Prenatal Syphilis Screening: Identification of Population Risks

Abstract

Syphilis remains a leading cause of maternal and neonatal morbidity worldwide. Screening of pregnant women is an important preventative health measure, as maternal and neonatal effects are preventable if identified early. All patients receiving prenatal care at National Naval Medical Center have a rapid plasma reagin (RPR) test performed at their initial obstetric visit, in accordance with the Centers for Disease Control (CDC) guidelines and the Public Health Service Expert Panel on the Content of Prenatal Care. At the 28 week visit, this test is repeated. To better direct screening of our patient population, which is similar to other military and civilian institutions, the following study examines syphilis screening of all patients who delivered at National Naval Medical Center from February 1996 until July 1996. No patient had a positive RPR titer during this period. This study supports the CDC recommendation that RPR titers do not need to be repeated at the week 28 visit in a low-risk population. This study is pertinent to military and civilian hospitals changing to a TRI care or other HMO-based system, where observation of population risk will better direct the effectiveness of screening programs.