Treatment to prevent congenital syphilis is considered adequate if it is initiated 30 days before delivery. This regimen prevents congenital syphilis.
Additionally, the pregnant woman must receive treatment based on the staging of the case:
Primary, secondary, and early latent syphilis:
■ 1 dose of benzathine penicillin (2,400,000 IU IM).
Syphilis of unknown duration, late latent, and tertiary syphilis:
■ 3 doses of benzathine penicillin (2,400,000 IU IM), with one-week intervals between doses.
To evaluate treatment response and monitor for reinfection, the pregnant woman is followed up using non-treponemal tests (NTT). The evaluation and treatment of sexual partner(s) are of particular importance.
Order an NTT 4–8 weeks after treatment completion, followed by an NTT every 8 weeks. A change in titers (whether a decrease or an increase) is considered significant when it exceeds 4 titers or 2 dilutions.
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