In all, 35% of all UK-reported cases of syphilis in 2010 arose in London, 40% in women of childbearing age.1 Adequate antenatal screening aims to prevent cases of congenital syphilis. In England estimates show 95% of pregnant women are screened for syphilis; this hides wide regional variation (77%–100%).2 Evidence from London demonstrated complicated current follow-up practices leading to inadequacies in investigation, treatment and follow-up of pregnant women that may lead to unnecessary cases of congenital syphilis.3
We conducted a retrospective audit at Croydon University NHS Trust of the case notes of all women presenting in pregnancy with positive syphilis serology (positive Venereal Disease Research Laboratory (VDRL)/rapid plasma reagin and Treponoemal pallidum haemagglutination assay or treponoemal enzyme immunoassay) between 1 January 2009 and 31 December 2011 and their infants to establish whether serology result review, treatment and follow-up met local guidelines.
Overall, 22 women had positive VDRL…