Toxoplasmosis blood test during pregnancy

Toxoplasmosis in pregnant women, treatment, prevention

Toxoplasmosis – a parasitic disease caused by opportunistic intracellular parasite, for which man is only an intermediate host. The main hosts are Pets, cats and Kittens.

In most cases toxoplasmosis to humans is not dangerous and asymptomatic with symptoms of minor ailments and fatigue. Treatment once detected, as a rule, not assigned. If the disease is diagnosed in pregnant women, doctors say the most serious disease, causing malformations of the fetus that lead to his death.

What is the danger of Contracting toxoplasmosis during pregnancy?

Toxoplasmosis during pregnancy is especially dangerous for the baby. Penetrating through the placenta, the infection affects the organs and tissues of the fetus, causing severe birth defects and often fetal death. The risk of infection and the severity of the disease depends on the gestational age and the presence or absence of immunity to the disease in the mother.

Depending on what time and on what deadline has arrived toxoplasmosis infection in pregnant women, the consequences for the child may include the following:

  • 1 trimester of pregnancy is incompatible with life fetal malformations and after some time its intrauterine death.
  • 2nd trimester — damage to the Central nervous system and liver. Perhaps the development of hydrocephalus, chorioretinitis and seizures. In the brain tissue detected the calcification.
  • The end of 2 and beginning of 3 trimester of pregnancy – the defeat of different internal organs with symptoms of anemia, jaundice and thrombocytopenia.
  • 3 mid-trimester to end of pregnancy toxoplasmosis are asymptomatic. However, the effects of the disease in pregnant women appear after some time after birth in the form of deafness and chorioretinitis.
  • Gestational age is also at risk of intrauterine infection of the child. With increasing pregnancy susceptibility of the fetus to toxoplasmosis increases.

    The thing is that the placenta during pregnancy has a different degree of permeability. In the early stages of fetal development is the causative agent of toxoplasmosis is difficult to penetrate through it. In the later stages it can pass through the wall of the placenta of pregnant women and the risk of infection increases.

    If you analyze the risk of infection for the baby depending on the gestation, then the following can be observed:

  • In the 1st trimester the risk of fetal infection with toxoplasmosis is between 15 and 20%.
  • During the 2nd trimester, the risk increases to 30%.
  • The 3rd trimester has the highest percentage of infections 60%.
  • If a woman has already had toxoplasmosis, if he’s dangerous for the baby?

    If a pregnant woman ever has suffered from toxoplasmosis, in her blood has antibodies that protect her and the child from recurrent disease. In this case, the infection does not occur and treatment is not required.

    In order to identify whether there are antibodies in the body of pregnant women, conduct laboratory research. If the test is positive and shows their presence, then it is possible to say that women at any stage of their lives faced with this disease.

    However, antibodies can be detected in the blood of pregnant women and in case if the infection occurred recently. In this case, the blood of women examined for the presence of a specific class of immunoglobulins. There are only two – lgg and mgg. While lgg indicates that contamination occurred in the past. The presence of immunoglobulin class mgg may indicate that the pathogen is in the blood at the moment.

    If you have blood when pregnancy is detected immunoglobulin Mgg, you should immediately consult a specialist! Your doctor will refer you for tests and prescribe appropriate treatment.

    Igg and mgg

    The examination of blood of pregnant women may meet this situation: the result shows the presence of both types at the same time immunoglobulins – igg and mgg. These symptoms are observed in case if the infection occurred during the year. In this case, the doctor will advise you to take the test again after some time. A further increase in the level of igg indicate acute form of the disease requiring urgent referral to treatment.

    Can be detected and this pattern: the blood of a pregnant contains neither igg nor mgg. In this case we can talk about the lack of immunity to the disease. In the blood of women discovered antibodies, and in the event of pregnancy should be particularly careful while chatting with cats and frequently wash their hands before eating and after walking.

