Epidemiology: Stillbirths due to syphilis are now rare in industrialized countries, but are still a common cause in developing countries. And congenital syphilis remains a major problem in developing countries as well, with congenital syphilis ranking as the 4th or 5th cause of death for infants who die in the perinatal period in some African countries. In a study of pregnant women in Zambia, 43% of pregnant women who delivered stillbirths were seropositive for syphilis, and 19% of those who miscarried were seropositive for syphilis. Harter and Benirchke et al. observed that the fetus was infected as early as 9 weeks of gestation in untreated pregnant women with syphilis. In untreated pregnant women with first and second stage syphilis, almost 100% of the fetuses were infected and 50% of them had premature birth or perinatal death; in untreated pregnant women with early latent syphilis, 40% had premature birth or perinatal death; in untreated pregnant women with late syphilis, 10% of the infants had congenital syphilis and the perinatal mortality rate was increased about 10 times. Syphilis that is more than 2 years old is rarely transmitted sexually, but a woman with untreated syphilis can still infect her fetus within a few years. The proportion of fetuses infected and the severity of syphilis decreases as the duration of the disease increases. Despite this, untreated syphilis in pregnant women has a poor prognosis, and stillbirths, premature births and congenital syphilis can occur. Preventive measures: 1, detection of cases: congenital syphilis can be prevented by early prenatal diagnosis and treatment. Because women with early syphilis may not show signs and symptoms, serological testing is still the most useful test for screening and diagnosing syphilis. In order to detect and treat patients early, the Centers for Disease Control (CDC) recommends that syphilis serologic testing be performed on women at high risk during the initial prenatal visit, and then again in the late third trimester (28 weeks) and at the time of delivery. 2. Treatment: For positive syphilis serological screening test, quantitative [e.g. rapid plasma reactin ring card (RPR)] test and confirmatory test [e.g. fluorescent spirochete antibody absorption (FTA-ABS) or syphilis spirochete hemagglutination (TPHA) test] should be performed. The principles are: (1) pregnant women with a positive FTA-ABS test and no clear past history of regular (or adequate) treatment should be treated; (2) those with a recent history of sexual contact with a confirmed syphilis patient should be treated regardless of their serologic findings; (3) those who have received regular treatment without clinical or serologic evidence of recurrence may not be retreated; those with clinical or (5) The treatment of pregnant women with syphilis is generally the same as that of non-syphilitic pregnant women and is determined by the duration of infection and the presence or absence of neurological involvement. Some people are concerned that lumbar puncture may cause preterm labor, but it should be said that if the operation of lumbar puncture goes smoothly, it will not cause miscarriage. Premature labor can be induced in pregnant women who are treated for early syphilis and who develop a gi-hai reaction. In one report, 15 (65%) of 23 pregnant women with stage I and stage II syphilis had Gi-hai reaction, while none of the 10 pregnant women with latent syphilis had Gi-hai reaction. 67% of pregnant women with Gi-hai reaction had uterine contractions and reduced fetal activity or fetal distress was found during fetal monitoring. Therefore, some authors recommend that pregnant women with early syphilis beyond 20 weeks of gestation should be hospitalized at the start of anthelmintic treatment for close observation, fetal monitoring and obstetric management. After treatment, pregnant women with early syphilis should undergo quantitative serological examination once a month and should be retreated if the serum titer does not decrease 4-fold or increases 4-fold in 3 months.