Pregnant patients with Syph. - samomcos

[ArchivalUser]

GenXraver notes say that pregnant pts with 2^syph can be given erythromycin...i thought they're only give Pn (after desensitizaation if needed)

[ArchivalUser]

sure can be given erytromycin, u can desensitize them and give pen but erthromycin is also safe.

[ArchivalUser]

nope...just chkd:

SUMMARY AND RECOMMENDATIONS ” Syphilis remains an important health concern for women, especially HIV-infected women, despite the availability of effective and inexpensive treatment. Failure to detect or adequately treat maternal disease often results in serious sequelae for the fetus and neonate. Penicillin remains the gold standard for the treatment of syphilis in both pregnant and nonpregnant patients. Penicillin desensitization is indicated for infected pregnant women with documented penicillin allergy.


¢Each stage of syphilis has characteristic clinical features that are not altered by pregnancy (table 2). (See 'Clinical manifestations' above.)


¢All pregnant women should be screened for syphilis (Grade 1B). (See 'Maternal screening' above.)


¢Vertical transmission of syphilis can occur at any time during pregnancy and at any stage of the disease. Treatment of maternal syphilis reduced the risk of congenital infection. The diagnosis of congenital syphilis requires a high index of clinical suspicion and confirmatory microscopic and/or serologic testing. Cord blood screening alone is not reliable as false negatives occur if the maternal titer is low or the mother was infected late in pregnancy. (See 'Perinatal transmission' above.)


¢Penicillin therapy is effective for treating maternal disease, preventing transmission to the fetus, and treating established fetal disease. (See 'Maternal treatment' above.)


¢We recommend that pregnant women with syphilis be treated with the appropriate penicillin regimen according to their stage of disease (Grade 1A). (See 'Maternal treatment' above.)


¢We recommend that penicillin-allergic pregnant patients with syphilis undergo desensitization followed by penicillin therapy, given that alternative drugs are not as safe and effective in pregnancy (Grade 1B). (See 'Penicillin allergy' above.)


¢Treatment of syphilis may precipitate the Jarisch-Herxheimer reaction, which may precipitate uterine contractions, preterm labor, and/or nonreassuring fetal heart rate tracing in pregnant women treated in the second half of pregnancy. We suggest supportive care of maternal discomfort and standard obstetrical management of pregnancy complications (Grade 2C). (See 'Jarisch-Herxheimer reaction' above.)


¢Nontreponemal antibody serologic titers are checked at 1, 3, 6, 12, and 24 months following treatment and should decrease four-fold by six months post-therapy and become nonreactive by 12 to 24 months. If titers show a four-fold rise or do not decrease appropriately, then treatment failure or reinfection is likely. We recommend retreatment of these women (Grade 1B). (See 'Follow-up evaluation' above.)

[ArchivalUser]

STDs in pregnancy can harm you and your developing baby, depending on the type of infection. If you suspect you have been exposed to a STD, be sure to tell your doctor immediately. Fast treatment is the best way to protect you and your baby.