Currently, the incidence of syphilis shows a growing trend and a rapid growth rate, the incidence rate in 2010 increased by 1.6 times compared to 2000, according to the analysis of 5 types of STD cases reported in 2010 at 65 personality monitoring sites in Guangzhou, syphilis accounts for more than 40% of the reported cases, among the various types of syphilis, women in their reproductive years, sexually active women (young women), the largest proportion of hidden syphilis, which determines the fetal transmission The trend of syphilis is also on the rise. Among pregnant women with untreated early syphilis, the fetal infection rate is about 80-95%, which can lead to miscarriage, premature birth, stillbirth, and congenital syphilis children. After 5 years of syphilis infection in pregnant women, intrauterine infection is unlikely, and after 8 years, there is basically no infectivity. How to confirm the diagnosis of syphilis infection in pregnant women: As long as the blood test is positive for TPPA (confirmatory test for syphilis), the diagnosis is completely confirmed regardless of the RPR and TRUST titers. How to interrupt mother-to-child transmission: The principle is to treat the infection whenever it is detected, even if it is detected at the time of delivery. Preferred regimen: benzathine penicillin 2.4 million units by intramuscular injection on both sides of the buttocks, once a week for 3 times. Recommended regimen: procaine penicillin G 800,000 units/day, intramuscularly for 15 days. All women must also be treated with another course of treatment in late pregnancy (28 weeks of pregnancy and beyond), preferably at least 4 weeks between treatments (at least not less than 2 weeks). How to judge the effect of treatment: As long as the infection of syphilis, lifelong TPPA is positive, rarely turn negative. Therefore, when penicillin is applied to treat syphilis, the efficacy is evaluated based on the level of decrease in RPR/TRUST titers. If the RPR/TRUST titer drops by 2 standard deviations or less after 4 weeks of penicillin treatment, the treatment is effective (e.g., the RPR titer before treatment is 1:64, and after treatment the titer drops to 1:16 or less). Has syphilis combined with pregnancy infected the fetus? This is the most important question, which can be judged from the following aspects: 1) those who have been cured of syphilis before pregnancy; 2) those who have been infected with syphilis for more than 8 years; 3) those who have been detected before 24 weeks of pregnancy and underwent regular anthelmintic treatment; 4) those who are positive for TPPA but negative for RPR/TRUST; 5) those who started regular anthelmintic treatment after syphilis was detected during pregnancy and underwent another treatment in late pregnancy . In the above five cases, the chance of fetal infection is very small. If ultrasound examination during pregnancy reveals: 1) excessive amniotic fluid; 2) fetal ascites or even generalized edema (edematous child); 3) fetal hepatosplenomegaly; 4) multiple fetal malformations, it indicates that the fetus is infected with congenital syphilis and it is recommended to induce labor. How to determine whether the fetus is infected at birth (neonate): laboratory diagnosis is the indicator to confirm the diagnosis, if the fetal cord blood RPR is 4 times higher than that of the mother, or the neonate cerebrospinal fluid examination for lymphocytes ≥ 10×106/L; protein > 50mg/dl, the diagnosis can be confirmed. If the newborn is found to have persistent nasal congestion for 3 months after birth (syphilitic rhinitis); 2. crying at the slightest tug on the limbs, pain, pressure and swelling of the limbs (syphilitic chondromalacia); 3. pyknotic swelling of the fingers (syphilitic dactylitis); 4. peeling, papules and rashes on the head, face or limbs (syphilitic dermatitis); 5. old perianal radiolucency, dry and wrinkled skin like an old man; 6. apathy The patient should be able to see the symptoms of the disease, such as a lack of expression (juvenile paralytic dementia); 7. Abnormal newborn hearing screening (neurological deafness); 8. Loss of hair, eyebrows and eyelashes. If two or more of the above symptoms are present, most of them have been infected with congenital syphilis. What to do for newborns after birth? Newborns who have been diagnosed with congenital syphilis should be treated as soon as possible after birth (within 7 days). Procaine penicillin 50,000 units (kg?d), intramuscularly, for 15 days. If the diagnosis is not fully confirmed, but it cannot be ruled out whether there is an infection, such as a neonate with 2X < RPR titer < 4X and no obvious syphilis symptoms, it is recommended that benzathine penicillin 50,000 U/kg?d be given once intramuscularly. It should also be noted that: 1. It is very important to draw cord blood for RPR when the placenta and umbilical cord are delivered; 2. Normally breast milk does not contain syphilis spirochetes, so breastfeeding will not transmit syphilis, but if the nipples are cracked, there may be a small amount of syphilis spirochetes in the milk (not enough to cause infection), so you can wait for the nipples to recover before breastfeeding; 3. Husbands or sexual partners must be examined and treated at the same time; 4. During the treatment of syphilis deworming in pregnancy, the toxins released due to the large number of syphilis spirochetes killed will cause the body to react with fever, such as high body temperature, which may lead to intrauterine death of the fetus. 5. If you take Chinese herbal medicine Fu Zheng Detoxification Soup at the same time of syphilis deworming treatment, it will be easier to expel toxins and reduce fever.