Syphilis is a treponemal infection that can be acquired sexually, hematogenously, or via vertical transmission from mother to infant. Despite evidence-based curative treatment options with penicillin, it remains a public health threat with increasing prevalence over recent years. Congenital syphilis, a condition where a fetus acquires the infection during pregnancy, can lead to stillbirth, miscarriage, preterm birth, birth defects, and lifelong physical or neurologic changes. Congenital syphilis rates in the United States increased by 261% from 2013 to 2018 and continue to increase in 2021. The only recommended treatment for syphilis in pregnancy is benzathine penicillin G because evidence of decreased risk of congenital syphilis with other modalities is lacking. Testing for syphilis is complex and includes either the reverse-sequence algorithm or the traditional algorithm. Determination of the clinical stage of syphilis includes incorporation of the previous treatment sequence and physical examination. The goal of this review was to discuss the current evidence about optimal treatment and testing during pregnancy to optimize maternal health and prevent congenital syphilis.

梅毒是一种密螺旋体感染，可通过性传播、血源性传播或母婴垂直传播获得。尽管有基于证据的青霉素治疗选择，但它仍然是一个公共卫生威胁，近年来流行率不断上升。先天性梅毒是胎儿在怀孕期间感染的一种疾病，可导致死产、流产、早产、出生缺陷以及终生的身体或神经系统变化。美国的先天性梅毒发病率从 2013 年到 2018 年增加了 261%，并在 2021 年继续增加。唯一推荐的治疗妊娠期梅毒的药物是苄星青霉素 G，因为缺乏其他方法降低先天性梅毒风险的证据。梅毒检测很复杂，包括逆序算法或传统算法。梅毒临床分期的确定包括结合以前的治疗顺序和体格检查。本综述的目的是讨论有关妊娠期最佳治疗和检测以优化孕产妇健康和预防先天性梅毒的当前证据。