Toxoplasmosis in pregnancy complications for the fetus. Toxoplasmosis in pregnant women. Is toxoplasmosis always dangerous for pregnant women

Pregnancy is considered an important period in the life of every woman, and requires careful attention to their health. The expectant mother is prone to various diseases that can have a negative impact on the developing fetus. One of these pathologies is considered, infection with which during pregnancy can cause negative consequences for the developing fetus.

The insidiousness of such an ailment lies in the fact that most often it proceeds without vivid symptoms. What should a woman do if she was diagnosed with chronic toxoplasmosis during pregnancy and how can this affect the child's condition?

It should be remembered that the likelihood of hitting a child with toxoplasmosis with severe symptoms is reduced if the infection occurred in the third trimester.

Experts say that transplacental infection with toxoplasmosis is possible only if the infection of the woman occurred after the onset of pregnancy. In the event that the pregnancy is repeated, then vertical transmission of Toxoplasma is usually not observed.

If a woman becomes ill with toxoplasmosis more than six months before the onset of pregnancy, then usually there are no problems with the development of the fetus. When infected with Toxoplasma less than 6 months before conception, the likelihood of spontaneous abortion is high. In fact, the risk of infection of the child during fetal development depends on the gestational age, that is, permeability plays an important role.

Signs of illness in women

The occurrence of certain signs of the disease is determined by the form of the disease:

• Acute toxoplasmosis is accompanied by the appearance of increased weakness and pain in the muscles. In addition, the patient may notice an increase in lymph nodes and a rise in body temperature up to 39 degrees.
• With cerebral disease during pregnancy, the following symptoms usually appear: frequent headaches, rise in body temperature, decreased sensitivity in certain parts of the body, paralysis or coma.
• With ocular toxoplasmosis, vision problems can occur, painful sensations appear in the eyes, and blindness occurs.
• When diagnosing widespread toxoplasmosis, there is no damage to the eyes and brain. This form of the disease can manifest itself in different ways, and this is due to inflammation of the muscles of the heart, lungs and other organs. In the event that an inflammatory process begins in a certain organ, then it ceases to fully function.
• With chronic toxoplasmosis during pregnancy, a woman becomes too irritable, memory problems appear and neurotic reactions are disturbing. In addition, the patient may complain of attacks of nausea and vomiting, as well as problems with the abdomen in the form of flatulence and constipation. It should be remembered that the most important symptom of chronic toxoplasmosis is myocarditis and specific myositis.

More information about toxoplasmosis can be found in the video:

With toxoplasmosis in a developing fetus, the following symptoms may occur:

• an increase in the size of organs such as
• intracranial calcifications occur
• the placenta thickens
• significant expansion of the ventricles of the brain

With congenital toxoplasmosis during pregnancy, the following symptoms and the baby usually appear:

• yellow coloring of the skin
• the appearance of a rash
• too large or, conversely, small head size
• lag in psychomotor development

Any woman who finds out about her pregnancy should contact the antenatal clinic for registration. She will be assigned various studies, thanks to which she can predict the course of the entire pregnancy and childbirth, and also increase the chances of having a healthy baby.

Infection of the fetus during its intrauterine development is possible if during pregnancy there was a primary infection with Toxoplasma. In addition, it is possible for a child to become infected with a latent infectious process and its activation during pregnancy, however, this phenomenon is quite rare.

In fact, the developing fetus is susceptible to infection at any stage of pregnancy, but Toxoplasma infection is especially dangerous in the 2nd-3rd trimester. In the event that a woman falls ill in the last months of pregnancy, then often the newborns have an asymptomatic course of the disease. In this case, the appearance of clinical signs is observed after a few months or years.

The degree of danger of toxoplasmosis during pregnancy is determined by its duration:

Toxoplasmosis is considered a dangerous disease during pregnancy and everything must be done to avoid infection during this period.

Diagnostic methods

To detect toxoplasmosis during pregnancy, specialists conduct a serological blood test. The doctor needs not only to identify the infection in the female body, but also to determine when the infection occurred. To solve this problem, a specialist needs to determine the presence of class G and M immunoglobulins in the body.

The normal indicator during pregnancy is the presence in the body of stable LgG and the complete absence of LgM antibodies. In the event that the analysis shows the presence in the test blood of only class M immunoglobulins, then this indicates a very recent infection. In the case of pregnancy, this situation is considered extremely unfavorable and a miscarriage is not excluded in a short period of time.

