Toxoplasmosis during pregnancy

What is toxoplasmosis?

Toxoplasmosis is a parasitic disease of birds, animals and humans.

In most people, such a disease does not cause serious health problems. But for a pregnant woman and her developing child, toxoplasmosis in pregnancy can lead to impaired brain function and loss of vision. However, the risk for a pregnant woman to become infected with this infection and transfer to her fetus is negligible.

If you are already pregnant or plan to become a mother and are worried about toxoplasmosis, consult a doctor and go through the necessary testing. If earlier you were treated for toxoplasmosis, chances of recurrence of the disease and transmission to your child are reduced to zero, since antibodies are produced in your body.

But in the opposite case, you need to take safety measures during pregnancy: do not touch potentially infected foods and items, such as meat or feces of domestic animals.

Causes of toxoplasmosis

The cause of toxoplasmosis is the causative agent - a parasitizing organism. Infection is transmitted during:

• the use of infected meat, which is half-baked and frozen;
• cleaning of faeces of animals (cat);
• work on a site where the soil contains infected faeces of animals (cat);
• eating everything that came into contact with the feces of cats, including fruits and vegetables in an unwashed state, as well as food that lay on the surfaces where pets (cats) were walking.

Symptoms of toxoplasmosis

With toxoplasmosis, symptoms similar to influenza are observed. But in most cases people may not even know about it. In a healthy organism with strong immunity, the disease passes by itself. In newborns, the body does not yet fight infection, so the doctor prescribes medications to prevent complications.

Diagnosis of toxoplasmosis

A blood test indicates the presence of toxoplasmosis or the fact that the infection has already been in the past. If a woman becomes infected during pregnancy, the child should also be tested. The doctor makes a fence for the amniotic fluid and checks it for infection.

Infection

If toxoplasmosis appears during pregnancy, the doctor will prescribe antibiotics that:

• protect the child from infection;
• reduce the child's chances of developing serious complications.

If a woman undergoes treatment during pregnancy, the health of the child will not be affected. If a child has toxoplasmosis, he will have to take antibiotics for a year.

Prophylaxis of toxoplasmosis during pregnancy

• If at home there are animals (cat), ask relatives to clean after him during pregnancy. Wipe the tables and the work surface in the kitchen, as cats can easily get there. If you still need to change the box with the feces of the cat, put on gloves and a mask, then always wash with soap and hands.
• Eat well-roasted meat and do not eat jerky beef.
• Avoid contact with faeces of pets in the garden. If necessary, touch the ground, put on gloves and wash your hands with soap and water.
• Fruits and vegetables should be thoroughly washed before use.
• Beforehand, wash your hands and objects used for cooking meat, chicken, fish, fruit or vegetables.

Toxoplasmosis during pregnancy - causes

Toxoplasmosis is a widespread parasitic disease of humans and animals, which is caused by protozoan microorganisms. Cats are the only carriers of this pathogen. If the cat is infected, its feces contain toxoplasmic eggs for two weeks. They can survive in damp soil for a year and a half. Being in soil and sand, they infect food and water. Cats that are constantly in the house and do not catch mice are considered safe.

Infection through the mouth

Infection occurs through the faeces of cats, contaminated water and food.

Other ways of infection:

• Eggs of toxoplasma enter the intestinal tract of a person after they hit the food or other surfaces that the cat touched. The use of contaminated foods, such as unwashed vegetables or non-hygiene before eating, often leads to infection.
• Eating contaminated animal meat. Semi-prepared or raw meat of animals can contain toxoplasm eggs.

Infection of the fetus

If toxoplasmosis occurs during pregnancy or 8 weeks before conception, there is a possibility of transmission to the fetus. In the case of acquired immunity before conception, re-infection or transmission of the disease to the fetus is impossible.

Toxoplasmosis during pregnancy - symptoms

With a healthy immune system

Most people do not get sick at the first infection with toxoplasmosis. Some may have mild flu-like symptoms that last for several months. That's why people do not immediately know about the presence of the disease.

