As we all know, syphilis is a sexually transmitted disease, which is divided into dominant syphilis and recessive syphilis according to the presence or absence of clinical symptoms. The so-called recessive syphilis means that the patient does not have any clinical symptoms and is only found unintentionally during physical examination, while dominant syphilis, as the name suggests, has relevant clinical symptoms, mainly manifested on the skin, such as hard chancre (painless vulvar ulcers), generalized rash, which can mimic various skin diseases, the common ones are It can mimic various skin diseases, such as psoriasis, pityriasis rosea, nodular itchy rash, flat warts, worm-like alopecia, palmoplantar copper-red patches, and positive syphilis serologic test, whether recessive or dominant. The majority of the pregnancy syphilis seen clinically is latent syphilis, which is found during pregnancy checkups (nowadays, the four infectious diseases are routinely checked during pregnancy: AIDS, syphilis, hepatitis B, hepatitis C), and patients often do not have any symptoms and signs, and some patients are only found to be seropositive for syphilis when they go to the hospital because of frequent spontaneous miscarriages and stillbirths. With the abolition of marriage testing, the opening of the concept of sex, prostitution and prostitution, the prevalence of sexually transmitted diseases has become a serious social problem, in the clinic almost every day you can see two to three cases of pregnancy syphilis patients, and often the female side of the syphilis seropositive, while the male side is negative. They are often baffled by the fact that they are not “the kind of people who have sex outside”, so how could they have syphilis? “Why do I have it and my husband doesn’t? More often than not, pregnant patients are concerned about the impact on the baby in their womb. The following is a brief explanation of several issues of concern to patients: Question 1: What is the route of transmission of syphilis? The pathogen of syphilis is called pale spirochetes (TP), and syphilis is transmitted through three main routes: sexual transmission, blood transmission, and mother-to-child transmission. Ordinary contact such as shaking hands, kissing, sharing utensils and washing clothes together will not spread. Question 2: Why is it common for a pregnant woman to be seropositive for syphilis while her husband is seronegative for syphilis? This problem is also more difficult to explain, personally, I think that the pregnant woman may have been sick before, after regular treatment of syphilis, titer down, has been fixed serum, so the infectiousness is very low, because the infectiousness of syphilis with the extension of the infection time and decline, theoretically, after 4 years of infection TP infectiousness is already very low (not absolutely no infectiousness). There is also the phenomenon that there are also clinical false positive syphilis sera, most commonly in pregnant women, drug addicts, and the elderly, so perhaps patients suffer from false syphilis, or no STD at all, especially those with very low RPR titers. (Although there is a possibility of false positives, in the absence of a clear cause, the patient is treated as syphilis and treated with routine de-syphilization for safety) Question 3: What are the effects of syphilis combined with pregnancy? Combined syphilis in pregnancy, if left untreated, causes almost 100% of adverse consequences such as stillbirth, preterm delivery, miscarriage, fetal malformation, and fetal syphilis. If the syphilis is detected early and treated with conventional anthelmintic treatment, the likelihood of these adverse consequences is greatly reduced. Question 4: Do I need to terminate my pregnancy if I have syphilis in pregnancy? The answer to this question cannot be generalized. If the patient has a relatively low RPP titer (not higher than 1:8) and has undergone regular anthelmintic treatment in the first and last trimesters of pregnancy, a better pregnancy outcome is generally achieved. Patients are advised to think carefully about this. As a physician, you can only give a theoretical explanation and health education on the issues involved, but the decision to terminate the pregnancy should ultimately be made carefully by the patient. Question 5: What if the newborn baby is also seropositive for syphilis? Theoretically, if the fetus born to a pregnant woman who has undergone regular syphilis treatment is positive for RPR and positive for TPPA, the RPR titer is lower than the mother’s RPR titer, or only positive for TPPA and negative for RPR, and the child has no clinical manifestations of syphilis, it can be temporarily observed for six months to eight months, and generally after eight months, the TPPA and RPR will turn negative. However, clinically, if the baby born to a pregnant woman with syphilis has positive serum TPP and RPR, regardless of the titer, for insurance purposes, it should be treated with anti-syphilis.