In the event that the pregnancy continues to develop, then almost always experts recommend that a woman terminate the pregnancy, since the child will be born with many malformations and developmental abnormalities. In the event that toxoplasmosis is diagnosed during late pregnancy, then the expectant mother is prescribed effective treatment.

In such a situation, there is no danger to the woman and the unborn child, but after a few months, a second one is usually recommended.If a blood test for infection showed a complete absence of immunoglobulins of both groups, then this indicates the absence of toxoplasma in the female body. In such a situation, the expectant mother must take all precautions throughout the entire period of pregnancy, since she does not have immunity to such a pathology.

Often, during a blood test, specialists detect the presence of class G immunoglobulins in the patient’s body, and the absence of M. This indicator indicates that the infection has been present in the female body for a long time, and today a stable immunity has formed. Even if during pregnancy there is a re-penetration of Toxoplasma into the body of a woman, then this does not threaten her with absolutely nothing.

Features of the treatment of the disease

In the event that a future mother has chronic toxoplasmosis, then its treatment must be carried out before pregnancy or immediately after it. If a woman has no complaints about her condition and clinical indications, they do not need drug therapy and are considered healthy.

Etiotropic therapy involves taking antiprotozoal drugs of the pyrimethamine group, among which the most effective are:

• Rovamycin. An antibiotic such as Rovamycin helps reduce the likelihood of transmission of infection to a developing fetus, and it is well tolerated by the female body. The course of treatment is 2-3 cycles with a break of 30 days.
• Fansidar. Another effective drug that is used to treat toxoplasmosis during pregnancy is Fansidar. Usually, treatment with it is recommended to be combined with the intake of immunomodulatory drugs, because Fansidar has a depressing effect on the hematopoietic function in the female body.

It is worth remembering that the treatment of toxoplasmosis during pregnancy is carried out only under the supervision of a doctor. Any self-treatment can further worsen the situation and lead to sad consequences.

Compliance with such preventive measures allows a future mother without developed immunity to protect herself and her unborn child from infection. In fact, toxoplasmosis during pregnancy poses a threat to the developing fetus, but only if the infection of the body occurred for the first time. An ill woman with developed immunity should not be afraid of the disease, because if the body is re-infected, treatment is no longer required.

If a woman does not have immunity to such a disease, preventive measures must be taken to avoid the development of toxoplasmosis. In the event that infection does occur, the risk of possible complications is determined by the duration of pregnancy. The consequences of such a disease can be quite deplorable and result in the loss of a child.

Toxoplasmosis is one of the most dangerous infections during pregnancy. It affects not only the body of the future mother, but also the fetus, which is why the timely diagnosis of the disease is so important. In this article, we will talk about the symptoms and consequences of toxoplasmosis in early and late pregnancy, as well as methods for treating the infection.

Toxoplasmosis is an infectious disease caused by the protozoan Toxoplasma. They live everywhere, but a pregnant woman should be wary primarily of cats and other domestic animals. Most often, infection occurs through feces that the expectant mother removes, animal saliva and other direct contact. In addition, raw meat is also dangerous, which during pregnancy should not be consumed uncooked. The source of the disease can be poor hygiene, contact with the soil (for example, in the country), as well as blood transfusion or transplantation of organs infected with Toxoplasma.

Prevention of the disease is quite simple: you need to wash your hands often, cook or fry the meat until fully cooked, thoroughly wash fruits and vegetables, work with the earth only with gloves. During pregnancy planning, you can check your pets for the presence of toxoplasma: for this, it is enough to pass their feces for analysis. These simple manipulations will allow you to protect yourself and your unborn child from a dangerous infection as much as possible.

There are several forms of the disease: latent, acute and chronic toxoplasmosis. During pregnancy, they all pose a serious danger to the fetus.

Every girl planning a pregnancy is recommended to be tested for TORCH infections, among which there is toxoplasmosis. Based on these tests, it will be possible to draw conclusions: is it worth worrying about this infection at all and whether you are sick with it now. When a disease is detected during pregnancy for the first time, serious treatment will be required, and its consequences can be deplorable.

If during the bearing of a child you or your doctor have concerns about infection with Toxoplasma, then an immediate diagnosis will be required. Analysis for toxoplasmosis during pregnancy can be done by three methods: indirect immunofluorescence reaction, enzyme immunoassay and complement fixation reaction. The second method is most often used: a blood test for the presence of antibodies to the disease, class M and G immunoglobulins. Blood for toxoplasmosis during pregnancy is taken from a vein and allows you to identify a long-standing and fresh infection.