Symptoms:

• Swelling of the tonsils
• Muscle pain
• Fatigue
• Temperature increase
• A sore throat
• Skin rash

Symptoms of toxoplasmosis in a newborn

Most newborns do not have symptoms. But if not treated, complications can develop - there are problems with vision and brain damage occurs. Sometimes in 20 years blindness develops.

Some infected infants have a severe form of the disease, including:

• pain in the eyes, visual impairment, or blindness;
• the destruction of the brain, which leads to mental retardation and sometimes - convulsions.

With a weak immune system

People with a weakened immune system (HIV, after organ transplantation or lymphoma) can develop a fatal form of the disease (toxoplasmosis). Therefore, to prevent it, a course of antibiotics is prescribed. Severe disease requires intensive therapy. In very rare cases, the disease affects organs such as the brain, eyes, lungs and heart.

Toxoplasmosis during pregnancy - clinical picture

Repeated infection is impossible, because the body produces antibodies and fights infection. The probability of transmission in this case to the child is zero. But with a weakened immune system (HIV or chemotherapy), a possible re-infection and transmission to the fetus.

Infection before and during pregnancy

The fetus can not resist the infection. The parasite enters the fetus two months after infection of the mother. If this happened in the first half of pregnancy, serious complications may develop - the brain and eyes are affected. If infection occurs in the second half of pregnancy, the harm may be less.

If infected children are not treated with antibiotics after birth, they may develop serious complications in the first 20 years of life, often leading to mental retardation, visual impairment, and sometimes even blindness.

Toxoplasmosis during pregnancy - risk factors

The risk of infection with toxoplasmic parasites is significantly reduced when hygiene is observed, but increases in the case of:

• Use of meat with blood or products that come in contact with the raw cape. Any meat is potentially dangerous.
• Consumption of infected fruits, vegetables or water;
• Non-compliance with hygiene before eating (unwashed hands after toilet or touching raw meat).
• Clean up the faeces of domestic animals (cat) without washing your hands or breathing contaminated dust.
• Work in the garden without gloves without hygiene: parasites can survive in soil and sand for 18 months.

The threat of infection of the fetus

The longer the gestation period for infection with toxoplasmosis, the higher the risk of transmission of the disease to the fetus. But the earlier it occurs, the higher the risk of serious complications after birth. Any child with toxoplasmosis should be treated with antibiotics.

Toxoplasmosis during pregnancy - when to seek help from a doctor

During the first visit to the doctor, discuss the risk factors for toxoplasmosis and decide whether to do an analysis to identify it. Immediately contact your doctor if you have swelling of the tonsils, fever, sore throat, or flu-like symptoms.

Observation

Sometimes a woman is under the supervision of a doctor. Screening for toxoplasmosis is performed if there is a threat of infection of the fetus. In some countries with a high incidence of disease, experts recommend early testing and treatment to avoid complications in the future. If you are pregnant or are going to give birth to a child, think about the possible risk factors, and discuss with your doctor when it is better to do the testing.

Who to contact

If suspected of toxoplasmosis, you need to take tests. If toxoplasmosis is detected during pregnancy, the treatment will be prescribed by the attending physician. When a newborn is infected during pregnancy, the neonatologist or infectious disease doctor is engaged in treatment.

Toxoplasmosis during pregnancy - diagnosis and testing

Infection of the fetus with toxoplasmosis is very rare. From 1 to 10 infants per 10,000 infected with toxoplasmosis before birth. That is why screening for the disease is not an integral part of the program for caring for pregnant women. To pass analyzes on a toxoplasmosis in pregnancy or before conception it is necessary if:

• You are concerned about possible infection.
• You think that you can not avoid getting infected.

In countries where toxoplasmosis is rare, screening for infection is only for newborns. Where the disease is observed more often, screening for toxoplasmosis is done to all pregnant women.

A blood test is performed to identify antibodies that resist infection. Their presence in the blood indicates that you have already been infected before and your immune system is now producing antibodies, which will further protect the future child from toxoplasmosis. In some cases, for complete certainty, a blood test is done several times.

