State Health Advisory: New Syphilis Testing Requirements During Pregnancy In Effect
By David Doolittle


Physicians who care for pregnant women should be aware of a change in syphilis testing requirements in Texas.  

As of Sept. 1, Texas physicians are required to test pregnant women for syphilis three times: at the first prenatal visit, during the third trimester (no sooner than the 28th week), and at delivery. 

Previously, state law required testing at the first visit and during the third trimester. If testing was not performed during the third trimester, or could not be verified, testing was required at delivery.  

“Congenital syphilis can have devastating effects on a child, but it is preventable when treatment begins in time,” said John Hellerstedt, MD, commissioner of the Department of State Health Services (DSHS). “Testing in accordance with the new law will provide the best opportunity to treat the infection so the infant doesn’t suffer permanent consequences.”

In a new health advisory issued Oct. 3, DSHS recommended physicians:

  • Screen all pregnant women for syphilis according to new testing requirements;
  • Look for clinical signs/symptoms of syphilis in all patients;
  • Treat patients with evidence of syphilis or recent exposure to syphilis on-site when possible. Document stage of syphilis and treatment administered;
  • Report syphilis cases to your local or regional health department at the time of diagnosis. Include pregnancy status and treatment in the report;
  • Test and evaluate newborns potentially exposed to syphilis in utero; and
  • Update electronic health record/electronic medical record systems to reflect new testing.

In addition to issuing the health advisory, DSHS is taking a number of steps to detect and reduce the number of congenital syphilis cases in the state, including increased active surveillance and use of birth certificate data to follow up cases that may have been missed.    

The changes, which were part of Senate Bill 748, come amid an increase in congenital syphilis cases in Texas over the past few years.

“There were 367 cases of congenital syphilis in Texas in 2018, up from 164 in 2017,” DSHS said. “In addition to laboratory confirmed cases, the total includes all babies born to women with a history of syphilis and no documented treatment.”

SB 748 directs the state to expand pregnancy medical home pilots to new sites and to test the use of telemedicine, telehealth, and telemonitoring to improve prenatal and postpartum care. 

The bill, authored by Sen. Lois Kolkhorst (R-Brenham) and sponsored by Rep. Sarah Davis (R-West University Place), was signed by Gov. Greg Abbott in June and became effective Sept. 1. 

To help keep physicians up to date on the changes, the Texas Department of State Health Services (DSHS) revised its 10 Questions About HIV, Syphilis, and Pregnancy brochure, which is also available in Spanish.

TMA is committed to improving the health and lives of Texas mothers. Find more information about maternal mortality and morbidity on TMA’s website.


Last Updated On

October 04, 2019

Originally Published On

September 20, 2019