title: Systematic serologic screening for toxoplasmosis in pregnancy.
abstract: OBJECTIVE
  To determine which serologic method or combination of methods could most effectively identify acute toxoplasmosis during pregnancy and to assess whether systematic screening is practical and cost-effective.
  
  
  METHODS
  Using basic serologic tests (direct agglutination test and immunosorbent agglutination assay), we screened 2104 women for toxoplasmosis. Immunoglobulin M (IgM)-reactive patients (IgM immunosorbent agglutination assay score of at least 3) were studied by differentiating serologic tests performed sequentially.
  
  
  RESULTS
  Specific immunity was found in 874 pregnant women (41.6%); 155 (7.4%) were IgM-reactive and 12 (0.6%) had acute toxoplasmosis. Using a reduced immunosorbent agglutination assay score of at least 3 (normally a score of at least 6 is used), acute toxoplasmosis was identified in 11 women at their first prenatal visit, including two in whom acute infection would not have been detected by a score of 6 or more until 9 weeks later. One additional nonimmune patient with acute infection was identified only by follow-up serologic testing.
  
  
  CONCLUSIONS
  Systematic screening followed by sequential differentiating serologic tests is practical and cost-effective for the diagnosis of acute toxoplasmosis during pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, University of Würzburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Roos
authors.forename: J
authors.initials: J
authors.lastname: Martius
authors.forename: U
authors.initials: U
authors.lastname: Gross
authors.forename: L
authors.initials: L
authors.lastname: Schrod
mesh_terms: D000328:Adult; D000372:Agglutination Tests; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D011237:Predictive Value of Tests; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology / Q000517:prevention & control*; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000191:economics; D014123:Toxoplasmosis / Q000453:epidemiology / Q000517:prevention & control*