When you receive the result of the analysis, you will see two components in it: IgG and IgM. Normally, during pregnancy, toxoplasmosis IgM antibodies should be absent in the blood, since they mean the presence of an infection at the moment and cause a threat. Already in the third week of infection with Toxoplasma, these antibodies reach their maximum values ​​in the blood and disappear completely after about three months. IgG antibodies indicate that you have already had toxoplasmosis at some time, possibly in a latent form. This means that at the moment you have immunity to this disease.

If toxoplasmosis is IgG positive during pregnancy and IgM is negative, this is a good result. So, now you are healthy and will not get this infection. If both immunoglobulins are not found in the blood, then you have never met with Toxoplasma and are at risk. You should be as careful as possible to monitor hygiene during pregnancy. Both positive immunoglobulins indicate the presence of infection within a year, but IgM positive with negative IgG indicates a recent infection. In both cases, consultation with a gynecologist and treatment is required.

Toxoplasmosis: symptoms during pregnancy

As we have said, the infection affects almost all organs. Therefore, the signs of toxoplasmosis during pregnancy can be very diverse. Among them, it is worth identifying the most striking:

• enlargement and soreness of the lymph nodes,
• heat,
• headache,
• jaundice,
• muscle and joint pain,
• dizziness and loss of consciousness,
• enlargement of the liver and spleen,
• rash,
• inflammatory processes of the eyes,
• pneumonia and other lung diseases,
• memory and central nervous system disorders.

Such symptoms are characteristic of the acute period of toxoplasmosis and may threaten the life of the patient.

You should definitely consult a doctor immediately. Self-medication with toxoplasmosis is impossible.

Treatment of toxoplasmosis during pregnancy

We have already said how dangerous toxoplasmosis is during pregnancy. How to treat this disease, only your doctor can say for sure, based on the results of the tests. Drug therapy is indicated only for patients in the second and third trimesters of pregnancy. In the first trimester, all drugs for toxoplasma are contraindicated due to the possible negative impact on the development of the fetus.

It should be noted that Toxoplasma infection is most dangerous in the first trimester. Therefore, in this situation, with a severe course of the disease, doctors may recommend termination of pregnancy. Toxoplasmosis is treated with antibiotics. An effective macrolide drug Spiramycin is often prescribed, and in addition to it sulfonamides. Sometimes Spiramycin is replaced by Fansidar (an antibiotic of the pyrimethamine group). Additionally, it is necessary to take Folic acid, immunomodulators may be prescribed. The dosage and course of treatment is selected individually for each patient.

Why is toxoplasmosis dangerous during pregnancy?

The irreversible consequences of toxoplasmosis during pregnancy are infection of the fetus. According to statistics, it occurs more likely when a girl becomes infected with Toxoplasma in the third trimester. In this case, the baby is born with a congenital infection. Symptoms of intrauterine infection are enlarged lymph nodes, spleen and liver, hydrocephalus, convulsions, jaundice, intracerebral diseases.

If the infection occurred after conception and already in the first trimester, toxoplasmosis was diagnosed, it is difficult to say exactly how the infection affects the pregnancy. Possible consequences of this disease are spontaneous miscarriage at an early stage, premature birth and the birth of a dead child. Accordingly, this disease is better to prevent or detect at an early stage than to treat while waiting for the baby.

Such a term as TORCH infection is familiar mainly to pregnant women and women planning a child. The rest may throughout their lives and not know what it is. TORCH syndrome includes the following infections: toxoplasma, rubella, cytomegalovirus, herpes. The fact is that they pose a serious danger only to people with severely suppressed immunity (for example, HIV-infected) or those who are still unformed. Therefore, for a growing fetus, infection with any of these infections can, under certain circumstances, become a deadly threat. A feature of toxoplasmosis is that the sources of invasion are domestic and wild mammals. A pregnant woman should be aware of the risks of infection, preventive and therapeutic methods. Timely measures taken will contribute to a healthy and happy pregnancy.

What is toxoplasmosis, ways of infection

Toxoplasmosis is characterized by a variety of clinical effects on a person from an asymptomatic course in most cases to death. There are the following ways of infection:

• Eating raw or insufficiently thermally processed meat, poorly washed vegetables and fruits with the pathogen in them.
• Through the body of the expectant mother to the growing fetus.
• Blood transfusions, open wounds and cuts.

