Welcome back again dear readers and loyal readers of the Newborn Tips blog, today’s article explores everything about toxoplasmosis during pregnancy, the ways of transmission, symptoms, prevention measures and the importance of early diagnosis to protect both mother and child.
Table of contents
What is toxoplasmosis during pregnancy?
Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii, which can have serious consequences if contracted during pregnancy.
Although in most people this infection is asymptomatic or causes mild symptoms, such as fever and fatigue, in pregnant women it can cross the placenta and infect the fetus, causing complications such as birth defects or miscarriage.
On the other hand, the consequences of toxoplasmosis during pregnancy for the baby can vary depending on the period of gestation in which the infection occurs: in the first months, the risks are more serious and include malformations, developmental delays, neurological damage or spontaneous abortion. In the later stages, the risk of transmission increases, but with generally less serious consequences.
How is toxoplasmosis transmitted?
Transmission to the fetus can occur if a pregnant woman contracts the primary infection (i.e. for the first time) during pregnancy.
In the following lines we explain how toxoplasmosis is contracted during pregnancy:
- Through contaminated food: Raw or undercooked meat, especially pork, lamb or game, containing cysts of the parasite
- Unwashed fruit and vegetables that may be contaminated by soil or infected cat feces
- Water contaminated by Toxoplasma gondii oocysts
- Through contact with infected cat feces, this can occur when cleaning the litter box of a cat that expels the parasite in its feces (especially young or stray cats) or when touching soil contaminated with cat feces (for example when gardening) without gloves
- Maternal-fetal transmission: If a pregnant woman contracts the primary infection, the parasite can cross the placenta and infect the fetus. The risk of transmission increases as the pregnancy progresses (higher in the third trimester), but damage to the fetus tends to be more serious if the infection occurs in the first trimester
- Other rare ways of transmission: Blood transfusions or organ transplants from infected donors (rare case)
For this reason, it is essential to prevent toxoplasmosis during pregnancy, by implementing specific preventive measures that include:
- Cook all foods thoroughly, especially meat
- Wash fruit, vegetables and kitchen utensils thoroughly
- Avoid cleaning cat litter boxes: if necessary, use gloves and wash your hands well
- Wear gloves when gardening
- Avoid drinking untreated water
Symptoms of toxoplasmosis
As previously mentioned, toxoplasmosis in pregnant women is often asymptomatic, that is, it does not cause obvious signs in the mother.
However, in some cases, symptoms similar to those of a mild flu infection may occur, including:
- Mild fever
- Tiredness
- Muscle aches
- Swollen lymph nodes, especially in the neck
- Headache
- General malaise
How can you tell if you have toxoplasmosis during pregnancy?
Symptoms of toxoplasmosis, if present, may appear 1 to 3 weeks after exposure to the Toxoplasma gondii parasite.
Unfortunately, many women do not realize they have contracted the infection because the symptoms are mild or easily confused with other common conditions.
Since toxoplasmosis during pregnancy can have serious consequences for the fetus, it is important to undergo prenatal checkups and, if necessary, specific tests (such as avidity tests or dosage of IgM and IgG) to identify an active infection.
Toxoplasmosis tests during pregnancy
In order to obtain a correct diagnosis of toxoplasmosis during pregnancy, specific blood tests are performed that measure the presence of antibodies against the Toxoplasma gondii parasite:
- IgM positive: indicates a recent or ongoing infection
- IgG positive: indicates a past infection and acquired immunity
- IgG avidity test: used to understand if the infection occurred recently or in a period before pregnancy
These toxoplasmosis tests are usually performed during routine prenatal checks.
If infection is suspected, the doctor may request further tests, such as an amniocentesis to check if the fetus has been infected.
What happens if you get toxoplasmosis during pregnancy?
If a woman gets toxoplasmosis during pregnancy, the consequences vary depending on the trimester of pregnancy and the timeliness of diagnosis and treatment. Here’s what can happen:
Consequences for the mother
In most cases, the mother has no obvious symptoms or mild signs, such as fever, tiredness or swollen lymph nodes. However, the infection can cross the placenta and affect the fetus, with more or less serious effects.
Consequences for the fetus
As for the unborn baby, the consequences depend on the stage of pregnancy.
