GIHAY REACTION is an acute metabolic reaction that occurs after treatment with anti-syphilis drugs. It is characterized by fever, chills, body discomfort, headache, muscle aches, aggravation of the primary rash and arthritis. It can also occur in some patients with gestational syphilis after initial treatment, and its main risk is premature delivery, intrauterine asphyxia, and even stillbirth. In patients with cardiovascular syphilis, exacerbation of heart failure can occur, and some patients may suffer sudden death due to rupture of the aortic aneurysm. Although the gihai reaction is self-limiting and usually resolves spontaneously within 24 hours, symptomatic management is required. In particular, for neurosyphilis and cardiovascular syphilis, oral prednisone 30-60 mg per day for 3 days prior to treatment and anti-syphilis medication on day 3, followed by a gradual reduction of the drug dosage by 10 mg per day. for patients with gestational syphilis beyond 20 weeks, intensive observation and close monitoring of fetal related indications are required, and when signs of intrauterine distress appear, it is necessary to In case of intrauterine distress, termination of pregnancy by caesarean section should be carried out in a timely manner.