©Pregnancy bliss 2008

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Advice to an expectant mother confirmed to have the Toxoplasmosis infection

The risk to the fetus will be assessed, normally using ultrasound. If features suggestive of congenital toxoplasmosis infection are there, advice may be given to perform a fetal blood sampling, which will confirm or exclude the diagnosis in most cases.

 

Since the extent of damage and resultant disability is difficult to quantify before delivery, it is normally up to the parents to decide whether to proceed with the pregnancy or not.

 

Unfortunately, termination is never an easy option after the tests, because they can only be carried out rather late in pregnancy, certainly not before 20 weeks of gestation.

 

Treatment options for Toxoplasmosis during pregnancy

There are a few treatment options that may be used by any mother with primary Toxoplasmosis, even in the absence of documented fetal infection. This is because, in theory, the treatment may reduce the risk of fetal infection or at least moderate it. The doctor should fully explain the potential side-effects of the chosen drug and how long it needs to be used to confer the required benefit.

 

One of the options, spiramycin, is claimed to reduce the risk of fetal infection by half. The other, which is a combination of pyrimethamine and a sulphonamide, is similarly - if not more - protective.

 

Secondary Toxoplasma infection and pregnancy

Secondary infection does not pose the same degree of risk to the fetus. Secondary infection is probably an inappropriate term anyway. Some people who acquire toxoplasmosis have unusual manifes­tations, such as eye lesions.

 

In such cases, the eye lesions may flare up months or years after the primary infection. That is what is termed as secondary infection. In such instances, there is no evidence that specific action is required, as far as the pregnancy is concerned.

 

Primary Toxoplasma infection and mode of delivery

Normally, no special measures are required. Of course, the method of delivery will depend on all the usual obstetric variables. If the fetus is affected and one of the features is an abnormally large head (hydrocephaly), a cesarean section may be opted for, as long as the baby is viable.

Paediatricians will be on hand at delivery to give the required immediate treatment, if any.

 

Toxoplasmosis infection in pregnancy effect on future pregnancies

No. Babies in subsequent pregnancies will not be affected

 

Universal screening for Toxoplasmosis in pregnancy

As mentioned before, different population groups have varying degrees of risk, depending on life-style. Moreover, there is evidence that 25 to 50% will have had the infection in the past and are therefore not at risk.

 

Some countries, such as France, offer the screen test to all mothers, because the prevalence of the disease there is relatively high. Most other countries do not and instead target those expec­tant mothers at risk. These will include those keeping cats and those whose occupations involve frequent handling of raw meat or cat litter.

 

General advice regarding Toxoplasmosis infection

· Avoid eating raw meat and eggs

· Ensure meat is properly cooked, or at least frozen to minus 20°C (minus 4°F) prior to cooking, if it is to done rare.

· Use milk which has been pasteurized.

· Avoid cat litter or, if this is not possible, ensure protective gloves are used each time.

· Use gloves when gardening.

· Wash vegetables thoroughly before consumption.