Maternal syphilis: pathophysiology and treatment

Bull World Health Organ. 2004 Jun;82(6):433-8.


Despite the long history of medical interest in syphilis and its effects on pregnancy outcome, many fundamental questions about the pathophysiology and treatment of syphilis during pregnancy remain unanswered. However, understanding has been advanced by recent scientific reports such as those which delineate the complete sequence of the genome of the syphilis spirochaete, provide a more precise description of fetal and neonate infection by use of rabbit infectivity tests and describe the gestational age distribution of fetal death secondary to syphilis. It appears that fetal syphilitic involvement progresses in a rather predictable fashion, and although there is disagreement about the optimal prenatal treatment regimen, programmatic efforts to prevent fetal death must provide seropositive pregnant women with a recommended treatment early in pregnancy, and certainly before the third trimester.

Publication types

  • Review

MeSH terms

  • Female
  • Fetal Death / etiology
  • Fetal Death / prevention & control
  • Fetal Diseases / microbiology
  • Gestational Age
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control
  • Penicillin G Benzathine / administration & dosage
  • Penicillin G Benzathine / therapeutic use
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Pregnancy Complications, Infectious / physiopathology
  • Prenatal Care
  • Syphilis, Congenital / drug therapy*
  • Syphilis, Congenital / physiopathology
  • Treponema pallidum / drug effects
  • Treponema pallidum / isolation & purification
  • Treponema pallidum / pathogenicity


  • Penicillin G Benzathine