The 3 stages of syphilis and it management during pregnancy
What is syphilis ?
Syphilis is a sexually transmitted infection (STI) caused by a type of bacteria. If left untreated, syphilis can have serious long-term consequences. Fortunately, if it is diagnosed in time, it can be treated with antibiotics.
It is transmitted by direct contact with a wound on an infected person. The most common way to contract syphilis is vaginal, anal, or oral sex. It is also possible to catch it by kissing someone with a syphilitic sore on or around the lips or in the mouth.
Syphilis can be transmitted to your baby through the placenta during pregnancy or through contact with an injury during birth.
What are the symptoms?
The infection progresses in stages, with symptoms that differ from one stage to another and from person to person. In some cases, the symptoms are not noticeable and you may not know that you have the disease until you are tested.
- The first step
In the first stage, known as primary syphilis, the characteristic symptom is a painless and highly infectious burn or sores with raised edges called chancre.
A Chancre appears on the site of infection, usually three weeks after you are exposed to the bacteria. This may also appear earlier or up to three months later. Because chancre can be inside your vagina or your mouth, you could never see it. A chancre could also appear on your lips, perineum, or anus. Your lymph nodes can be enlarged in the area where the pain develops.
If you get proper treatment at this stage, the infection can be cured. If you are not treated, the pain lasts for three to six weeks, then heals alone. However, bacteria (known as spirochaetes) are likely to continue to multiply and spread throughout the bloodstream. When this happens, the disease moves to the next stage, called secondary syphilis.
- Secondary stage
In the secondary stage, syphilis can present a variety of symptoms that appear in the weeks or months following the onset of the wound, but again, they may not be noticeable.
Most people with secondary syphilis develop an itchy rash, usually on their palms and soles. They can also appear on other parts of the body. You may also have some lesions in your mouth and vagina. As well as unwanted but infectious wounds in the genital area, flu-like symptoms, weight loss and hair loss. The infection is still curable with treatment at this stage.
Without treatment, the symptoms usually get lonely for a few months, but the infection remains in your body. The bacteria continue to multiply during this latent phase and can cause very serious problems years later.
- Tertiary stage
This late stage of the disease can develop up to 30 years after your first infection and can cause serious heart abnormalities. Life-threatening lesions can develop in your bones, on your skin and in a multitude of organs. Fortunately, most people are treated early enough nowadays that very few end up with tertiary syphilis.
How can syphilis affect my pregnancy and the health of my baby?
Syphilis can leave your bloodstream to the placenta and infect your baby at any time during pregnancy. It can also infect your baby during delivery. If your syphilis is detected and treated early, you and your baby will probably be healthy.
If you are not treated, your baby is very likely to become infected. The risk of transmission is higher if you are in the early stages of the disease. About 50% of pregnant women with untreated early syphilis end up with an infected baby. They can lose the baby in case of miscarriage, death at birth or shortly after birth. Or the baby can be born with serious neurological problems. It also increases the risk of premature strain and restriction of intrauterine growth.
Some infected babies whose mothers are not treated in time develop problems before birth. These can be seen on an ultrasound. It may be too large placenta, fluid in the abdomen and severe swelling, as well as an enlarged liver or spleen. An infected baby may have other abnormalities at birth. Rash and lesions around the mouth, genitals and anus; abnormal nasal secretions; pneumonia; and anemia.
Most babies do not have these symptoms initially, but without treatment, they develop in the first two months after birth. Babies born with syphilis may have more problems years later. It can cause bone and dental deformities, loss of vision and hearing, and other serious neurological problems.
Recommendation
It is essential that women be tested and treated during pregnancy. Any baby who may have syphilis at birth must undergo a full evaluation and be treated.