Readers react: Screen, rescreen, and rescreen again

I enjoyed the update in the article on the rise of congenital syphilis. I have been giving prenatal care since the late 1980s and have always screened initially then again at 35-36 weeks. We did not see patients in the hospital, but when they returned to us for their postpartum visit, they would be tested again.

It astounds me to hear that some of the reasons for not rescreening may be that “providers are hesitant to ask uncomfortable questions about sexual histories” or that “providers assume a treated patient will remain infection-free and do not retest”...or for that matter...that someone that has been treated is not rescreened because they are “not high risk??”  I would think if they had syphilis and were treated...they would be high risk??? Common sense needed here, perhaps? 

As healthcare providers, we are trained in this area - sexual practice assessment - and with experience comes comfort. So I strongly recommend if one is in the business of the provision of health care, then one should become comfortable in the area of asking questions - any questions - and getting answers, whether pleasant or not, to enable provision of the best health care possible. NOT asking is close to negligence, in my mind anyway.

Thank you very much for the simple reminders of how important it is to screen, rescreen and then hopefully at delivery...rescreen again.

Veronica L. Howard-Burch, PhD, MSN, RNCWomen’s Health Nurse Practitioner-BC
Fort Stockton, Texas

I could not agree more – these are the real-world limitations we have to deal with from a public health perspective. Thank you for your comments.

Dr. Lockwood