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Toxoplasmosis in pregnancy is a problem faced by mothers-to-be. Toxoplasma gondii is a protozoan widely distributed throughout the world. Its intermediate host is man and many animals. In contrast, domestic and wild cats are the final hosts.
Infection with toxoplasmosis
Man becomes infected with oocysts excreted in faeces by cats. These oocysts are common in soil and contaminate vegetables and fruit. Infection also occurs by eating raw or undercooked meat.
The fetus is infected through the placenta. In our latitude, the most common route of infection with toxoplasmosis is the consumption of raw or undercooked pork. After entering the body, the protozoan spreads through the blood and lymph. The number of parasites increases, they multiply and a parasitemia develops for about 2 weeks.
In healthy people, as a result of the development of specific antibodies, the infection is self-extinguishing. However, some cysts can become encapsulated and remain dormant in various organs for many years. During this time, antibodies testifying to a past protozoal infection remain in the serum. Dormant cysts do not reactivate – the exception is people with strong immunosuppression (i.e. a significant decrease in immunity, e.g. in the course of AIDS).
Symptoms of toxoplasmosis
In the first stage of the disease, non-specific flu-like symptoms occur. They disappear on their own after some time. The severe form, with irritation of the meninges and enlargement of the spleen, is very rare.
It is assumed that infection with fetal toxoplasmosis occurs only when the pregnant woman becomes ill for the first time and has not yet developed immunity. The fetus becomes infected through the placentain which protozoa accumulate. Fetal infections occur in 50% of untreated mothers. The risk of fetal infection increases with the duration of pregnancy.
Danger to the fetus
The most dangerous infection for the fetus is between the 10th and 24th week of pregnancy. This leads to a miscarriage or premature delivery, and infected newborns may develop little or no eyeball, nervous system defects, blindness, and deafness. In the later stages of pregnancy, infection with toxoplasmosis no longer causes such dramatic complications. With congenital toxoplasmosis, the mortality rate is approximately 15%.
How to avoid toxoplasmosis?
As a rule, the first determination of anti-toxoplasma antibodies is performed already in pregnancy. There is a risk of infection in women who do not have IgG antibodies. Then it is recommended to re-measure the level of antibodies. Depending on the results obtained, the woman does not require treatment or must receive the antibiotic spiromycin. Spiromycin reaches high levels in tissues, especially in the placenta, and thus acts directly in the protozoan reservoir. The drug reduces the number of protozoa that can penetrate the fetus. Therefore, diagnosis and possible treatment of toxoplasmosis should be undertaken as soon as possible.
Of course, it would be best if a woman planning pregnancy had previously determined the level of IgG and IgM antibodies against toxoplasmosis. Her baseline serological status is then known and repeated pregnancy testing can be related to this result.
Profilaktyka toksoplasmosis
The most important recommendation in the prevention of toxoplasmosis is proper hygiene when preparing meals: carefully washing fruits and vegetables, baking, cooking or frying meat, not eating raw meat. After preparing the meat and the remaining ingredients of the meal, you should thoroughly wash your hands before touching them, for example, in the eyes or mouth – they are the gateway to infection. The same rules also apply when working in the garden or when replacing litter boxes for domestic cats. Finally, remember that a sandbox can also be a source of contamination. There is no reason to make drastic decisions, but hygiene rules should be strictly observed, and women wishing to become pregnant should prepare for it, among others – by performing the above-mentioned tests.