I. Prevention and treatment strategies
1.Conduct pre-pregnancy check-up: serological examination for syphilis before planning pregnancy, and if found positive, pregnancy should be suspended and systematic treatment should be carried out, and spouses should be examined at the same time to exclude any infection.
2.Screening and anti-syphilis treatment should be carried out within 3 months of pregnancy.
When the test is suspicious, regular follow-up review and treatment should be carried out. If the RPR or TRUST titer is low, false positives need to be excluded, and if the cause of false positives cannot be found in late pregnancy, pregnant women should undergo plum repellent treatment
3, TPPA positive, RPR or TRUST negative, there may be previous infection, and early syphilis, part of the late syphilis, immediately give a course of treatment, monthly RPR or TRUST titer test, for 3 months, if three times are negative, routine pregnancy test, if there is a positive RPR or TRUST, give 2 courses of standardized treatment, monthly titer follow-up.
4.TPPA positive, RPR or TRUST positive, given 2 courses of standardized treatment, monthly follow-up of RPR or TRUST titer.
II. Treatment plan for pregnant women with syphilis infection
Recommended regimen: Once the infection is detected, start treatment immediately and choose any of the following drugs.
1.Benzathine penicillin 2.4 million U, injected intramuscularly on both sides of the buttocks, once a week, 3 times in a row for a course of treatment.
2.Procaine penicillin G, 800,000 U daily, intramuscularly, for 15 consecutive days as a course of treatment.
Alternative regimen
1.For penicillin allergy, Ceftriaxone sodium, 1g daily, intramuscular injection or intravenous administration, for 10 consecutive days as a course of treatment.
2, penicillin allergy, available erythromycin treatment, 500mg, 4 times daily, oral, for 15 days as a course of treatment.
3. Tetracyclines, such as doxycycline and memantine, are prohibited.
Third, treatment precautions
1. Pregnant women with infection found in early pregnancy should have 1 course of treatment in early pregnancy and 1 course of treatment in late pregnancy, for a total of 2 courses.
2. Pregnant women with infection found in the middle and late pregnancy should be given 2 courses of treatment immediately, with an interval of more than 4 weeks between the 2 courses of treatment (at least 2 weeks), and the second course of treatment should be started in the late pregnancy, preferably completed one month before delivery.
3. A course of treatment should also be given immediately to infected mothers found at the time of delivery.
4. For those who have relapsed or re-infected during the course of treatment, an additional course of treatment should be given.
5. Pregnant women with previous infections should also be given a course of treatment in a timely manner.