Doctors distinguish the following forms of toxoplasmosis:

• Acute. It usually occurs in people with weakened immune systems. It is characterized by pronounced painful symptoms that require immediate treatment to reduce the likelihood of complications.
• Latent. It is typical for most infected people. Passes without symptoms. Special therapy is required only for AIDS patients, cancer patients.
• Congenital. Occurs when the fetus is infected through the placental barrier in an infected pregnant woman.

Symptoms

Most (more than ninety percent) of infected pregnant women do not experience any symptoms of the disease. After some time, they recover, without even assuming the appearance of Toxoplasma in the body in an inactive form. Recovery occurs due to the formation of specific antibodies in the blood.

In rare cases, a pregnant woman may experience moderate clinical signs similar to influenza and SARS:

• elevated temperature;
• headache;
• body aches;
• enlarged cervical lymph nodes.

The incubation period after the penetration of the pathogen is from a week to three.
Enlarged cervical lymph nodes against the background of ARVI symptoms are one of the signs of primary infection with Toxoplasma

Danger during pregnancy for mother and child, possible consequences

According to doctors, toxoplasmosis is a serious danger to the fetus if a woman becomes infected already during pregnancy. In this case, the primary infection is diagnosed. Toxoplasma is highly likely to affect the unborn child. The degree of damage depends on the duration of pregnancy. When a woman is ill in the first trimester, the risk of fetal death is high. With increasing gestational age, this risk decreases, but the likelihood of having a child with the following severe defects increases:

• brain damage;
• disorders of the nervous system;
• visual impairment;
• pathology of the liver and spleen.

Medical science has revealed another pattern - with an increase in the duration of pregnancy, the protective functions of the placenta decrease. Therefore, the probability of infection of the fetus in the first trimester is about fifteen percent, in the second - twenty-five and in the third - seventy. Despite the fact that in many cases, congenital toxoplasmosis does not manifest itself in any way immediately after birth, in the future, mental and mental disorders, defects in internal organs and eyes, which significantly reduce the quality of life of the child, can still be observed. The only comforting news is that only one child can become infected in one woman. The next children will be protected by the developed immunity of the mother's body.

Statistics from European countries show that congenital toxoplasmosis is registered in no more than one child per thousand newborns. Among them, severe brain pathologies occur in every tenth.

Table: the likelihood of infection of the fetus and possible malformations in toxoplasmosis in a pregnant woman

Diagnostics

When the fetus is infected by nature, a self-destruction mechanism is triggered, which ends in a miscarriage. But modern medicine has enough opportunities to save pregnancy. Therefore, in this case, accurate timely diagnosis, comprehensive treatment and regular examinations are of great importance.

Toxoplasmosis can be diagnosed as a result of so-called serological tests. Serological studies are methods for determining the appearance of antibodies in the blood in response to infection. Also, a suspicion of toxoplasmosis can be detected by an abnormal development of the fetus during ultrasound. When registering with a antenatal clinic, such studies should be carried out. In the future, it is recommended to repeat them, depending on the results of previous analyzes, on a monthly or trimester basis. This procedure allows you to recognize in time the danger of infection of the unborn child and begin drug treatment to prevent congenital toxoplasmosis.

The purpose of serological studies is to determine the period of infection (before or after pregnancy). If tests show recent infection during pregnancy, then the risk of infection to the fetus is high. Primary research is carried out in a conventional laboratory. Their result is the determination of the presence of IgM antibodies and IgG antibodies. If the results for these antibodies are negative, then there is no infection. If only IgG antibodies are observed, then the infection occurred long before pregnancy, and the woman developed immunity to Toxoplasma. In both cases, additional studies are not required.
During the primary infection with Toxoplasma, there is a sharp production of IgM antibodies by the body, followed by a decrease and a slow IgG antibody.

Additional diagnostics during pregnancy

If IgM antibodies are detected in a pregnant woman, then the woman is at risk. In such cases, the expectant mother is subject to medical examination, in-depth serological examination, monitoring of the body's response in dynamics, prevention and therapeutic effects.

In addition to the usual antibody test, an avidity test is performed. This test provides additional information to assess the duration of the disease. Such studies can only be carried out in specialized reference laboratories.

It should be noted that negative results for IgM antibodies with high accuracy indicate that there is no need to worry about toxoplasmosis. The presence of IgM antibodies does not mean at all that the fetus has become infected. This may be due to the fact that such antibodies can be in the blood for one and a half years after infection. In addition, half of the positive results for IgM antibodies turn out to be false, which is associated with imperfect diagnostics.

