Preventing CS begins with routinely screening sexually active individuals for syphilis and other STDs. Ideally, any sexually active female of child-bearing age should be tested and treated for any STDs.  Partners should be tested and treated to avoid re-infection.

• CDC-Diagnosis and Treatment Guidelines for Adults

In Texas, providers who care for pregnant women must test them for syphilis at three times: their first prenatal visit, during the third trimester (between 28 and 32 weeks), and at delivery. How syphilis is treated depends on what stage of the disease the woman has, so it is important for doctors to carefully check and follow the right steps. Women should also get tested for other sexually transmitted diseases (STDs) that could make pregnancy or birth harder for both mother and baby. 

• Texas law testing during pregnancy
• Syphilis, HIV, and Hepatitis B Testing and Pregnancy | Texas DSHS

If a woman gives birth in Texas and there is no record of syphilis testing, or had a positive test for syphilis, the baby is evaluated for syphilis.  Because a baby can have syphilis but not have any visible symptoms, this evaluation is important.

• Diagnosis and Treatment Guidelines for Pregnancy

Syphilis is a complicated disease with different diagnostic tests and  stages. Treatment can vary by stage.  For this reason, many clinicians find the following visual aids helpful:

• Provider Management of Syphilis to Prevent Congenital Syphilis
• American College of Gynecologists Syphilis Screening Algorithm

For questions on diagnosis and treatment of infants exposed to syphilis, refer to the American Academy of Pediatrics (AAP) Red Book: 

• Red book syphilis chapter – For an interactive algorithm for diagnosing infants exposed to mothers with reactive serologic tests scroll  to “View the Interactive Syphilis Algorithm”
• CDC Congenital Syphilis Evaluation and Treatment Guidelines

Clinicians classify babies exposed to syphilis into five categories based on mother’s and baby’s test and physical examination results:

• Confirmed
• Highly Probable
• Possible
• Less Likely
• Unlikely

Treatment is determined by these categories. The AAP provides a visual representation for staging the infant’s syphilis status and providing treatment recommendations.

Review the AAP Congenital Syphilis Evaluation and Treatment Guide to highlight a treatment. Scroll past the table and use the “Choose One” buttons to select a condition.