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Physiology in childbearing (Stables and Rankin, 2017 edition)

Medical disorders in pregnancy: a manual for midwives (Robson and Waugh, 2013) table is from here.

Sexually transmitted diseases, prevention and control (Lawrence and Rosenthal, 2013)

Reported Estimates of Adverse Pregnancy Outcomes among Women with and without Syphilis: A Systematic Review and Meta-Analysis (Qin, Yang et Xiao, 2014)

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Public Health England. (2016). NHS infectious diseases in pregnancy screening programme

standards 2016 to 2017. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529070/IDPS_Programme_Standards_2016_to_2017.pdf

Stanberry, L. R., & Rosenthal, S. L. (2013). Sexually transmitted diseases vaccines, prevention and control (2nd ed. ed.). GB: Academic Press. Retrieved from http://replace-me/ebraryid=10607278

Varma Rick, Escort Claudia, & Mindel Adrian,. (2013). Sexually transmitted diseases (2nd ed.) Elsevier.

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PRIMARY:
-lesions, may be asymptomatic

SECONDARY:
-lesions may become painful
-malaise
-headache
-myalgia
-sore throat
-some may develop a rash, pale pink becoming darker
-alopecia in late stage

(Stanberry  et al, 2013)

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Risk of contracting HIV.

Adverse pregnancy outcomes are 12 times more likely in those infected with the disease including early fetal loss or stillbirth (21%), neonatal death (9%), low birth weight or premature birth (6%), and infection in a live-born infant (15%), and among untreated pregnant women with syphilis, fetal loss and stillbirth were 21% more frequent, neonatal deaths were 9.3% more frequent and prematurity or low birth weight were 5.8% more frequent than among women without syphilis.

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Transmission and who is most at risk? A bacterial infection, the organism enters the body through a break in the skin or mucous membrane. In men the infection is usually in the penis while the woman’s infection is usually hidden in the cervix or vagina. The infection is transmitted by sexual activity and the risk of transmission with an infected person is 30%. The organism multiplies at the entry site and causes localised infection and a generalised skin rash, but can spread to the whole body.More common with people infected with HIV. African American women represent the most high demographic of those infected. Prostitutes or those exchanging cash for sex. Uninsured or low income women are at risk and those diagnosed with another STD in pregnancy. The infection can be transmitted across the placenta to cause congenital syphillis in the newborn. 

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Transmission and who is most at risk? A bacterial infection, the organism enters the body through a break in the skin or mucous membrane. In men the infection is usually in the penis while the woman’s infection is usually hidden in the cervix or vagina. The infection is transmitted by sexual activity and the risk of transmission with an infected person is 30%. The organism multiplies at the entry site and causes localised infection and a generalised skin rash, but can spread to the whole body.More common with people infected with HIV. African American women represent the most high demographic of those infected. Prostitutes or those exchanging cash for sex. Uninsured or low income women are at risk and those diagnosed with another STD in pregnancy. The infection can be transmitted across the placenta to cause congenital syphillis in the newborn. 

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Current practice guidelines recommend that all pregnant women are offered screening for syphilis early in pregnancy alongside the other antenatal booking blood tests as part of the Infectious Diseases in Pregnancy Screening Programme (Public Health England, 2016). Guidelines also suggest that the screening should be repeated between 26-28 weeks for every woman.

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The infection is caused by a bacterium called Treponema pallidum. Initially the organism causes local infection at the site of invasion; however, the infection can spread throughout the body. Sexually transmitted syphilis is known as ‘acquired syphilis’ whereas transmission from mother to fetus is known as ‘congenital syphilis’.(Varma et al, 2013).