However, heart problems, central nervous system damage, blindness, and even death may take place during this stage. Transmission is most likely to occur during the first year of infection. An infection that has persisted for more than four years is rarely communicable. The exception is an untreated pregnant woman who may transmit syphilis to the fetus regardless of the duration of her disease. A dark-field examination of all genital ulcerative lesions can also be useful.
Intramuscular penicillin is the preferred drug for treatment of all stages of syphilis.
Adequate treatment for the mother early in pregnancy can prevent infection of the fetus. Spontaneous abortion or stillbirth. This is a very serious condition that can result in the death of the infant, or in serious and permanent damage to the infant. Regular examinations for sexually transmitted diseases are advised when unprotected sex is practiced. Patients should avoid sexual intercourse until therapy is completed by both themselves and their sexual partners to minimize the risk of reinfection.