Outcome for children infected with congenital toxoplasmosis in the first trimester and with normal ultrasound findings: a study of 36 cases.
OBJECTIVE
We wished to investigate the prognosis of children infected with Toxoplasma gondii during the first trimester of pregnancy and whose ultrasound findings were entirely normal, in order to find out whether congenital toxoplasmosis did or did not justify termination of pregnancy if there was no fetal abnormality on ultrasound.


METHODS
A prospective and retrospective study was carried out by 12 French centers who enrolled 36 children infected with T. gondii during the first trimester of pregnancy and whose ultrasound examinations showed no anomaly. The outcome of these children after the age of 12 months (mean 50 months, range 12-144 months) was analyzed.


RESULTS
Of the 36 infected children, 28 (78%) presented subclinical toxoplasmosis. Only specific IgG antibodies persisted after 1 year. The principal manifestation in 7 children (19%) was chorioretinitis without major vision loss. Their intellectual development was entirely normal. One child (3%) developed severe congenital toxoplasmosis.


CONCLUSIONS
Since 97% of children infected with toxoplasmosis during the first trimester of pregnancy are asymptomatic or only slightly affected, we believe that in such circumstances termination of pregnancy is not indicated. However, appropriate treatment is essential and prenatal ultrasound examinations should be free of any anomaly.
Berrebi
Alain
A
Fédération de Gynécologie-Obstétrique, CHU Paule de Viguier, TSA 70034, 31059 Toulouse Cedex 9, France. carcagno.c@chu-toulouse.fr
Bardou
Magali
M
Bessieres
Marie-Hélène
MH
Nowakowska
Dorota
D
Castagno
Romina
R
Rolland
Michel
M
Wallon
Martine
M
Franck
Jacqueline
J
Bongain
André
A
Monnier-Barbarino
Patricia
P
Assouline
Corinne
C
Cassaing
Sophie
S
D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic; D011261:Pregnancy Trimester, First; D011297:Prenatal Exposure Delayed Effects / Q000469:parasitology*; D011379:Prognosis; D011739:Pyrimethamine / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D014125:Toxoplasmosis, Congenital / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016216:Ultrasonography, Prenatal
D013449:Sulfonamides; D011739:Pyrimethamine