title: Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis in a Setting With No Systematic Screening in Pregnancy.
abstract: To determine the risk of congenital toxoplasmosis (CT) and provide early (pre- or postnatal) identification of cases of CT in the absence of systematic screening in pregnancy.I n the presented cross-sectional study, serological criteria were used to date Toxoplasma gondii infection versus conception in 80 pregnant women with fetal abnormalities or referred to as suspected of acute infection, and in 16 women after delivery of symptomatic neonates. A combination of serological, molecular (qPCR), and biological (bioassay) methods was used for prenatal and/or postnatal diagnosis of CT. Most (77.5%) pregnant women were examined in advanced pregnancy. Of all the examined seropositive women (n = 90), infection could not be ruled out to have occurred during pregnancy in 93.3%, of which the majority (69%) was dated to the periconceptual period. CT was diagnosed in 25 cases, of which 17 prenatally and 8 postnatally. Molecular diagnosis proved superior, but the diagnosis of CT based on bioassay in 7 instances and by Western blot in 2 neonates shows that other methods remain indispensable. In the absence of systematic screening in pregnancy, maternal infection is often diagnosed late, or even only when fetal/neonatal infection is suspected. In such situations, use of a complex algorithm involving a combination of serological, biological, and molecular methods allows for prenatal and/or early postnatal diagnosis of CT, but lacks the preventive capacity provided by early maternal treatment.
authors.affiliation: From the National Reference Laboratory for Toxoplasmosis, Center of Excellence for Food- and Vector-Borne Zoonoses, Institute for Medical Research, University of Belgrade, Belgrade, Serbia.
authors.forename: Tijana
authors.initials: T
authors.lastname: Stajner
authors.forename: Branko
authors.initials: B
authors.lastname: Bobic
authors.forename: Ivana
authors.initials: I
authors.lastname: Klun
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Nikolic
authors.forename: Jelena
authors.initials: J
authors.lastname: Srbljanovic
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Uzelac
authors.forename: Irena
authors.initials: I
authors.lastname: Rajnpreht
authors.forename: Olgica
authors.initials: O
authors.lastname: Djurkovic-Djakovic
mesh_terms: D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis* / Q000209:etiology; D011296:Prenatal Diagnosis / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D055771:Serbia; D014125:Toxoplasmosis, Congenital / Q000175:diagnosis* / Q000209:etiology