To reliably interpret serological tests, the doctor uses the complete clinical picture, including the results of ultrasound and amniocentesis (a procedure for examining amniotic fluid to study malformations in the fetus).

Table: approximate transcript of serological tests for toxoplasmosis during pregnancy

Infection of a pregnant woman, treatment

When a pregnant woman is diagnosed with infection and the fetus is not infected, doctors will prescribe a special treatment to prevent the disease of the unborn child. For this, Spiramycin is used, which is an antibiotic of the macrolide group, is prescribed at a dose of one gram three times a day. The course of therapy is intermittent: two weeks of admission and two breaks. Such prevention should be carried out throughout pregnancy. There is no significant evidence base for the use of Spiramycin, but preliminary studies have shown that the incidence of fetal infection is reduced by more than fifty percent.

If infection of the fetus is confirmed with a high probability, then timely treatment of congenital toxoplasmosis will reduce the severity of malformations by half. Therapy is carried out with drugs such as Pyrimethamine and Sulfadiazine. The intake of these drugs must be combined with the intake of folic acid. Such treatment is recommended only in the second and third trimester. The dosage and duration of the therapeutic course can only be selected by a doctor.

If infection of the fetus is confirmed by several consecutive studies and ultrasound in the first trimester, when the likelihood of malformations is high, a council of doctors and the pregnant woman may consider terminating or continuing the pregnancy. Pregnant women infected in the second and third trimesters should be treated.

Photo gallery: drugs for the treatment of toxoplasmosis

Spiramycin is used to prevent infection of the fetus in a sick pregnant woman Pyrimethamine is the main drug in the treatment of toxoplasmosis Sulfadiazine increases the effectiveness of therapy for toxoplasmosis Pyrimethamine

Congenital toxoplasmosis in a newborn, diagnosis and treatment

After childbirth, congenital toxoplasmosis in a newborn is often not immediately expressed by any symptoms. Therefore, if this disease is suspected, serological tests for mother and child should be performed at least four to six times during the first year. IgG antibodies can be passed from mother to fetus. If the number of these antibodies decreases, then most likely there is no congenital toxoplasmosis. An increase in indicators means the presence of a disease. The presence of IgM antibodies in the baby's blood serum is an additional sign of infection.

The results of serological studies are compared with the clinical condition of the child, the mother's tests and data on the detection of Toxoplasma DNA in the blood and urine of the child by PCR (polymerase chain reaction).

Congenital toxoplasmosis is still a hidden problem associated with the complexity of intravital diagnosis and the presence of clinical and immunological features. It is dangerous for its late manifestations: symptoms of chorioretinitis or neurological signs are recorded in 80–90% of cases.

T.I. Long

"TOXOPLASMOSIS: A MODERN STRATEGY FOR LABORATORY DIAGNOSIS"

Treatment of congenital toxoplasmosis in a newborn should begin immediately when a preliminary diagnosis is made. The choice of therapy is carried out taking into account the patient's condition and laboratory tests. The child should be transferred as soon as possible to the neonatal pathology department. Further treatment is continued on an outpatient basis. The following drugs are used: Pyrimethamine, Sulfadiazine, Spiramycin. According to the observations of doctors, timely treatment of congenital toxoplasmosis can lead to the normal development of the child. Otherwise, the statistics are very sad. In acute forms, mortality under the age of five years is about ten percent. Most of them have mental retardation. The latent form of congenital toxoplasmosis without appropriate therapy leads to nervous disorders in eighty percent of children. Treatment reduces this figure to three to five percent.

Prevention

General measures to prevent infection with Toxoplasma are the following:

• avoiding contact with cats;
• compliance with the rules of personal hygiene;
• exclusion from the menu of insufficiently thermally processed meat products (toxoplasma dies at a temperature of more than 67 degrees and less than minus 13);
• thorough washing before eating greens, vegetables, fruits.

Unfortunately, there is currently no developed vaccine against toxoplasmosis.

Video: Dr. O.E. Komarovsky about toxoplasmosis

In this case, an infected person is not a distributor of the disease and does not need to be isolated. Therefore, toxoplasmosis in pregnant women can be treated on an outpatient basis.

It is important that against the background of reduced immunity of a pregnant woman with a chronic form of the disease, reactivation of the pathogen (exit from oocysts) may occur, followed by infection of the child.

