Ask the Doctor

Hello Doctor, My husband is suffering from syphilis, however we found out after I was already 3 months pregnant. I am now worried about my baby. Will it also be born with that STD? Is there anything I can do to protect my unborn from getting infected within the womb? Josephine, 29, Nyamirambo resident Dear Josephine I am sad about your state of affairs. I presume that right now you have not developed symptoms of syphilis as you have not specified it. Once somebody is infected by syphilis, there may be no manifestations initially. After about 2 -3 weeks or longer, there may be an ulcer with hard margins on the private parts. There are also painless small swellings in the groin due to lymph node enlargement. In case of oral or anal sex, this ulcer may appear on the tongue or anus. After about a month or so, these microbes spread through blood in other parts of body. This causes rashes in other moist parts like tongue, palm, armpits, etc, and generalized lymph node enlargement. Untreated, after 8 -10 years or so, the disease also damages the heart and nervous system. Throughout all these phases, one is capable of transmitting the disease to others. Having syphilis makes one more vulnerable to acquire other sexually transmitted diseases and HIV/AIDS. If a woman is pregnant with syphilis, the germs pass through the mother to the baby through the placenta and also due to direct contact during delivery. During pregnancy there can be abortion, intrauterine growth retardation and death of the baby due to syphilis. If the child is born he is prone to multiple health problems and physical defects known as stigmata of congenital syphilis. These include large maxillary bones, undue prominence of frontal bones, forward enhancement of shin bone, large liver and spleen, heart problems, etc. Some of these abnormalities can be seen on ultra sound done during pregnancy, thus giving a clue to the infection. At times vaginal delivery is avoided to minimize risk of infection to the child. Diagnosis is via tests demonstrating the germs in blood or fluid from the ulcer. Blood tests showing antibodies against syphilis are also used for testing when there is doubt. Treatment is by penicillin in doses depending on the stage of the disease. It is prudent to avoid syphilis. One should avoid sex with any partner having sores or ulcers over private parts. Condoms are not fully effective in preventing it, unless they cover the entire penis. Ideally if one has syphilis, they should avoid sex till it is completely cured to avoid infecting others. Every pregnant woman is recommended to be tested for syphilis. In early infection, the test may be negative. Therefore it is important to repeat the test again after 4 weeks or so, then at 28 weeks and even before delivery. Any time the test is positive, treatment should be by penicillin in doses depending on the stage of the disease. Dr. Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital.