Pregnant women and their sex partners should be questioned about STDs and should be counseled about the possibility of perinatal infections. A serologic test for syphilis should be performed on all pregnant women at the first prenatal visit. For patients at high risk, screening should be repeated in the third trimester and again at delivery.
Some states also mandate screening all women at delivery.
No infant should be discharged from the hospital without the syphilis serologic status of its mother having been determined at least one time during pregnancy and, preferably, again at delivery. Any woman who delivers a stillborn infant should be tested for syphilis. A test for Neisseria gonorrhoeae should be performed at the first prenatal visit for women at risk or for women living in an area in which the prevalence of N. gonorrhoeae is high. A repeat test should be performed during the third trimester for those at continued risk. Screening during the first trimester might enable prevention of adverse effects of chlamydia during pregnancy.