Symptoms of the disease

It is difficult to recognize toxoplasmosis: a diagnosis can only be made after deciphering specific blood tests. In most cases, the disease proceeds in a chronic form, and only 0.2-0.3% of those infected develop symptoms of acute infection, more often with weakened immunity (in patients with chronic diseases, HIV, AIDS).

The acute period occurs after 2-25 days of the incubation period (mainly clinical manifestations appear 12-14 days after infection). Common complaints of patients are noted:

• The appearance of chills.
• Decreased performance.
• A person quickly gets tired, feels weak, chills.
• Body temperature can exceed the threshold of 38.5 degrees.
• Head, muscle and joint pains are noted.
• Lymph nodes in the neck are significantly enlarged after a few weeks after infection.
• There may be an increase in inguinal, sub- and supraclavicular lymph nodes, pain is absent.
• The disease can occur against the background of pneumonia, severe damage to the brain, heart muscle, inflammation of the vessels of the eyeball and retina.

After a period of acute course, lasting from one to several months, toxoplasmosis becomes chronic. In this case, there may be a slight deterioration in human health for several years. During this period, the patient experiences:

1. An increase in body temperature to 37.6 degrees, not amenable to therapy with conventional drugs that have an antipyretic effect.
2. Enlargement of the spleen and liver.
3. Memory deterioration.
4. The appearance of apathy.
5. Headache.
6. Enlarged lymph nodes.
7. General weakness.
8. The development of obsessive states, the appearance of an unreasonable fear of something.
9. Disorder of appetite and sleep.
10. Mood swings, increased irritability.
11. Reluctance to move.

Depending on the site of introduction of Toxoplasma, a person may develop specific symptoms of the disease. With damage to the heart and blood vessels, the patient may feel palpitations, manifestations of arrhythmias (changes in heart rate), hypotension (lowering blood pressure), pressing pains in the heart.

Sufficiently specific symptoms of toxoplasmosis are eye diseases: uveitis, progression of myopia, chorioretinitis. With damage to the musculoskeletal system, patients may experience constant severe pain in the muscles of the legs and lower back, less often pain appears in the neck, arms or back. Often, these kinds of symptoms prevent the patient from moving and lead to a predominantly recumbent lifestyle.

The chronic course of the disease passes with periods of remission, during which the patient can lead a normal life and not feel any inconvenience or deterioration in well-being.

Threat to the fetus

If toxoplasmosis is transmitted to the fetus during pregnancy, then intensive reproduction of the pathogen can lead to the development of various kinds of inflammatory reactions, accompanied by intense calcification (calcium deposition in tissues) and necrosis (tissue death). If by the time of infection the baby's own immune system has not yet formed, then hydrocephalus, ascites, hepatosis, meningoencephalitis (brain tissue damage) and chorioretinitis (eye disease) may develop. Often, Toxoplasma develops in a specific organ of the fetus, in which case there are specific symptoms (hepatitis, myocarditis). In early pregnancy, such violations lead to miscarriage. If the fetus survives, a child is born with signs of deformity and impaired functioning of organs and systems affected in utero.

Later infection of the fetus can manifest itself in the form of mild pathology, or extremely severe organ damage. Symptoms may manifest as fever, swollen lymph nodes, jaundice, anemia, hepatosplenomegaly, seizures, exanthema, or thrombocytopenia. If there are no obvious signs of developmental disorders of the born child, then they may appear years later. Such late manifestations are expressed in the form of neurological abnormalities, mental retardation, deafness, chorioretinitis and other diseases.

Diagnosis of toxoplasmosis

To recognize the disease, several types of laboratory tests are used:

• RNIF (indirect immunofluorescence reaction).
• ELISA (enzymatic immunoassay).

The diagnosis of toxoplasmosis is made by the results of a clear increase in the level of indicators, or by the presence of specific antibodies (IgM) in the blood. That is why the sampling of the analysis is carried out repeatedly and the change in the indicators of serological reactions is monitored. The greatest number of indicators reach by the end of the second or third week after infection.

After the studies carried out in comparison with previous analyzes, the doctor determines the conclusion and recommends further actions. Several options are possible.

If toxoplasmosis is found in a pregnant woman, this does not mean that the child inside the womb will also be infected. With timely medical treatment, you can count on the birth of a completely healthy baby.

Treatment of the disease in pregnant women

If a woman found out about the disease in the first trimester and persistently wants to keep the pregnancy, then she is warned about the possible consequences of the disease and the use of drugs, and they take a receipt that she was warned about the risks. In the first three months, a pregnant woman is prescribed spiramycin, subsequently therapy is carried out with pyrimethamine and sulfonamides, with alternating spiramycin until delivery. Only 2 weeks before the time of delivery, sulfonamides are canceled.

