Toxoplasmosis in pregnancy is still an open subject.
OBJECTIVE
To assess the consequences of a systematic screening for toxoplasma infection in pregnant women in a potentially high risk population.


METHODS
We have investigated all consecutive women with likely toxoplasma seroconversion in a referral center setting. Data were obtained from 68 women for whom an acute infection during pregnancy was considered likely or definite. They were all treated with antibiotics in the first instance and offered, if in the first or second trimester, amniocentesis for detection of vertical transmission (PCR and IFAT). Third trimester seroconversions and positive cases after amniocentesis were offered more aggressive antibiotic treatment.


RESULTS
Five fetuses/neonates (7%) were found to be infected. Four of them were diagnosed prenatally at amniocentesis, two women decided for termination of pregnancy, two were treated and gave birth to seronegative, normally developing children. One case was found postnatally, after a third trimester conversion; this developed into hydrocephalus with neurologic impairment.


CONCLUSIONS
Prenatal screening and antibiotic treatment of mothers infected with toxoplasmosis showed good feasibility in our infection-susceptible population. However, there were some weak points; for example, the high number of invasive procedures and the questionable prevention of mother to child transmission in the second to third trimester.
Greco
Pantaleo
P
Institute of Obstetrics and Gynecology, University of Foggia, Italy.
Vimercati
Antonella
A
Angelici
Maria Cristina
MC
Carbonara
Sergio
S
Doria
Grazia
G
Nappi
Luigi
L
Angarano
Giuseppe
G
Selvaggi
Luigi
L
D000653:Amniotic Fluid / Q000469:parasitology; D000818:Animals; D003049:Coccidiostats / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000517:prevention & control*; D011256:Pregnancy Outcome; D012698:Serologic Tests; D015572:Spiramycin / Q000627:therapeutic use; D014122:Toxoplasma / Q000302:isolation & purification; D014123:Toxoplasmosis / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission
D003049:Coccidiostats; D015572:Spiramycin