    Immunoglobulin of the class igg is retained in the human body for quite a long time – up to 10 years. And the blood counts in the absence of immunoglobulin mgg, can be called the most favourable for pregnant women, because it would mean that their baby be all right.

    According to statistics, in most cases, the survey shows a positive test for the presence of igg in a pregnant woman, even if she claims that she never suffered from toxoplasmosis. The symptoms are so similar with the usual malaise that many people believe that this is the norm and not go to the doctor. Therefore, it is important to get tested for igg.

    Symptoms of toxoplasmosis in pregnancy

    However, despite all the evil of the disease is still some signs of the disease are available, and every pregnant woman should know about.

    Toxoplasmosis in pregnant women occurs in exactly the same way as in non-pregnant women. You may experience the following symptoms:

    But the symptoms are usually the norm during pregnancy, and many women do not pay any attention to them.

    A woman should alert to such symptoms and signs of disease, such as:

    • swollen lymph nodes;
    • the appearance of pain in muscles and joints;
    • the increase in temperature.

    In this case, you must immediately contact a doctor who will prescribe treatment. Even if the test shows the absence of toxoplasmosis, these symptoms may indicate the presence of other infectious diseases. In any case, the presence of such symptoms is not the norm!

    In chronic course of the disease the main symptoms of the disease — myositis and myocarditis. Also simultaneously with the main signs of chronic toxoplasmosis during pregnancy is manifested by indigestion, nausea and bloating.

    How is the infection?

    The infection carrier is the cat. People and other animals are only intermediate host of this intracellular parasite.

    The diseased animal is able, within 2 weeks after the onset of the disease to identify the causative agent into the environment with faeces. The infection may occur in case of ingestion of cysts a woman who had a sick cat-carrier can move to surrounding objects.

    The probability of catching toxoplasmosis during cleaning kitty litter is more likely to occur if the woman didn’t wash my hands with soap and water. If all rules of personal hygiene are observed, even if a cat is determined by the carrier, it does not 100% guarantee of infection. Moreover, in most cases, the woman has antibodies to her and toxoplasmosis is not dangerous.

    Prior to planning a pregnancy the woman is desirable to test for igg and depending on the result make the decision to examination cats for carriers of the pathogen.

    How to protect yourself from toxoplasmosis?

    Prevention of the disease common to all infectious diseases. So you don’t catch toxoplasmosis during pregnancy and to avoid the consequences of infection, it is necessary to observe following rules.

  • The woman should wash hands frequently throughout the day.
  • If the house has cat and other Pets, contact with them it is better to limit.
  • When working in the garden and the garden wear rubber gloves and to wash hands after any contact with soil.
  • All food should be subjected to long thermal processing, and fruit and vegetables to wash in running water.
  • These simple rules will help a woman during pregnancy to protect themselves from many problems, including such disease as toxoplasmosis.

    Nor can we forget that the key to a successful pregnancy in the long preparation for it in the planning period. The woman is desirable to pass the required tests for the absence of any disease, including the presence of immunoglobulin class igg. Antibodies will protect from the disease if suddenly while carrying a child to meet is a carrier of toxoplasmosis.

    Every woman in the period of planning pregnancy need to be tested for the presence of blood immunoglobulin class igg. The consequences of toxoplasmosis during pregnancy can be unpredictable!

    If the house has a pet, you need to examine it for the presence of the disease, to ensure that he does not support it. Especially if you have a cat.

    We must not forget that infection occurs not only by direct contact with the animal, but also through soil and infected subjects. Toxoplasmosis can enter the body through unwashed vegetables and dirty hands.

    Is there a cure for toxoplasmosis?

    If a pregnant woman has signs and symptoms of toxoplasmosis, and in the blood are detected antibodies igg and mgg, the doctor will prescribe additional tests. If after re-testing, the diagnosis is confirmed, depending on the timing of pregnancy, the doctor will make the decision about its termination or prescribe the appropriate treatment.