During the entire treatment period, the woman is under the supervision of a doctor and takes weekly blood and urine tests to monitor her condition and the condition of the fetus. If a woman does not tolerate pyrimethamine preparations, then they can be replaced with erythromycin.

Violation of erythropoiesis with anemia of various types, impaired renal function, liver failure, impaired cardiac activity are contraindications for therapy with a combination of sulfonamides and pyrimethamine.

Perhaps the simultaneous appointment of immunomodulators (drugs such as Polyoxidonium and Galovit have proven themselves well). The need for their use is determined only by the doctor.

Since the diagnosis of the disease is possible only in the laboratory and treatment is carried out with drugs from the group of antibiotics that can affect the condition of the fetus if taken uncontrolled, only a doctor can prescribe treatment. He determines the type of drugs, the scheme and the frequency of their use. Self-medication can result in even greater pathologies in the development of the fetus. It is better for a woman to pay more attention to preventive measures to prevent the pathogen from entering the body.

Prevention

All preventive measures can be divided into three groups.

1. primary prevention. It is expressed in informing the population about the ways of transmission of toxoplasmosis, and the need to follow simple rules during pregnancy:
   • It is good to fry or boil meat.
   • Do not use the same cutting board for slicing fresh and cooked meat and fish.
   • Pour boiled water over fresh vegetables and fruits collected from the ground.
   • Wash hands well after contact with soil.
   • Entrust the care of a domestic cat to other family members.
   • Carry out daily cleaning of the cat litter with boiling water.
   • Do not give your pet raw meat.
   • Conduct periodic examination and timely treatment of the cat for the presence of toxoplasmosis.
   • Seek immediate medical attention if you experience the slightest discomfort.
2. secondary prevention. It consists in the timely detection of a disease in a pregnant woman. carried out by periodically passing all the necessary tests during pregnancy.
3. Tertiary prevention. It consists in the timely appointment of the necessary medications to prevent intrauterine infection of the fetus with Toxoplasma; examination of a newborn; dispensary observation of a child until he is 5 years old.

Toxoplasmosis is often diagnosed during pregnancy. There are legends about an incredibly terrible disease that leads to complications and undermines the health of mother and child.

Is toxoplasmosis dangerous during pregnancy? To understand whether the threat is so great, you should understand what pathology is.

As a rule, animals are the host of Toxoplasma.

The disease belongs to the group of TORCH infections, which includes, as well as. A severe form of pathology is indeed considered dangerous for normal intrauterine development.

How does infection occur?

Pathogenic microorganisms can be infected in different ways:

Cats are more likely to transmit toxoplasmosis than other animal species. Although the carriers of toxoplasmosis can be rodents, foxes, wolves, fur animals, etc.

In this case, the organisms enter the blood through abrasions and scratches;

• When eating meat that has undergone insufficient heat treatment.

It is possible to lick raw minced meat to determine if there is enough salt and to get toxoplasmosis unnoticed.

• When eating unwashed raw fruits or vegetables.
• In the absence of standard hygiene while working at their summer cottage.
• When transfusing infected blood;
• Transplacental way, when microorganisms are transmitted through the bloodstream from mother to fetus.

By the way, you should not part with your pet during pregnancy. Toxoplasmosis affects animals that eat raw meat or rodents.

If the cat is kept in the house, does not make night walks around the neighborhood and eats exclusively ready-made food or dishes specially prepared for her, the risk of becoming infected from a cat is minimal.

To verify this, you need to take the animal to the veterinarian.

If infection with toxoplasma occurred long before conception and the disease proceeded in a latent form, without giving any characteristic symptoms, it is believed that toxoplasma does not pose a threat to the mother and child.

When does toxoplasmosis become dangerous?

Chronic toxoplasmosis (when IgG antibodies are present in the blood) does not pose a danger to the mother and child, but primary infection with toxoplasmosis during pregnancy is very dangerous, because pathogenic microorganisms can adversely affect the intrauterine development of the fetus.

Acute toxoplasmosis, as well as rubella, is ill only once. If a woman has already met with this disease before pregnancy, then information about this event in the form of antibodies will inevitably remain in her blood.

It is the antibodies that prevent the development of a recurrent disease.

You can find out about the carriage of toxoplasmosis by a blood test from a vein for antibodies to toxoplasmosis. If the analysis is negative, then toxoplasmosis is really dangerous.

