North American Registry of Midwives (NARM) Practice Exam

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What is the recommended treatment for syphilis during pregnancy?

Tetracycline
Doxycycline
Parenteral penicillin G
Azithromycin

The correct answer is: Parenteral penicillin G

The recommended treatment for syphilis during pregnancy is parenteral penicillin G. This choice is based on the fact that penicillin G is the only proven medication that effectively clears the syphilis infection in both the pregnant individual and their fetus. It is recommended at various stages of pregnancy and is crucial for preventing complications such as congenital syphilis, which can occur if the infection is left untreated. Penicillin is the first-line treatment due to its efficacy and safety profile. Other antibiotics, like tetracycline or doxycycline, are not advised during pregnancy because they may pose risks to the developing fetus. Azithromycin is not recommended as a primary treatment for syphilis in pregnant individuals due to concerns about resistance and inferior effectiveness compared to penicillin. The clear and established guidelines support the use of parenteral penicillin G to ensure the health and safety of both the individual and the baby.