IMPACT OF PRENATAL CARE AND PENICILLIN PROTOCOLS IN THE TREATMENT OF SYPHILIS IN PREGNANT WOMEN

Abstract

Introduction: Prenatal care is the essential medical and nursing follow-up to ensure the health of the mother and baby during pregnancy. This includes rapid tests and blood tests to detect sexually transmitted infections such as HIV, syphilis, and Hepatitis B and C. When syphilis is positive, it is important that healthcare professionals advise the woman and her partner to begin treatment as soon as possible. Syphilis is caused by the bacterium *Treponema pallidum*, which can cross the placental barrier and reach the fetus during pregnancy and at the time of delivery. Some risks that syphilis presents to the mother in the tertiary stage are: irreversible damage to the heart, brain, eyes, and bones, which can lead to death. In the baby, there may be miscarriage, premature birth, fetal malformation, or fetal death. Therefore, the gold standard treatment is with benzathine penicillin, a long-acting antibiotic indicated for combating bacterial infections sensitive to the penicillin compound. Thus, the importance of prenatal care is evident, both in the timely diagnosis and treatment of syphilis, and in the protection of maternal and child health. Methodology: This work constitutes a narrative literature review, in which data was searched in the PubMed database. Articles published in the last five years, available in full and written in Portuguese or English, were included. The approach includes prenatal care and therapeutic strategies in the management of congenital syphilis. Results and Discussion: To be considered adequate and to prevent congenital syphilis, maternal treatment must be completed at least 30 days before the expected date of delivery. Benzathine penicillin is the first-choice drug, administered intramuscularly, in doses and units prescribed by a doctor or nurse, according to the results of the tests and the stage of the disease. Treatment can occur in both Basic Health Units and Specialized Units/Hospitals, in the case of high-risk prenatal care. Unfortunately, the high rates of syphilis in pregnancy reveal a cascade of socioeconomic inequities and structural deficiencies in the health system. Factors such as low maternal education, multiple partners, and the use of illicit substances are linked to treatment failure. Few trained professionals, uncertain care pathways, and institutions far from the patient's residence also delay treatment. Furthermore, the partner who does not get tested and does not undergo treatment is another critical point, as it results in reinfection of the pregnant woman and the chain of transmission persists. Conclusion: Prenatal care is fundamental in monitoring the clinical condition of the mother and baby, guiding the pregnant woman and her family, as well as intervening in risky situations and reducing complications. However, to reduce the number of cases of congenital syphilis in Brazil, more than prescribing medication is needed. Focus should also be placed on health education, multidisciplinary work, accessibility to prenatal care, and control of transmission.