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Clinical Summary

Syphilis Infection in Pregnancy: Screening

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Clinical Summary of U.S. Preventive Services Task Force Recommendation

This document is a summary of the 2009 recommendation of the U.S. Preventive Services Task Force (USPSTF) on screening for syphilis infection in pregnant women. This summary is intended for use by primary care clinicians.

Select for copyright and source information.

This summary was first published in Annals of Internal Medicine in May 2009 (Ann Intern Med 2009;150:707. http://www.annals.org).


Population All Pregnant Women
Recommendation Screen for syphilis infection.
Grade: A
Screening Tests

Nontreponemal tests commonly used for initial screening include:

  • Venereal Disease Research Laboratory (VDRL)
  • Rapid Plasma Reagin (RPR)

Confirmatory tests include:

  • Fluorescent treponemal antibody absorbed (FTA-ABS)
  • Treponema pallidum particle agglutination (TPPA)
Timing of Screening
Test all pregnant women at the first prenatal visit.
Other Clinical Considerations

Most organizations recommend testing high-risk women again during the third trimester and at delivery. Groups at increased risk include:

  • Uninsured women
  • Women living in poverty
  • Sex workers
  • Illicit drug users
  • Those diagnosed with other sexually transmitted diseases (STDs)
  • Other women living in communities with high syphilis morbidity

Prevalence is higher in southern U.S. and in metropolitan areas and in Hispanic and African American populations.

Interventions

The Centers for Disease Control and Prevention (CDC) recommends treatment with parenteral benzathine penicillin G. Women with penicillin allergies should be desensitized and treated with penicillin.

Consult the CDC for the most up-to-date recommendations: http://ww.cdc.gov/std/treatment/

Relevant USPSTF Recommendations
Recommendations on screening for other STDs, and on counseling for STDs, can be found at http://www.uspreventiveservicestaskforce.org.

For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents please go to http://www.uspreventiveservicestaskforce.org.

Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Copyright and Source Information

This document is in the public domain within the United States.

Requests for linking or to incorporate content in electronic resources should be sent via the USPSTF contact form.

Current as of: May 2009

Internet Citation: Clinical Summary: Syphilis Infection in Pregnancy: Screening. U.S. Preventive Services Task Force. June 2016.
https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening

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