Congenital syphilis (CS) rates reached a 20‐year high in the United States in 2018. Unlike previous years, most babies diagnosed with CS were born to mothers who received prenatal care, indicative of the need for better provider education and guideline adherence. Current rates suggest that screening for syphilis should be performed at the first prenatal care visit and twice during the third trimester. There are two diagnostic algorithms available for use in the United States (traditional and reverse) and providers must understand how to perform each algorithm. Treatment should be administered according to stage of syphilis per Centers for Disease Control recommendations with best neonatal outcomes seen when treatment is initiated >30 days before delivery. Benzathine Penicillin G remains the only recommended treatment of syphilis during pregnancy. In viable pregnancies, a pretreatment ultrasound is recommended to identify sonographic evidence of fetal infection and treatment should be initiated with continuous fetal monitoring to evaluate for the Jarisch‐Herxheimer reaction which can cause preterm labor and fetal distress. After adequate syphilotherapy, a fourfold decline in maternal nontreponemal titers may not be observed by delivery and does not correlate with rates of CS.

中文翻译：

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先天性梅毒：一种古老疾病的当代更新。

2018 年美国先天性梅毒 (CS) 发病率达到 20 年来的最高水平。目前的比率表明，梅毒筛查应在第一次产前检查时进行，并在妊娠晚期进行两次。在美国有两种诊断算法可供使用（传统和反向），提供者必须了解如何执行每种算法。治疗应根据疾病控制中心建议的梅毒分期进行，在分娩前 30 天开始治疗时可观察到最佳新生儿结局。苄星青霉素 G 仍然是唯一推荐的妊娠期梅毒治疗方法。在可行妊娠中，建议进行预处理超声以识别胎儿感染的超声证据，并应在持续胎儿监测的情况下开始治疗，以评估可能导致早产和胎儿窘迫的 Jarisch-Herxheimer 反应。充分梅毒治疗后，分娩时可能不会观察到母体非密螺旋体滴度下降四倍，并且与 CS 发生率无关。