    The difficulty is that to treat toxoplasmosis are required, use of antibiotics, and they, in turn, can affect a child’s development. Therefore, the treatment of such diseases as toxoplasmosis, pregnant requires a special approach. Within 12 weeks toxoplasmosis in pregnant women not treated, and the doctor will advise you to terminate the pregnancy.

    After 12 weeks treatment of toxoplasmosis becomes possible. Scheme and order of treatment includes antibiotics and folic acid. The causative agent not destroyed completely, since that is impossible, but its activity is reduced, and the disease is not progressing.

    Do not try to treat toxoplasmosis yourself! Optimal treatment can be prescribed only by a doctor. After the baby is born, it will be necessary to examine the carriage of the causative agent of toxoplasmosis.

    Toxoplasmosis in pregnancy

    Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii that can affect the growing baby in pregnancy.

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    What is toxoplasmosis?

    Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. In non-pregnant women it doesn’t have many symptoms. In fact, many people will never know they have had it. Some people may have mild flu-like symptoms. A few may experience a more long-term illness similar to glandular fever and swollen lymph nodes.

    Although toxoplasmosis normally causes a mild illness in people with healthy immune systems, it’s risky during pregnancy because it may harm your baby.

    The parasite can be found in meat, cat faeces, the soil where cats defecate and unpasteurised goats’ milk. The toxoplasma parasite can infect most birds and warm-blooded animals, including humans. Cats are the only animals that can have infected faeces. After it catches the infection through eating birds, mice or other raw meat, a cat can shed infectious faeces for about 14 days.

    Toxoplasmosis cannot be caught by stroking a cat or having a cat as a pet. The infection comes from coming into contact with the infected faeces of a cat.

    How common is toxoplasmosis?

    It is estimated that between a third and half of the UK population will have the infection at some point in their lives. Once you have had the infection, you are then immune for life – you cannot catch it again. Around 2,000 UK women per year contract toxoplasmosis during pregnancy.

    Most pregnant women may never know they have been infected unless they experience problems during their pregnancy that mean they have tests. However the infection often has no symptoms at all.

    The effects of toxoplasmosis in pregnancy

    Toxoplasmosis does not usually cause any symptoms and in most cases a person does not realise they have caught the infection. It can cause symptoms similar to flu or glandular fever, sometimes including swollen lymph nodes. Once a person has had the disease they are generally thought to be protected for life, unless they suffer an impairment of their immune system.

    Risks of toxoplasmosis

    Toxoplasmosis is only a risk to an unborn baby if caught for the first time during pregnancy or within a few weeks before you get pregnant.

    If an unborn baby catches the disease they are said to have ‘congenital toxoplasmosis’. The damage the infection may cause will depend on when in pregnancy you got the infection.

    If you catch toxoplasmosis for the first time during pregnancy, it does not mean that your baby will be infected.

    On average, only 4 in 10 of such infections will pass to the baby. Caught during pregnancy, toxoplasmosis can cause miscarriage, stillbirth or damage to the baby’s brain and other organs, particularly the eyes.

    However, most babies born with toxoplasmosis have no obvious damage at birth but develop symptoms, usually eye damage, during childhood or even adulthood. A few will have more serious symptoms such as blindness or brain damage.

    How is toxoplasmosis caught?

    Toxoplasmosis is caught by swallowing anything infected with, or contaminated by, the parasite.

    • raw or undercooked meat (meat showing any traces of pink or blood), and raw cured meat such as Parma ham or salami
    • unwashed vegetables and fruit
    • cat faeces or soil contaminated with cat faeces
    • unpasteurised goats’ milk and dairy products made from it.

    The infection can also be passed:

    • through the placenta if the mother becomes infected infection (mother to unborn baby).
    • through infected matter entering human body fluids; if, for example, during the process of lambing, material splashes into eyes or open cuts.
    • through transplanted organs or blood products from other humans that are infected toxoplasmosis
    • through inhaling the parasite eggs (possible but very unusual).

    Person-to-person infection is not possible, except from mother to unborn child.

