- What is toxoplasmosis?
- Who is at increased risk for toxoplasmosis?
- How can I find out if I am at risk for toxoplasmosis?
- What precautions can I take to avoid infection?
- I had a toxoplasmosis infection two years ago and I am currently pregnant. Is my fetus at risk?
- I am pregnant and have just found out that I have recently been infected with toxoplasmosis. Is my fetus at risk?
- Is there a higher risk to my pregnancy because I have toxoplasmosis and am only 10 weeks pregnant?
- How can I find out if my fetus has been infected with toxoplasmosis?
- Is there any treatment for toxoplasmosis during pregnancy?
- If my baby is born without any symptoms of congenital toxoplasmosis, does this mean the toxoplasmosis infection in pregnancy had no effect?
- References
What is toxoplasmosis?
Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. You can get it by eating undercooked, infected meat, or handling soil or cat feces that contain the parasite. Swelling of the lymph nodes or a mononucleosis-type (fever, fatigue, and sore throat) illness may be seen. Most adults have no symptoms. In most cases, once you have gotten toxoplasmosis, you cannot get it again. return to top
Who is at increased risk for toxoplasmosis?
Women who have outdoor cats, have recently gotten cats, clean litter boxes, eat undercooked meat, garden, or who have had a recent mononucleosis-type illness are at increased risk. return to top
How can I find out if I am at risk for toxoplasmosis?
In the United States, approximately two-thirds of women have never had toxoplasmosis and are at risk for an infection. A blood test can determine if you have ever had toxoplasmosis. Ideally, testing for toxoplasmosis should be done prior to conception. If an infection is identified during pregnancy, several tests may be needed to see whether the infection is recent or old. You should discuss whether you should be tested with your health care provider. Because testing for toxoplasmosis infection can be difficult to interpret, your test may need to be sent to a special laboratory. return to top
What precautions can I take to avoid infection?
Toxoplasma gondii can be found in raw or undercooked meat, raw eggs and unpasteurized milk. Cats that eat raw meat or rodents can become infected, and the parasite lives in the catís feces for two weeks. Thus, pregnant women or those trying to become pregnant should not change a catís litter. Toxoplasma gondii eggs can live in cat feces buried in soil up to 18 months. To avoid infection, pregnant women should cook their meat until it is no longer pink and the juices run clear, wear gloves when gardening,wash all fruits and vegetables,wash hands carefully after handling raw meat, fruit, vegetables, and soil, and not change a cat's litter. return to top
I had a toxoplasmosis infection two years ago and I am currently pregnant. Is my fetus at risk?
Congenital toxoplasmosis only occurs when the mother has an active infection during pregnancy. In general, there is no increased risk to the fetus when toxoplasmosis occurs more than 6 months prior to conception. If you had toxoplasmosis in the past, you are usually immune, and the fetus is not at risk. If you have a weakened immune system, such as in AIDS, you can develop another active infection. return to top
I am pregnant and have just found out that I have recently been infected with toxoplasmosis. Is my fetus at risk?
The toxoplasmosis parasite is known to cross the placenta. In about 40 percent of the cases in which a pregnant woman has toxoplasmosis, the baby is also infected. Infants who become infected during pregnancy are said to have "congenital toxoplasmosis" infection. In the United Sates, 1 to 2 per 1000 babies that are born each year have toxoplasmosis. Some infants with congenital toxoplasmosis will have medical conditions that include problems with the brain, eyes, heart, kidneys, blood, liver, or spleen. Long term effects may include seizures, mental retardation, cerebral palsy, deafness, and blindness. Many infected infants will have no problems at birth. Discuss with your health care provider whether you should see a specialist for further information. return to top
Is there a higher risk to my pregnancy because I have toxoplasmosis and am only 10 weeks pregnant?
When the mother is infected between 10 to 24 weeks ngestation, the risk for severe problems in the newborn is about 5 to 6 percent. When the mother is infected late in a pregnancy, the chance that the baby will have problems is very small. return to top
How can I find out if my fetus has been infected with toxoplasmosis?
