pallidum bacterium can cross the placental barrier, infecting the fetus at any time during pregnancy. The likelihood of transmission increases with the gestational age and the stage of maternal syphilis.

Perinatal Transmission

Although less common, transmission can also occur during childbirth if the mother has active genital syphilis lesions. This perinatal transmission can result in immediate health complications for the newborn.

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Symptoms of Congenital Syphilis

Early Congenital Syphilis

Symptoms of early congenital syphilis, appearing within the first two years of life, can include:

Late Congenital Syphilis

Symptoms of late congenital syphilis, manifesting after two years of age, may include:

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Diagnosis of Congenital Syphilis

Maternal Testing

Early diagnosis of congenital syphilis begins with maternal testing. Pregnant women should be screened for syphilis during their first prenatal visit and again in the third trimester and at delivery if they are at high risk. Serological tests, such as the Rapid Plasma Reagin (RPR) test, are commonly used for initial screening, followed by confirmatory tests like the Fluorescent Treponemal Antibody Absorption (FTA-ABS) test.

Infant Testing

Infants born to mothers with syphilis should undergo thorough examination and testing. Diagnostic methods include:

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Treatment of Congenital Syphilis

Penicillin Therapy

Penicillin remains the most effective treatment for congenital syphilis. Administering aqueous crystalline penicillin G or procaine penicillin G, depending on the stage and severity, can effectively treat both the mother and the infant. Early treatment is crucial to prevent long-term complications.

Follow-Up and Monitoring

Post-treatment follow-up is essential to ensure the effectiveness of the therapy and to monitor for any signs of relapse or complications. Regular serological testing and clinical evaluations are recommended for both mother and child.

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Prevention of Congenital Syphilis

Prenatal Screening and Treatment

The cornerstone of congenital syphilis prevention is comprehensive prenatal screening and timely treatment of infected pregnant women. Ensuring that all pregnant women receive syphilis testing during their prenatal visits can significantly reduce the risk of transmission to the fetus.

Education and Awareness

Raising awareness about the importance of prenatal care and the risks associated with untreated syphilis is vital. Healthcare providers should educate expectant mothers on the necessity of regular prenatal visits, syphilis testing, and adhering to treatment protocols.

Partner Notification and Treatment

To prevent reinfection and further spread of syphilis, it is crucial to identify and treat the sexual partners of infected pregnant women. Partner notification and treatment programs can help break the chain of transmission and protect future pregnancies.

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Complications of Congenital Syphilis

Neurological Complications

Untreated congenital syphilis can lead to severe neurological complications, including:

Musculoskeletal Complications

Bone and joint abnormalities are common in congenital syphilis, potentially resulting in:

Cardiovascular Complications

Late congenital syphilis can cause cardiovascular issues such as: