Syphilis Screening in Pregnancy: Complete Guide
Syphilis screening is a routine part of NHS antenatal care, offered to every pregnant woman as one of several infection screens at the booking appointment. It's easy to overlook among the many tests offered early on, but it matters because syphilis is treatable, and picking it up early protects both you and your baby.
Why syphilis is screened for in pregnancy
Syphilis is a bacterial infection that's usually passed on through sexual contact. Left untreated during pregnancy, it can be passed to the baby (known as congenital syphilis) and, in some cases, is associated with serious complications, including miscarriage, stillbirth, or health problems in the newborn. Because it can be present without obvious symptoms, screening every pregnant woman — rather than only those thought to be at higher risk — is the approach used across the UK to catch cases that would otherwise go unnoticed.
What the test involves
- Syphilis screening is done using a simple blood sample, taken alongside your other booking bloods (which also screen for things like HIV, hepatitis B, and blood group)
- This is usually done at your booking appointment, ideally by around 10 weeks, though it can be done later if needed
- No special preparation is required beforehand
- Results are usually available within a week or two, and your midwife or GP will let you know if any follow-up is needed
- A positive screening result doesn't necessarily mean an active infection — further blood tests are used to confirm the diagnosis, as screening tests can occasionally give a false positive
If your result needs follow-up
If your initial screen suggests possible syphilis, you'll be referred for further blood tests and a review with a specialist, usually in genitourinary medicine (GUM) or sexual health services, to confirm the diagnosis and plan treatment. If syphilis is confirmed:
- It's treated with a course of antibiotics — usually penicillin, which is considered safe and effective in pregnancy
- Prompt treatment significantly reduces the risk of the infection passing to the baby
- Your partner may also be offered testing and treatment where appropriate
- You'll usually have extra monitoring for the rest of your pregnancy to check the treatment has worked and that your baby is doing well
Being told you need further tests can feel worrying, but syphilis is one of the more straightforward infections to treat effectively once identified, which is exactly why the screening programme exists.
Frequently Asked Questions
Is syphilis screening compulsory in pregnancy?
Screening is offered to every pregnant woman in the UK as part of routine antenatal care, but like all antenatal screening, it's your choice whether to accept it. Your midwife will explain what the test involves so you can make an informed decision, and you can ask questions at any point.
What happens if I test positive for syphilis while pregnant?
A positive initial screen is followed by confirmatory blood tests. If syphilis is confirmed, you'll be treated with antibiotics (usually penicillin), which is safe and effective in pregnancy, and you'll have extra monitoring afterwards. Early treatment greatly reduces the risk of the infection affecting your baby.
Can syphilis screening give a false positive result?
Yes, occasionally an initial screening test can come back positive when no active infection is actually present, which is why any positive screen is always followed up with further, more specific blood tests before a diagnosis is confirmed. Try not to worry before you've had the follow-up results, and speak to your midwife if you have questions.
This article is for general information only and does not replace advice from your midwife, GP, or the antenatal team caring for you.
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