    Who is at risk of toxoplasmosis?

    Anyone who eats anything infected with the parasite. Pregnant women who work on the land, in catering or farming may be at higher risk as they may be more likely to come into contact with the parasite. Lambing is a particular risk for pregnant women.

    Tips to avoid toxoplasmosis during pregnancy

    Only eat meat that has been thoroughly cooked (ie, with no trace of blood or pinkness).

    • Avoid raw meat and cured meat, such as Parma ham.
    • Wash hands, chopping boards and utensils thoroughly after preparing raw meat.
    • Wash all fruit and vegetables thoroughly before cooking/eating to remove all traces of soil.
    • Avoid unpasteurised goats’ milk and dairy products made from it.
    • Wear gloves when gardening and wash hands and gloves afterwards – if you eat while gardening wash your hands first, and try to avoid gardening in areas that may have been soiled with cat faeces.
    • Cover children’s sandpits to prevent cats using them as litter boxes.
    • Remove faeces from cat litter tray every day wearing rubber gloves (or ask someone else do this), scald trays regularly with boiling water.
    • If you are handling litter trays, wash gloves and hands thoroughly afterwards.
    • Do not handle lambing ewes and do not bring lambs into the house.

    Can I change the cat litter tray while pregnant?

    Cats are the only animals that can shed this parasite in their faeces. Provided precautions are taken, cats are not a particular risk to a pregnant woman. If you are handling litter trays, wash gloves and hands thoroughly afterwards.

    What should I do if I think I may have toxoplasmosis?

    Toxoplasmosis is not routinely tested for during pregnancy in the UK. You may however request a blood test from your GP if you feel you may have put yourself at risk, you are concerned about symptoms.

    The blood test looks for antibodies – the body’s natural defences – to the infection. It may take three weeks for these antibodies to be present following an infection, so the blood test will only pick up an infection that you’ve had for at least three weeks. Depending on the type of antibodies found and whether levels are stable, rising or falling, it’s possible to determine when the infection took place.

    The results may come back in a week, or longer if they have been passed on to a Toxoplasma Reference Laboratory .

    Tests for toxoplasmosis in pregnancy

    Blood tests for toxoplasmosis can be done at any stage before or during pregnancy. The blood test can usually only show possible infection two to three weeks after any risk incident, as it can take this long for antibodies to be detectable.

    The blood test involves taking a small amount of blood from the mother. There is no risk to the unborn baby. The blood test aims to show whether certain antibodies indicating toxoplasmosis are present or not, and, if they are present, to find out when the infection happened.

    If the tests show that there is a recent or current infection, there is a risk that the baby will be infected. The obstetrician or GP will make a recommendation about any further action that might be required. It may take several weeks for the infection to pass from you to your baby. The degree of risk and severity of damage depends on when you were infected.

    A positive result due to a current/recent infection

    If the test shows a current or recent infection the blood must be sent on from the local laboratory to the Toxoplasma Reference Laboratory, for confirmation and further testing.

    A small percentage of tests will appear positive when in reality a woman has never had the disease.

    If further tests show that you have a current or recent infection, it means you are suffering from an acute toxoplasma infection. Further action needs to be taken to assess the risk of passing the infection on to your baby.

    If you were infected shortly before conception

    Infection caught shortly before conception (within a few weeks before) carries a one percent risk or below of transmission to the baby, but there is a risk of miscarriage if the baby does become infected.

    If you were infected in the first trimester (week one to 12)

    Infection caught at this stage of pregnancy carries about 10-15% risk of transmission to the baby. A baby infected at this stage has a risk of being miscarried or born with severe symptoms such as hydrocephalus (water on the brain), calcifications of the brain, or retinochoroiditis (inflammation of the retina).

    If you were infected in the second trimester (week 13 to 28)

    Infection caught at this stage of pregnancy brings about 25% risk of transmission. A baby infected at this stage is less likely to be miscarried, but is still at risk of developing severe symptoms as above.

