12-05-2010, 05:56 PM
. A 20-year-old woman returns to the office for the results of her prenatal laboratory studies. By date of her last menstrual period she is 14 weeks pregnant with her second child. Her first pregnancy, which you followed, resulted in an uncomplicated vaginal delivery approximately 11 months ago. Her prenatal serology screening for syphilis is positive with a titer of 1:126, and a fluorescent treponemal antibody absorption (FTA-ABS) test is positive. The patient denies having lesions consistent with syphilis, and her current physical examination shows no lesions. Serology during her first pregnancy was negative. At this time, which of the following is the most appropriate management?
A
) Do an amniocentesis to obtain fluid for darkfield evaluation
B
) Follow the treatment regimen recommended for primary or secondary syphilis
C
) Postpone treatment until the patient is at least 20 weeks pregnant
D
) Schedule a lumbar puncture before instituting treatment
E
) Withhold treatment until further studies rule out a biologic false-positive
A
) Do an amniocentesis to obtain fluid for darkfield evaluation
B
) Follow the treatment regimen recommended for primary or secondary syphilis
C
) Postpone treatment until the patient is at least 20 weeks pregnant
D
) Schedule a lumbar puncture before instituting treatment
E
) Withhold treatment until further studies rule out a biologic false-positive