Background The re-emergence of congenital syphilis in the North East and outcomes of a regional audit prompted the development of regional good practice arrangements in managing pregnant women with syphilis and their babies.
Aims Guidance documents for the various clinical specialties were present for the management of pregnant women with syphilis in our region, but not a clear description of the whole patient (mother and baby) pathway. The overall aim of the good practice arrangement was to clarify precise roles of clinicians looking after these pregnant women, prompt re-testing of syphilis based on subsequent risks and concerns, create referral pathways and encourage multidisciplinary communication in management of pregnant women with syphilis.
Method Current national guidance was reviewed and discussed between Northern BASHH group, Health Protection Agency (HPU and virology), regional Paediatric Infectious Diseases and Antenatal screening coordinators. Audit outcomes highlighted areas needing improvement and these were addressed including use of named rather than numbered GUM serology specimens.
Results The good practice arrangement outlines clearly the patient journey from diagnosis to delivery and follow-up of her baby. It is divided into different stages, with each outlining clearly who is responsible for care, locally recommended practice and referring to national guidance where indicated for the management of that stage. These stages are antenatal screening and referral process to GUM, management of positive results in mother, investigations of baby at birth, follow-up of babies born to mothers with positive syphilis results and treatment of baby with suspected congenital syphilis. Good practice is included on the management of mothers who do not attend GUM follow-up, communication to those involved in care and a named lead paediatrician in every hospital trust in the North East region has been created.