In 2015, the Texas Legislature passed Senate Bill 1128 revising Texas law to require that every pregnant woman be tested for syphilis at her first prenatal visit and at the third trimester, no earlier than 28 weeks gestation. (1) This law takes effect September 1, 2015.
The Centers for Disease Control and Prevention (CDC) recommend the third trimester test should occur between 28-32 weeks gestation, ensuring timely treatment of the mother and fetus. Although not required by law, the Texas Department of State Health Services (DSHS) recommends testing for syphilis at delivery for women who:
- Live in a high-morbidity area (rates of primary and secondary syphilis of 2.0 per 100,000 or higher);
- Have no evidence of prior testing;
- Are uninsured or low income;
- Are diagnosed with a STD during pregnancy; and/or
- Exchange sex for money and/or drugs.
If the serologic status of the mother is not known, serologic status of the newborn must be determined less than two hours post-delivery. Any woman who delivers a stillborn infant after 20 weeks gestation should be tested for syphilis. Infants should not be discharged from the hospital unless the syphilis serologic status of the mother has been determined either during pregnancy or at delivery. (2)
All infants born to women with reactive serologic tests for syphilis should be examined thoroughly for evidence of congenital syphilis (e.g., non-immune hydrops, jaundice, hepatosplenomegaly, rhinitis, skin rash, and pseudoparalysis of an extremity). (3)
For more information, please see the DSHS website.
1. Texas Health and Safety Code 81.090. Accessed August 25 2015.
2. Centers for Disease Control and Prevention. Accessed August 25, 2015
3. Centers for Disease Control and Prevention. Accessed August 25, 2015.
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