Syphilis and pregnancy

Syphilis is a sexually transmitted infection (STI) caused by a bacterium called Treponema pallidum.

If syphilis is found early, it can be easy to treat. If you don't get treatment, it can cause some serious health problems.

There are four different stages of syphilis:

• primary — when you first get symptoms
• secondary — when you've had syphilis for at least 4 weeks
• latent — when you have syphilis with no symptoms
• tertiary — late stage of syphilis

If you get syphilis while you are pregnant, it can spread to your baby via the placenta or at birth. This is called congenital syphilis.

Syphilis can cause serious health problems for your baby. It can also stop your baby from growing normally during pregnancy.

You have the highest chance of passing it to your baby if you have primary or secondary stage syphilis.

The symptoms of syphilis are different at each stage of the infection.

Primary syphilis

Symptoms of primary syphilis begin to show between 10 to 90 days after infection.

• mouth
• anus
• penis
• vagina
• cervix

You may also have swollen lymph nodes in your groin area.

Secondary syphilis

Symptoms of secondary syphilis begin to show between 28 to 70 days after infection.

Common symptoms are a rash on:

• your palms
• the soles of your feet
• your chest
• your back

Other symptoms can be:

• white or grey sores on your mouth or genitals
• fever
• fatigue (feeling very tired)
• headache
• swollen glands in your armpit or groin
• hair loss

Latent syphilis

You can have latent syphilis with no symptoms. This means you can have syphilis and not know you have it until you get tested. It might happen when you have previously been treated for syphilis, but it comes back.

If latent syphilis is not treated, it can progress to tertiary syphilis.

Tertiary syphilis

If you have syphilis and don't get treatment it can turn into tertiary syphilis. Symptoms of tertiary syphilis start to appear years after getting infected.

You may have neurological (brain and nerve) symptoms such as:

• headaches
• difficulty coordinating movements
• paralysis
• numbness
• dementia

Other symptoms of tertiary syphilis can be:

• heart disease
• blindness
• soft growths (gummas) that appear on your skin, bones or organs

You can get syphilis from unprotected vaginal, anal or oral sex.

Your baby can catch congenital syphilis during pregnancy through the placenta or during birth.

Some less common ways of catching syphilis can be:

• contact with contaminated blood
• sharing syringes
• needle-stick injury
• contact with the sores of an infected person

If you are pregnant and think you may have been exposed to syphilis, see your doctor or midwife as soon as possible.

To find out if you have syphilis, your doctor or midwife will:

• ask about your medical history
• check your symptoms
• refer you for a blood test
• take a swab from a sore (wound)

Your doctor or midwife may also recommend you get tested for other STIs and HIV.

If you are pregnant and diagnosed with syphilis, your doctor or midwife may recommend more testing:

• 8 weeks after treatment
• at 28 to 32 weeks of pregnancy
• at birth

Routine antenatal screening

Pregnant women are routinely offered screening tests for syphilis.

If you are pregnant, it is recommended that you be screened:

• before 10 weeks (during your confirmation of pregnancy or first antenatal appointment)
• between 26 to 28 weeks of pregnancy
• at 36 weeks of pregnancy or birth (whichever is earlier)

If you have been diagnosed with syphilis during your pregnancy, your doctor will prescribe you antibiotics. You will need 2 doses of penicillin by injection. The doses are given 7 days apart.

If you have a penicillin allergy, you may need to see an infectious disease specialist to get a treatment that is suitable for you.

You may need a follow up appointment 3, 6 and 12 months after getting treatment.

Contact tracing

Contact tracing is when you work out who you may have been infected by, and if you could have passed on the infection. Your doctor will ask about people you've had sexual contact with. If you are diagnosed with syphilis, your doctor will recommend that your previous sexual partners get tested for syphilis.

Your doctor can offer advice on how to tell your previous sexual partners. Your doctor can also help you to tell them anonymously if you prefer.

Contact tracing can let others know they should get tested. It helps stop the spread of syphilis.

Getting syphilis during pregnancy is very serious. If left untreated it can lead to miscarriage or stillbirth.

Congenital syphilis

When your baby is born, they might have symptoms of congenital syphilis:

• premature birth or low birth weight
• enlarged liver and spleen
• jaundice
• dental and skeletal abnormalities
• central nervous system disease
• neurological problems
• hearing loss

Your baby can also get a rash on their skin and in their mouth.

These symptoms usually show up in the first 8 weeks of life, but they can also happen later in childhood.

Early neurosyphilis

Anyone with untreated syphilis can get early neurosyphilis. This is when the untreated syphilis infection has progressed to an infection of the central nervous system. Symptoms of early neurosyphilis can be:

• changes in vision
• tinnitus
• deafness
• cranial nerve palsies
• meningitis

There is no vaccine against syphilis.

You can protect yourself and your baby from syphilis by:

• getting regular STI checks
• avoiding sexual activity with someone with symptoms
• having safe sex by using barrier contraception such as a condom
• getting tested for syphilis if you're pregnant

The best way to protect your baby from syphilis is to get tested at least 3 times during your pregnancy and get treatment if needed.

Read more about having safe sex while pregnant.

If you have had syphilis and recovered in the past, you can still get it again.

Speak to your maternity care provider for more information about syphilis and pregnancy.

Sexual Health Quarters has information and support about STIs and how to get tested.

Languages other than English

Talk. Test. Treat. has information about different STIs including syphilis in languages other than English.

Information for Aboriginal and/or Torres Strait Islander peoples

Family Planning Australia has resources about how STIs are spread and their symptoms for Aboriginal and Torres Strait Islander people.

The Department of Health, Disability and Aging has more information and support about syphilis for Aboriginal and Torres Strait Islander peoples.