So in the following lines we will answer the question: In which week is toxoplasmosis dangerous?
In fact, the danger of toxoplasmosis depends on the trimester of pregnancy, as mentioned below:
First trimester: this is the riskiest period, with a lower rate of transmission to the fetus (10-15%), but the consequences can be very serious
Possible complications: spontaneous abortion, congenital malformations, hydrocephalus, cerebral calcifications or chorioretinitis.
Second trimester: the risk of transmission increases (30-40%)
Possible complications: damage to the central nervous system (mental retardation, epilepsy), eye problems (chorioretinitis), enlarged liver and spleen or developmental delays.
Third trimester: the rate of transmission is higher (up to 70%), but the consequences tend to be less serious, often with symptoms that appear only after birth or in the first years of the child’s life
In many cases, newborns appear healthy at birth, but may develop neurological or eye problems in later years.
However, early diagnosis and timely treatment with specific drugs (such as spiramycin or the combination of pyrimethamine and sulfadiazine) are essential to reduce the risks of toxoplasmosis during pregnancy for the fetus.
What to do if you have toxoplasmosis during pregnancy?
If you test positive for toxoplasmosis during pregnancy, it is essential to act promptly to reduce the risks to the fetus. Here are the main steps to follow:
- Confirmation of the diagnosis
- Specific blood tests: to understand if the infection is recent or past, the doctor will analyze the levels of IgM and IgG antibodies
- IgG avidity test: helps determine when the infection occurred. Low avidity indicates a recent infection
- Fetal monitoring
If toxoplasmosis infection during pregnancy is confirmed, the doctor may request additional tests to check if the fetus has been infected, such as:
- Amniocentesis: allows the presence of the parasite to be detected in the amniotic fluid. It is usually performed after the 16th week of pregnancy
- Fetal ultrasound: to detect any abnormalities or signs of fetal distress (for example, hydrocephalus, cerebral calcifications)
- Start of treatment
Toxoplasmosis treatment varies depending on the stage of the infection:
- Spiramycin: prescribed if the fetus is not yet infected. This antibiotic reduces the risk of transmission to the fetus.
- Pyrimethamine and sulfadiazine: used if the fetus has been infected, often in combination with folinic acid to prevent side effects on the blood
- Regular check-ups
It is important to undergo frequent check-ups to monitor the health of the fetus and evaluate the effectiveness of the treatment.
- Additional preventive measures
Even after diagnosis, it is useful to take precautions to avoid further exposure to the parasite, such as:
- Eat well-cooked meat
- Wash fruits and vegetables thoroughly
- Avoid contact with cat feces or contaminated soil
Prompt and appropriate management significantly reduces risks to the fetus and improves the chances of a healthy pregnancy.
How is toxoplasmosis treated during pregnancy?
Treatment of toxoplasmosis during pregnancy varies depending on the stage of infection and fetal involvement. The main goal is to reduce the risk of transmission to the fetus or, if the fetus is already infected, to minimize complications.
- If the fetus is NOT infected
When maternal infection has been confirmed but the fetus is not infected (for example after a negative amniocentesis), the drug used is Spiramycin. This is a safe antibiotic during pregnancy that reduces the risk of transmission to the fetus.
It is usually administered until the end of the pregnancy.
- If the fetus IS infected
If the baby in the womb is infected (through positive amniocentesis or ultrasound signs), the drugs used are the following:
- Pyrimethamine and Sulfadiazine, antiparasitics that fight the infection in the fetus
- Folinic acid: administered together to protect the bone marrow from the side effects of the drugs
Overall, this toxoplasmosis therapy in pregnancy is generally started after the 16th week of gestation, since the drugs can be toxic in the early stages of gestation.
- Continuous monitoring
Regardless of the treatment for toxoplasmosis during pregnancy, the health of the fetus must be monitored through tests and evaluations, as explained below:
- Regular ultrasound examinations: to check for fetal abnormalities
- Clinical evaluations: to monitor the side effects of treatment on both the mother and the fetus
To sum up, timely treatment, based on an accurate diagnosis of toxoplasmosis during pregnancy, can significantly reduce the risk of serious complications, such as neurological or ocular damage in the fetus.
Finally, collaboration with a medical specialist is essential to personalize the therapy and ensure the safety of mother and child.
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