How it affects pregnancy: the consequences of the disease

Penetrating through the placenta, Toxoplasma gondii can disrupt the natural development of the embryo and lead to deformities or death. At the same time, the risk increases inversely with the gestational age:

• 1 trimester.

Why is toxoplasmosis dangerous in early pregnancy?

Infection during the first 12 weeks often leads to spontaneous abortion. If a miscarriage does not occur, we are talking about artificial termination of pregnancy.

Otherwise, the consequence of acute toxoplasmosis, transferred during pregnancy, may be the birth of a child with significant disturbances in the functioning of the internal organs or the nervous system.

• 2 trimester.

Despite the risk of infection, termination of pregnancy is no longer discussed.

If infection does occur, then the brain, nervous system and organs of vision are primarily affected.

This disease is manifested by characteristic symptoms, which are often accompanied by chorioretinitis, hydrocephalus, thrombocytopenia, microphthalmia.

• 3rd trimester.

In the third trimester, the placenta begins to age and cannot guarantee reliable protection for the baby.

When a woman is infected with acute toxoplasmosis in late pregnancy, in 90% of cases, the fetus is also infected.

At this time, the risk of having a child with abnormalities is significantly reduced, since the own, not fully formed, immune system begins to function.

There is a high risk of the birth of a baby with a congenital form of toxoplasmosis.

A born baby is sick in utero, and after birth, antibodies are found in his blood. In most cases, toxoplasmosis in the 3rd trimester does not adversely affect the fetus.

The most dangerous is the primary infection that occurred in the early stages of pregnancy, since the fetal egg does not yet have its own protection.

Signs and symptoms of acute toxoplasmosis

Is it possible to self-diagnose the disease, focusing on specific manifestations and signs?

Toxoplasmosis cannot be determined without laboratory tests, since in 90% of cases the disease is asymptomatic.

The acute form leads to damage to internal organs and entire systems. Because of this, the clinical picture varies significantly depending on the organ that has undergone the most severe exposure to Toxoplasma.

In rare cases, the following symptoms of acute toxoplasmosis are observed:

• systematic cephalgia;
• , sometimes more than 38°C;
• weakness;
• the appearance of a skin rash and yellowness;
• lack of appetite;
• constant sleepiness.

On examination, an increase in the lymph nodes, as well as the liver, is usually detected. Often the eyes are prone to inflammation. There is a decrease in the tone of muscle tissues, a memory disorder, the presence of obsessive-compulsive states.

Such symptoms make it much faster to determine which system has suffered the most during the development of acute toxoplasmosis.

Modern laboratory diagnostic methods

The main method to detect toxoplasmosis is a blood test.

I will clarify that at the time of the first pregnancy I already had antibodies to toxoplasmosis. This was confirmed by a blood test, which I took at the stage of pregnancy planning: IgM was negative, and IgG was positive.

I took all the tests that I had done during planning with me when I went to register at the antenatal clinic. The doctor took a quick look and filed it to the map. And I remembered these tests only in the second trimester - at week 20.

She looked again and said that the presence of antibodies is not very good, that I may have a chronic form that is about to worsen. That, they say, toxoplasmosis is very dangerous during pregnancy, as it causes "deformities of the fetus." Yes, yes, she said so. In general, I sent for a consultation with an infectious disease specialist. What happened to me then: shock, hysteria, anger, despair - all rolled into one.

The infectious disease specialist is also neither "be" nor "me". She says yes, there are antibodies, there is no acute phase, she does not know how serious this condition is, since Torch infection, where toxoplasmosis belongs, is not her profile. She told me to look at the ultrasound. If everything is fine, then there is no need to worry. I had to do an unscheduled ultrasound at week 20, since I was already signed up for a paid clinic, and there was no strength to wait another 2 weeks. Ultrasound examination showed that there are no abnormalities, and the daughter is developing normally.

Over the past few days, I have scoured the entire Internet and realized that the presence of IgG antibodies is much better than their absence. Since in this case the child is reliably protected, after all, only the primary infection with toxoplasma is dangerous.

Xenia, 35.

How to prevent infection?

If a woman did not suffer from toxoplasmosis before pregnancy, then during the period of gestation, she should adhere to the following recommendations:

Using simple rules of hygiene, you can avoid the primary infection with toxoplasmosis during pregnancy. However, it is better to undergo a diagnosis in order to know for sure whether or not immunity to this disease exists.