Prognosis of Fetal Parenchymal Cerebral Lesions without Ventriculomegaly in Congenital Toxoplasmosis Infection.
OBJECTIVE
To evaluate the neurodevelopmental and ocular outcome of a continuous retrospective series of fetal toxoplasmosis infections for which prenatal ultrasound (US) follow-up revealed abnormal cerebral findings without associated ventriculomegaly.


METHODS
We retrospectively reviewed all cases of proven fetal Toxoplasma gondii infection with fetal cerebral anomalies at US examination without significant ventriculomegaly (≥10 mm) evaluated in our center over a 5-year period. US and magnetic resonance imaging findings were collected. The neurodevelopmental and ocular outcomes of the cases were studied.


RESULTS
Nine fetuses were included. Hyperechogenic foci of the cerebral parenchyma were isolated in five cases. Among those, four children had normal neurological development. Amblyopia was detected in on case. Hyperechogenic foci were associated with other anomalies of cerebral parenchyma in three cases among which two children had normal neurological development. Termination of pregnancy was performed in three cases: one case within the context of severe maternal schizophrenia with isolated hyperechogenic foci, one case where hyperechogenic foci were associated with extensive lesions of the white matter, and one case for severe fetal hydrops.


CONCLUSIONS
The neurological prognosis of cerebral hyperechogenic lesions without ventriculomegaly in fetal toxoplasmosis infection may be favorable. The risk of ocular damage however remains high and unpredictable in the prenatal period.
Sorbonne Universités, UPMC Université Paris 6, APHP, Service de Médecine Foetale, Hôpital Armand Trousseau, Paris, France.
Ferdinand
F
Dhombres
Stéphanie
S
Friszer
Paul
P
Maurice
Marie
M
Gonzales
François
F
Kieffer
Catherine
C
Garel
Jean-Marie
JM
Jouannic
D054022:Cerebrum / Q000002:abnormalities / Q000000981:diagnostic imaging*; D005260:Female; D005865:Gestational Age; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011379:Prognosis; D012164:Retinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D012189:Retrospective Studies; D014125:Toxoplasmosis, Congenital / Q000150:complications / Q000000981:diagnostic imaging*; D016216:Ultrasonography, Prenatal