Testing of toxoplasmosis

• A blood test for toxoplasmosis is performed to detect antibodies to toxoplasm. If the results or symptoms indicate infection, a second analysis is performed to confirm the diagnosis.
• Amniocentesis - sampling of amniotic fluid for analysis. Blot-hybridization test with polymerase amplification is used to detect DNA toxoplasm (in fetus).
• Ultrasound is aimed at determining signs of organ damage in the fetus.

Early diagnosis of the disease

Congenital defects mainly develop when the fetus is infected for 10-24 weeks of pregnancy. That is why the early detection of toxoplasmosis in the fetus plays an important role in preventing serious complications. (If infection occurs late in pregnancy, severe complications are unlikely to develop, but to prevent future problems, treatment must be mandatory).

Toxoplasmosis during pregnancy - treatment overview

If you are pregnant and you have a strong immune system, you will not need to treat toxoplasmosis, because the symptoms usually go away on their own. But if infection occurs during pregnancy, it is required to undergo a course of treatment in order to protect a developing child. The immune system of the fetus is not yet able to withstand toxoplasmosis, so antibiotics are introduced to kill parasitic organisms. Newborns who received treatment in the womb look healthier after birth.

Children who have not been diagnosed and treated before birth are at risk for developing brain disease and vision in the womb or in the first two years of life.

Ultrasound sometimes determines severe damage to the fetus as a result of toxoplasmosis in the early stages of pregnancy. In such cases, parents may decide to terminate their pregnancy.

Toxoplasmosis during pregnancy - prevention

If you are not pregnant and you have a strong immune system, it will not be necessary to prevent toxoplasmosis, as the disease can have a mild form or not provoke symptoms at all.

Re-infection is impossible, because the body has learned to resist infection, and the immune system of the mother also protects the fetus. To determine the antibodies to this disease, a blood test is performed.

During pregnancy and before conception:

• If you are not sure that your immune system can fight the infection, avoid contact with provocateurs of the disease in order to protect the future child from infection.
• Try not to touch the excrement of cats, both in the house and in the garden.
• If there is a cat in the house, and you are pregnant or plan to become a mother, ask someone from relatives to remove his bowel movements. If this is not possible, clean daily, as toxoplasma eggs become dangerous within 1-5 days.
• Wear gloves and a mask and wash your hands thoroughly with soap and water.
• Regularly rinse the table and working surfaces in the kitchen, where the cat could visit.
• Think about keeping the cat in the house. Cats that walk in the street can be infected with parasitic organisms of Toxoplasma gondii by eating infected birds or rodents. (But you can not also allow a cat to catch domestic animals, because they too can be contagious).
• When working in the garden, wear gloves and wash thoroughly afterwards with soap and hands.
• Flush all products that could theoretically contact the cat's feces, including fruits and vegetables.
• Use only fully cooked (but not with blood) meat. Avoid jerky meat. Parasitic organisms of Toxoplasma gondii die at high temperature.
• Wash your hands and kitchen objects well after preparing raw meat, poultry, seafood, fruits and vegetables.
• Do not drink unpeeled water when you are in nature or while traveling.

Toxoplasmosis during pregnancy - medical preparations

Medical preparations for the treatment of toxoplasmosis are necessary only in cases when it is possible to infect a developing child (fetus) or a person has a weak immune system. Even if the pregnant woman is healthy and has strong immunity, a course of treatment is recommended for fetal safety.

If the disease is diagnosed during pregnancy, antibiotics are prescribed.

• Treatment with antibiotics reduces the risk of infection of the fetus.
• In case of infection of the fetus (the diagnosis is made with the help of amniocentesis), the doctor can prescribe another antibiotic or add one more.

If a newborn has a toxoplasmosis, the child needs to undergo a course of treatment in the first year of life, which will lower the risk of brain damage and development of visual problems (including blindness).

Choice of medicinal product

If a pregnant woman takes antibiotics, this does not mean that they will act in the same way for fetal infection.