title: Implementation of Screening for Toxoplasma gondii Infection in Pregnancy.
abstract: BACKGROUND
  Since 1998, Italian law requires serological screening for toxoplasmosis by the thirteenth week of pregnancy, and seronegative women should undergo further checks every 30 - 40 days until delivery (a total of 5 - 7 screenings). This is an improvement of the previous law which foresaw three free tests (one by the end of the third month, one in the fifth, and one in the ninth month of pregnancy). The aim of this study was to assess the implementation, in an urban area of Northern Italy, of the 1998 law about 10 years after its entry into force.
  
  
  METHODS
  Of the 4,694 women who initiated and completed a pregnancy in the period 2006 - 2008, we recorded the trimester of pregnancy in which they underwent their first screening, the total and average number of screenings during pregnancy, and the trimester distribution of the screenings.
  
  
  RESULTS
  A total of 84.1% of the women underwent their first screening during the first trimester. The negative cases underwent an average of 3.7 screenings during pregnancy, with 34.9% undergoing five or more. Sixty percent of the women underwent at least one screening per trimester.
  
  
  CONCLUSIONS
  Our data indicates active screening during the first trimester, but fewer screenings than required by law during pregnancy as a whole. Therefore further efforts are needed to improve screening implementation.
  
  
  BACKGROUND
  Anti-Toxoplasma antibodies; Congenital infection; Pregnancy trimester; Toxoplasma screening; Seroconversion; Seronegative women; Seropositive women; Screening protocol.
authors.affiliation: Microbiology Unit, Hospital of Legnano, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: De Paschale
authors.forename: Carlo
authors.initials: C
authors.lastname: Agrappi
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Manco
authors.forename: Teresa
authors.initials: T
authors.lastname: Cerulli
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Clerici