Toxoplasmosis in pregnancy

What is toxoplasmosis in pregnancy? Toxoplasma gondii is a tiny parasite that lives in the cells of many mammals and birds. Man is for the exciter only a random stopover; To multiply, he needs a cat as a host. In the course of their lives, many people come into contact with the tiny creatures - mostly unnoticed. The parasites cause severe damage only in people with a weakness of the immune system or in pregnancy with the unborn child, when the mother first becomes infected.

Symptoms of toxoplasmosis

At the age of 30, about every third person had contact, and for the 70s over 70%. Most of the time the body discovers unnoticed with the onslaught of the parasites. Rarely does the infection manifest itself with flu-like symptoms: swollen lymph nodes, fever, fatigue. The toxoplasmas remain as cysts in the tissue. Thus, the immune system maintains immunity lifelong and successfully prevents further infections.

When is toxoplasmosis dangerous?

For humans, there are two situations in which the harmless parasites become threatening agents: on the one hand a weakness of the immune defense, as it occurs in serious diseases, such as AIDS. Then the toxoplasmas in the cysts can spread unhindered and destroy vital organs. Parasites can also cause harm to the unborn baby during pregnancy; but only if the mother becomes infected for the first time during pregnancy.

In such cases, the masses of toxoplasma that occur at the beginning of the infection may reach the uterus before being intercepted by the maternal immune defense force. Once there, the way to the fetus is only short. Since its organism does not have an immune system, it is exposed to infection unprotected.

What are the consequences of toxoplasmosis for the unborn child?

Only a primary infection of the mother is at all a risk for the fetus to be infected. This in turn depends on the time at which the first contact takes place during pregnancy. Exact numbers do not exist, estimates are 5-15% in the first trimester, 30% in the second and over 60% in the last three months of pregnancy.

The sooner the unborn child is affected, the more serious the consequences can be. This is because the organs train in the first weeks of pregnancy and during this time are very sensitive to harmful influences.

Therefore, the brain in particular can be severely affected - with the result of calcifications, hydrocephalus and scarring. It can also come to a miscarriage. If the infection occurs only in the second half of the pregnancy, newborns often have little or no abnormalities. Sometimes long-term consequences such as changes in the eyes or developmental delays are apparent.

How can an infection be avoided?

There are two major sources of infection for humans. The most important thing is raw or insufficiently heated meat, in which cysts with pathogens can be found. The other is cat feces, especially if it is not completely fresh, since the toxoplasmas take several days to form infectious stages. However, these can then remain contagious for months. Ways to prevent a primary infection as pregnant women are:

  • Do not eat or season raw meat like pork
  • Always heat meat long enough
  • Wash fruits and vegetables carefully
  • Wash hands thoroughly after touching raw meat, fruits and vegetables
  • Avoid contact with cat droppings; Family members ask to clean the cat lavatory daily with hot water (> 70 ° C)
  • Feed cat with canned or dry food
  • Wash hands after contact with cats and after finished gardening

Toxoplasmos: diagnosis and diagnosis

If there is a suspicion of toxoplasmosis, the blood can be tested for antibodies. These provide information on whether an infection has taken place and whether it is fresh or has been older. This test can also be performed if you want to have children or in early pregnancy. However, he does not belong to the prenatal care, so is only paid by the health insurance, if there is a reasonable suspicion of infection.

What to do in case of toxoplasmosis?

Pregnant women who have become newly infected must be treated with medication - even if they have no symptoms! The choice of antibiotic is made by the attending physician depending on the week of pregnancy; The intake takes at least 4 weeks. Furthermore, the specialist will assess the development of the child by means of extensive ultrasound and if necessary - after the 20th week of pregnancy - also initiate an amniocentesis examination in order to check whether the pathogens have ever passed on to the unborn child.

Immediately after birth and three times at intervals of 4 weeks, an ultrasound of the head and an ophthalmoscope are performed on the newborn. In addition, mother and child blood is taken and examined together with umbilical cord blood and placenta in a special laboratory. The child's blood is then tested twice more to see if it contained only the antibodies of the mother or if it forms its own antibodies that indicate a persistent infection with the risk of late damage.

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