Recently, many patients have asked about syphilis in pregnancy, plus our hospital is located in the southwest, there are many patients from rural areas, in the consultation also found that many pregnant women from the primary hospital examination found positive RPR, they are injected with 5 or even 10 or more times of benzathine penicillin sodium intramuscularly, mainly to bring great psychological pressure to the patient, and there may be false positives in it, so the correct diagnosis is very necessary to to avoid unnecessary treatment. How to diagnose accurately? It should be carried out according to the “Latest STD Treatment Standards and Recommended Program for STD Treatment” issued by the Ministry of Health in 2000. First of all, all normal pregnant women should be screened for syphilis serology once at the first prenatal checkup, once at 28-32 weeks of gestation and once before delivery. If RPR is found to be positive, it is best to repeat the test again and a confirmatory test (including titer test) can be performed with a detailed history, as well as relevant tests on the husband to clarify the diagnosis. If the pregnant woman is serologically positive for syphilis and syphilis cannot be ruled out, even if anti-syphilis treatment has been performed in the past, anti-syphilis treatment should be done again in order to protect the fetus. If a pregnant woman with syphilis is already receiving regular treatment and follow-up at the time of pregnancy, no further treatment is necessary. If there are doubts about the last treatment and follow-up or if the current examination reveals signs of syphilis activity, a further course of treatment should be given. Specific treatment regimen: Early syphilis (stage I syphilis, stage II syphilis and early latent syphilis) and late syphilis (except cardiovascular syphilis and neurosyphilis) are given benzathine penicillin 2.4 million U, intramuscularly, once/week, 4 times. For those who are allergic to penicillin, erythromycin is used as treatment (the infant born should be treated with penicillin supplement). If necessary, increase the course of treatment. The use of potentin or tetracycline is contraindicated. A course of treatment is required in the first and last trimesters of pregnancy. Pregnant women with syphilis need to have a quantitative non-spirochete serologic test once a month until delivery in order to monitor changes in their condition. Patients should be informed that pregnant women may experience a gi-hai reaction during treatment, which can lead to intrauterine distress and preterm delivery. Treatment should not be discontinued due to the development of Gi-Hai reactions.