The role of VDRL Testing in routine screening of antenatal women in the present decade

Background - Prevalence of syphilis is decreasing in India, but it has been a part of routine antenatal screening. With the increasing number of laboratories varied recommendations and reverse screening algorithm , we undertook this study to determine the present prevalence of syphilis in the antenatal women, cost effectiveness of routine screening with VDRL test and to identify the best method of screening for syphilis. Methods - Retrospective review of charts from January 2006 to June 2011. Results - Prevalence of syphilis was 0.1 among the antenatal women. Since syphilis is a preventable cause perinatal mortality and morbidity, routine screening was identified as the defence against these problems. The present CDC recommendation of screening with VDRL followed by TPPA on VDRL reactive cases was found to be the best method of screening. Conclusion - Though the seroprevalence of syphilis is low and showing a downward trend in our population, still screening for syphilis is cost effective. The best method of screening is with VDRL and confirmation of reactive cases with TPPA. We need further studies before we could implement TPPA as screening test for antenatal women.