Toxoplasmosis and Pregnancy

ExitCare ImageToxoplasmosis in pregnancy is a serious illness because of the effects it has on the fetus. It is caused by the parasite Toxoplasma gondi. Infection most often comes from the feces of infected cats. It can also come from the ingestion of poorly cooked meat, contaminated food by insects, contact with infected insects or soil. Infected cat feces may remain infectious in the soil for over one year. House cats living on cat food are usually not infectious; cats who hunt for their food can be. These cats should be avoided and cared for by someone else during pregnancy. Infections that do not cause symptoms are common. About one third of child bearing age women have antibodies to this disease. Almost two thirds of mothers infected during pregnancy will pass the infection on to their baby.

SYMPTOMS

Usually there are no identifiable symptoms. However, following an incubation period of 5 to 18 days, there may be:

  • Fever.

  • Confusion.

  • Seizures.

  • Swollen lymph glands.

  • Muscle aches.

  • Night sweats.

  • Enlarged spleen in 10 to 20% of people

TOXOPLASMOSIS IN THE FETUS

Congenital disease (something you are born with) in the fetus or infection in the first three months (first trimester) of pregnancy can cause miscarriage or severe problems such as:

  • Mental retardation.

  • Blindness.

  • Deafness.

  • Ascites (fluid in the abdomen).

  • Fever.

  • Epilepsy.

  • Calcifications in the brain,

  • Head and brain development problem (hydrocephaly) can occur.

The later the infection occurs in the pregnancy, the more likely it will be transmitted to the fetus. Ultrasound can determine the amount and seriousness of the infection in the fetus. Treatment for this is not entirely satisfactory. Prevention is important.

DIAGNOSIS

The diagnosis depends upon blood testing because this infection is often without symptoms. This testing is not routinely done on new pregnancies. The test does not determine the time of infection. Testing can be done on the fetus if infection is suspected. Amniocentesis (fluid from the baby's sac) can identify the infection in the uterus.

PREVENTION

  • Cook all meat thoroughly.

  • Keep house cats indoors. Feed them only store bought foods.

  • Avoid outdoor cats.

  • Screening women who had toxoplasmosis in the past.

  • Getting blood tests in high risk patients before getting pregnant.

TREATMENT

The treatment in pregnancy is not entirely effective. It is best to take steps to avoid infection. Treatment can reduce the risk of congenital defects but cannot eliminate them. When suspected and diagnosed, treatment should be given right away. Spiramycin, an antibiotic, is given along with pyrimethamine, sulfonamides and folic acid to help get rid of the infection in the placenta and the fetus. Early treatment can result in a normal pregnancy and a healthy fetus.

Treatment of infants with toxoplasmosis is done by giving pyrimethamine, sulfonamides and spiramycin every other month for a year. Treatment can get rid of brain calcifications and improve neurological and mental problems of the infant.

HOME CARE INSTRUCTIONS

  • Follow the recommendations in prevention.

  • Do not take in stray cats before having them checked for toxoplasmosis.

  • If you are at risk for toxoplasmosis, get checked before getting pregnant.

SEEK MEDICAL CARE IF:

  • You think you may have contracted toxoplasmosis.

  • You came in contact with a stray cat.

  • You have a cat and think it may have toxoplasmosis.

  • You want to get pregnant and want to be tested for toxoplasmosis.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop a fever of 102° F (38.9° C) or higher.

  • You have or came in contact with a cat and you develop any of the symptoms listed above.

  • You think your baby may have contracted toxoplasmosis.