title: Suspected acute toxoplasmosis in pregnant women.
abstract: OBJECTIVE
  To determine the prevalence of reagent serology for suspected acute toxoplasmosis in pregnant women and to describe clinical, laboratory and therapeutic profiles of mothers and their children.
  
  
  METHODS
  A retrospective study was conducted with IgM-anti-Toxoplasma gondii-reagent pregnant women and their children who attended the public health system in the state of Paraná, Southern Brazil, from January 2001 to December 2003. Information were obtained from clinical, laboratory (ELISA IgM/IgG) and ultrasonographic data and from interviews with the mothers. To test the homogeneity of the IgM indices in relation to the treatment used, the Pearson's Chi-square test was applied. Comparisons were considered significant at a 5% level.
  
  
  RESULTS
  Two hundred and ninety (1.0%) cases of suspected IgM-reagent infection were documented, with a prevalence of 10.7 IgM-reagent women per 1,000 births. Prenatal care started within the first 12 weeks for 214/290; 146/204 were asymptomatic. Frequent complaints included headaches, visual disturbance and myalgia. Ultrasonography revealed abnormalities in 13 of 204 pregnancies. Chemoprophylaxis was administered to 112/227; a single ELISA test supported most decisions to begin treatment. Pregnant women with IgM indices =2.000 tended to be treated more often. Among exposed children, 44/208 were serologically followed up and all were IgG-reagent, and three IgM-reagent cases showed clinical symptoms.
  
  
  CONCLUSIONS
  The existence of pregnant women with laboratorially suspected acute toxoplasmosis who were not properly followed up, and of fetuses that were not adequately monitored, shows that basic aspects of the prenatal care are not being systematically observed. There is need of implementing a surveillance system of pregnant women and their children exposed to T. gondii.
authors.affiliation: Universidade Estadual de Maringá, Maringá, PR, Brasil. cellacpp@yahoo.com.br
authors.forename: Marcela Peres
authors.initials: MP
authors.lastname: Castilho-Pelloso
authors.forename: Dina Lúcia Morais
authors.initials: DL
authors.lastname: Falavigna
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: Falavigna-Guilherme
mesh_terms: D000208:Acute Disease; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood*; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007231:Infant, Newborn; D008137:Longitudinal Studies; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D011296:Prenatal Diagnosis; D015995:Prevalence; D012189:Retrospective Studies; D014122:Toxoplasma / Q000276:immunology*; D014123:Toxoplasmosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014125:Toxoplasmosis, Congenital / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000913:Antibodies, Protozoan; D000981:Antiprotozoal Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M