Diagnostic evaluation of syphilis during pregnancy

Obstetric patients with serologic evidence of syphilis should have cerebrospinal fluid (CSF) analysis to determine the presence of tertiary disease. In the present study, 19% of untreated and asymptomatic patients with serologic evidence of syphilis were found to have tertiary syphilis following examination of CSF. Despite maternal therapy, 11% of the infants born to mothers with syphilis had reactive serum and CSF involvement as documented by the presence of a fluorescent treponemal antibody absorption (FTA-ABS)-specific IgM.