A 32-year-old woman at 12 weeks of gestation has routine booking bloods showing positive Treponema pallidum antibodies. She was treated for syphilis 4...

Question

A 32-year-old woman at 12 weeks of gestation has routine booking bloods showing positive Treponema pallidum antibodies. She was treated for syphilis 4 years ago with intramuscular benzathine benzylpenicillin and believes she was cured. Her RPR titre is now 1:2. Which is the single most appropriate action?

Accepted Answer

Refer urgently to GUM to assess treatment adequacy, confirm no reinfection, and consider retreatment in pregnancy

Answer

No treatment needed as she was previously treated and the low RPR titre indicates past infection

Answer

Prescribe oral amoxicillin for 14 days

Answer

Repeat serology at 28 weeks

Answer

Reassure that low titre syphilis is not harmful in pregnancy

uk-drcog MCQ (SBA): Previously Treated Syphilis in Pregnancy