    If you were infected in the third trimester (week 29 to 40)

    Infection caught later in pregnancy is more likely to spread to your baby, the risk of transmission may be as high as 70–80%, but if problems develop, they are less likely to be as serious. Most babies infected will be apparently healthy at birth, but a large proportion will develop symptoms later in life, usually eye damage.

    Finding out if the baby has been infected

    Further tests can be carried out to find out whether or not the baby is infected, although the tests will not show how severe the damage is. An obstetrician or GP can explain the risks and benefits of conducting these tests.

    Amniocentesis is a technique where amniotic fluid is removed by a fine needle from the amniotic sac – the fluid-filled sac around the baby.

    Cordocentesis is a technique where a sample of the baby’s blood is removed from the umbilical cord.

    These procedures carry a .5-1% percent risk of causing miscarriage. They are normally carried out after 15 weeks of pregnancy. The amniotic fluid or blood from the umbilical cord is then tested at the Toxoplasma Reference Laboratory using a range of specialised tests.

    If this is positive, the baby will be considered to be infected. Results typically take two to five days. A detailed ultrasound scan will show if there is major damage, such as hydrocephalus (water on the brain), but a scan that shows no damage, while reassuring, does not rule out the possibility that the baby is both infected and affected.

    Treatment of toxoplasmosis in pregnancy

    If you have a positive blood test result, you may be prescribed an antibiotic called spiramycin, which reduces the risk of the infection being passed from you to the baby. Spiramycin only reduces the risk of transmission from mother to baby and is not active against the parasite. It therefore cannot limit any damage if a baby has already become infected.

    If the baby is found to be infected, a combination of pyrimethamine and sulphadiazine can be taken. These are both stronger antibiotics and help limit any damage to the baby, although again, they cannot undo any damage.

    At 20 weeks an ultrasound scan may also highlight any obvious physical problems in the baby. Termination of pregnancy is also an option for some women, when an infected baby with severe developmental problems has been confirmed.

    All babies born to women with confirmed toxoplasmosis in pregnancy will be monitored closely by paediatricians and receive blood tests during their first year.

    Side effects of treatments

    Spiramycin is used routinely in France for treatment of toxoplasmosis in pregnancy, with little evidence of adverse effects. Experts consider that it is safe to use in pregnancy when a baby is at risk. Women taking spiramycin sometimes experience side effects such as nausea or rashes. Pyrimethamine and sulphadiazine can have side effects for both the mother and baby related to red-blood cell production. Although not normally prescribed in pregnancy, they can be used in extreme circumstances. They are taken with folinic acid, which helps to reduce the worst side effects.

    All babies born to women who have had a recent or current infection in pregnancy should be given a thorough physical examination after birth, followed by blood tests during the first year of the baby’s life.

    Treatment after the baby is born

    Blood sample

    A blood sample should be taken from at-risk babies shortly after birth. A blood sample should also then be taken from you to compare the levels of specific antibodies between you and your baby.

    Tests will be carried out to look for different types of antibodies to toxoplasmosis in the baby’s blood. Your baby carries some of your antibodies, so a positive result is expected and not necessarily alarming. If additional antibodies are present, this may indicate that your baby is infected.

    Other checks/examinations

    Babies who are known to be at risk of having congenital toxoplasmosis should be checked for signs of neurological damage. The eyes will be examined for signs of any problem, preferably by an ophthalmologist (eye specialist). Long-term follow-up by an ophthalmologist might be necessary if eye damage is confirmed.

    Your baby’s general health will also be checked. If there is any possibility that the baby has brain damage, special head X-rays might be carried out to check for calcifications, enlarged ventricles or any other abnormalities.

    Treatment for babies who have been infected with toxoplasmosis

    If blood tests showed that your baby has been infected, antibiotics might be prescribed, even if your baby shows no symptoms. Treatment can sometimes be continued for as long as one year, to help prevent or limit the eye damage that can possibly occur later.

