Explaining a positive antenatal syphilis screen — OSCE

Candidate instructions (8-minute station)

You are the paediatric or neonatal registrar meeting a woman in the antenatal clinic. She is 24 years old and 30 weeks pregnant. Her routine antenatal blood test has come back positive for syphilis. She is well and has no symptoms, and the pregnancy has been otherwise uncomplicated. She is frightened and worried about the baby, and she is upset and anxious about the stigma of a sexually transmitted infection. ^[11]

Your tasks are: ^[6]

1. Explain what the positive syphilis test means and what syphilis is, in plain, non-stigmatising language. ^[6]
2. Explain why she needs treatment now, what the treatment is (benzathine penicillin), and why it must be completed before delivery. ^[6]
3. Explain the Jarisch-Herxheimer reaction she may experience after treatment, so she is not frightened by it. ^[13]
4. Explain the plan for checking the baby after birth, partner testing and treatment, and how this is all preventable. ^[11]

You are not expected to manage her penicillin allergy yourself — flag that, if she reports one, the maternity team will arrange a safe alternative path. Use a trained interpreter if needed. ^[6]