A. Must a pregnant woman with syphilis give birth to a baby with congenital syphilis? If a pregnant woman has syphilis, the syphilis spirochete can enter the fetus through the placenta and cause fetal infection in the womb. The placenta is formed by the fourth month of pregnancy and the fetus is susceptible to infection, but not before. On the other hand, the placenta is invaded by the spirochete and becomes inflamed, resulting in necrosis of the placental tissue and denial of nutrition to the fetus. Generally speaking, the shorter the duration of syphilis infection, the greater the chance of transmission to the fetus and the more severe the symptoms. If a pregnant woman has been infected with syphilis for more than 3 years, she may still deliver a normal baby, although untreated or untreated. If a pregnant woman with syphilis receives regular anti-syphilis treatment before or during pregnancy, it is completely possible to prevent the birth of a baby with congenital syphilis. Second, what are the pregnancy outcomes for pregnant women with syphilis? If a pregnant woman with syphilis does not receive anti-syphilis treatment, her pregnancy will result in the following four outcomes: (1) miscarriage, which occurs in the fifth to seventh month of pregnancy, with syphilis lesions in the fetal organs; (2) premature birth, with a dead or live baby with syphilis lesions; or a live baby born without syphilis symptoms at the time, but symptoms will appear soon; (3) normal delivery, with a full-term normal delivery, with a baby born with congenital syphilis, which can develop syphilis symptoms within one to two months after birth. ～(4) A healthy baby is born and no symptoms of syphilis appear later. Therefore, it is possible for a pregnant woman with syphilis to give birth to a completely normal and healthy baby, mainly in the case of a pregnant woman with advanced syphilis or congenital syphilis.