    Further tests/examinations

    A blood sample taken every few months, up to the age of one year, can show whether your baby’s antibody level is falling. By that age, the level should be completely negative. This means that your baby will have lost the antibodies acquired from you and is not infected. When your baby’s blood sample is completely antibody-negative, it means they are definitely not congenitally infected. A falling antibody level is a good sign, but is not conclusive and tests should continue until the antibody level is completely negative.


    Breastfeeding is safe if you have toxoplasmosis, the disease cannot be transmitted this way. You are also passing on extra antibodies to your baby, making their immune system stronger. Breastfeeding is therefore recommended, unless you are being treated with pyrimethamine. This medication should be changed before breastfeeding.

    UK government policy on toxoplasmosis screening

    The UK National Screening Committee recently reported that screening for toxoplasmosis in pregnancy should not be offered routinely as there is not enough evidence that it would help .

    The Committee suggests that getting pregnant women to avoid undercooked or cured meat and communicating the best ways of avoiding infection is a better way of controlling toxoplasmosis than antenatal screening.

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  • ℹ Last reviewed on October 3rd, 2016. Next review date October 3rd, 2019.

    Toxoplasmosis in pregnancy

    In this article

    What is toxoplasmosis?

    • unpasteurised goat's milk or cheese (NHS 2015a)
    • unwashed fruit or vegetables
    • cat poo (most animals can be infected with toxoplasmosis but cats are the only ones to pass it on through their poo) (NHS 2015a, Tommy's 2016)

    You can only catch toxoplasmosis once, after that you're immune to it. So if you've had it in the past there's no risk to your pregnancy. The problem is, the symptoms are so mild you probably won't know if you've had it or not. So it's wise for everyone to take steps to avoid being infected. Fortunately there's lots you can do.

    Will toxoplasmosis harm my unborn baby?

    • damage to the eyes
    • hearing problems
    • learning difficulties as a result of brain damage (BMJ 2015, NHS 2015a)

    About one in 10 babies with congenital toxoplasmosis will have a severe infection with problems that affect them as soon as they are born. Signs of a serious infection include:

    • an eye infection
    • an enlarged liver and spleen
    • jaundice (yellowing of the eyes and skin)
    • pneumonia (BMJ 2015)

    Sadly, congenital toxoplasmosis can also cause a baby to be stillborn (Tommy's 2016) .

    How can I prevent toxoplasmosis?

    • Thoroughly cook all meat and chilled or frozen ready meals before you eat them.
    • Avoid eating cured meats, such as parma ham and salami.
    • Follow good hygiene when handling or preparing meat. Keep kitchen utensils that you've used on raw meat away from food that you're going to eat without cooking and wash the utensils thoroughly before you use them again (NHS 2015a) .

    When you're gardening or handling soil or sand, wear gloves. Then wash your hands afterwards in case you have come into contact with cat poo in the soil (NHS 2015a) . If your child has an outdoor sand box, cover it up to prevent cats using it as a litter tray (NHS 2015a, Tommy's 2016) .

    How will I know if I have toxoplasmosis?

    • a high temperature (fever) of 38C (100.4F) or over
    • aching muscles
    • tiredness
    • feeling sick
    • a sore throat
    • swollen glands (NHS 2015a)

    The NHS does not routinely test pregnant women for toxoplasmosis because the risk is so small (Chapple 2015, NHS 2015a, 2016a, NICE 2008) . So if you're worried that you may have been exposed to the infection during your pregnancy, ask your midwife or doctor about a blood test.

    • That you have never been infected with toxoplasmosis and you are not immune to it.
    • That you have been infected so recently that your body hasn't had a chance to produce the antibodies it needs to fight the infection (false negative). (NHS 2015a)

    If there is a risk that you've been exposed to toxoplasmosis during your pregnancy, your doctor is likely to recommend a repeat blood test a few weeks later, just to be sure (NHS 2015a, Tommy's 2016) .