Once you have been shown to be recently infected, there are several ways to check if your fetus has been infected. The fluid around the fetus or fetal blood can be examined to determine the presence of infection. However, if the fetus is infected, these tests cannot tell you how severe the infection is. About one-third of the babies born with congenital toxoplasmosis will have a problem that could have been seen on ultrasound. After birth, a blood test can be performed on the baby. You should discuss these tests with your health care provider. return to top
Is there any treatment for toxoplasmosis during pregnancy?
Maternal toxoplasmosis infection can be successfully treated with antibiotic medication. Early identification and treatment can reduce the chance that the fetus will become infected. If the fetus has already become infected, treatment with other medications will make the fetal disease less severe. However, treatment may not prevent effects in the baby. Treatment during the first year of life may also be helpful. Your health care provider can discuss specific treatment options with you. return to top
If my baby is born without any symptoms of congenital toxoplasmosis, does this mean the toxoplasmosis infection in pregnancy had no effect?
Infants with congenital toxoplasmosis usually don't appear any different at birth. Yet, long-term studies show that up to 90 percent develop problems including vision loss, hearing loss, or developmental delays. These symptoms can occur months or even several years after birth. For this reason, infants with congenital toxoplasmosis should be treated for the infection during the first year of life and then should be periodically screened for problems. return to top
References:
Berrebi A, et al. Termination of pregnancy for maternal toxoplasmosis. Lancet 344: 36-39, 1994.
Couvreur J, et al. In utero treatment of toxoplasmic fetopathy with the combination pyrimethamine-sulfadiazine. Fetal Diagn Ther 8: 45-50,1993.
Daffos F, et al. Prenatal management of 746 pregnancies at risk for congenital toxoplasmosis. New Engl J Med 318(5): 271-275, 1988.
Desmonts G, et al. Prenatal diagnosis of congenital toxoplasmosis. Lancet 1:500-504, 1985.
Dubey JP, Beattie CP. Toxoplasmosis of Animals and Man. Boca Raton: CRC Press, p 288, 1988.
Foulon W, et al. Detection of congenital toxoplasmosis by chorionic villus sampling and early amniocentesis. Am J Obstet Gynecol 163:1511-1513, 1990b.
Foulon W, et al. Prenatal diagnosis of congenital toxoplasmosis. Obstet Gynecol 76(5): 769-772, 1990a.
Hohlfeld P, et al. Prenatal diagnosis of congenital toxoplasmosis with a polymerase-chain-reaction test on amniotic fluid. New Engl J of Med 331 (11): 695-699, 1994.
Hunter K, et al. Prenatal screening of pregnant women for infections caused by cytomegalovirus, Epstein-Barr virus, herpes virus, rubella, and Toxoplasma gondii. Am J Obstet Gyn 145: 269-273, 1983.
Johnson JD, et al. Application of the polymerase chain reaction to the diagnosis of human toxoplasmosis. J of Infection 26(2): 147-158,1993.
Koppe JG, et al. Results of 20-year follow-up of congenital toxoplasmosis. Lancet 1:254-255, 1986.
Lynfield R, Eaton RB. Teratogen Update: Congenital Toxoplasmosis. Teratology 52(3): 176-180, 1995.
Matsui D. Prevention, diagnosis and treatment of fetal toxoplasmosis. Clinics in Perinatology 21(3): 675-689, 1994.
Remington JS, Desmonts G. Toxoplasmosis. In: Remington JS, Klein JO (eds.), Infectious Diseases of the Fetus and the Newborn Infant. Philadelphia: W.B. Sanders Co., pp 89-195, 1990.
Stray-Pedersen B. Toxoplasmosis in pregnancy. Baillieres Clinical OB and Gyn 7(1): 107-137, 1993 Mar.
Wilson CB. Development of adverse sequelae in children born with subclinical toxoplasmosis infection. Pediatrics 66(5): 767-774, 1980. The Toxoplasmosis Study Group: Congenital toxoplasmosis. Am J Dis Child 144: 619, 1990.