    Toxoplasmosis and Pregnancy

    Toxoplasmosis is caused by a parasite called toxoplasma gondii. This is found in different forms in raw meat, within cats who eat raw meat and their faeces. Toxoplasmosis infection is common in both men and women outside of pregnancy, however it is infection during pregnancy that is of most concern as it can lead to infection in the unborn infant: congenital toxoplasmosis.

    Who is at Risk?

    Once you have had toxoplasmosis, the body develops immunity and new exposure during pregnancy is not an issue. Peak incidence is between ages 25 and 30 years and in the UK by this time, about 30% of people will have had toxoplasmosis, hence will not be at risk of any problems during pregnancy. In the US, about 30-35% have antibodies and in France more than 65% of women will have already had toxoplasmosis. Because infection is more common in France, congenital toxoplasmosis occurs at over twice the rate in the UK or US.

    It is not known for sure how many women catch toxoplasmosis during pregnancy, but some research suggests it is of the order 2 in every 1000, which means about 1400 each year in the UK.

    What are the Symptoms of Toxoplasmosis?

    It is unusual for otherwise healthy people to be ill when infection occurs.

    How is it Diagnosed?

    A blood test can indicate whether you are susceptible to getting an infection, hence at risk. It can also diagnose new infection in the mother. In France all women are screened at the beginning of pregnancy to see if they are susceptible to infection. In the UK this is not the case as the incidence of infection is low. In any case, risk can be avoided with simple measures, and although ascertaining your antibody status may reassure you if you are immune, it’s not as though there is a vaccine to prevent infection, as is the case with Rubella, for example.

    What are the Risks to the Baby?

    In only about 30-40% of women who catch toxoplasmosis during pregnancy, does the infection pass to the unborn baby. The actual risk appears to be related to the gestation at which it is acquired. It is greatest in the third trimester at 70%, whereas in early pregnancy only 15% of infants will become infected.

    Toxoplasmosis infection may lead to miscarriage, stillbirth, or survival with growth problems, blindness, water on the brain (hydrocephalus), brain damage, epilepsy, or deafness. This often develops after birth, so even normally born infants of women with known infection should be kept under observation for some time.

    If a woman is found to have acquired toxoplasmosis during pregnancy, she will be offered an ultrasound scan to look for signs of fetal infection. After 20 weeks gestation, she may be offered a definitive test – cordocentesis. This involves a scan and blood sample being taken from the umbilical cord.

    What is the Treatment?

    The evidence that antibiotic treatment can help to prevent some of the sequelae of toxoplasmosis infection is unfortunately contradictory. If a scan suggests severe damage, the woman is offered the option of terminating the pregnancy.

    How can I Avoid Catching Toxoplasmosis?

    Although toxoplasmosis is quite serious when it occurs, as you will see from the figures above, it is relatively rare. Women with cats do not need to get rid of them when they become pregnant; it is just necessary to take a few precautions.

    Be sure to only eat meat which has been cooked right through. Wash your hands, cooking utensils and food surfaces after preparing raw meat and wash all the soil from fruit and vegetables before eating. Keep raw meat and cooked foods on separate plates. If possible get someone else to clean out the dirty cat litter or use gloves and wash your hands afterwards. Always use gloves when gardening and wash your hands afterwards.

    Try not to worry excessively or become paranoid about this – if you take these precautions, chance of infection is practically eliminated – you can still pet your cat, without fear!

    Finally, it is important for pregnant farmers to be aware that toxoplasmosis can be caught from sheep at lambing time.

    Where can I get More Information?

    The Toxoplasmosis Trust has information sheets for women with current infection, for those with congenital toxoplasmosis and their families, and for sufferers of acute acquired toxoplasmosis. The address is: 61-71 Collier Street, London N1 9BE. Tel: 0171 713 0599

    Thanks to Dr Roger B. Eaton, Infectious Disease Division, New England Regional Newborn Screening Program, Boston for additional information.

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