Abstract
Maternal infection by Toxoplasma gondii during pregnancy may have serious consequences for the fetus, ranging from miscarriage, central nervous system involvement, retinochoroiditis, or subclinical infection at birth with a risk of late onset of ocular diseases. As infection in pregnant women is usually symptomless, the diagnosis relies only on serological tests. Some countries like France and Austria have organized a regular serological testing of pregnant women, some others have no prenatal program of surveillance. Reasons for these discrepant attitudes are many and debatable. Among them are the efficacy of antenatal treatment and cost-effectiveness of such a program. A significant body of data demonstrated that rapid onset of treatment after maternal infection reduces the risk and severity of fetal infection. Recent cost-effectiveness studies support regular screening. This lack of consensus put both pregnant women and care providers in a difficult situation. Another reason why congenital toxoplasmosis is disregarded in some countries is the lack of precise information about its impact on the population. Precise estimations on the burden of the disease can be achieved by systematic screening that will avoid bias or underreporting of cases and provide a clear view of its outcome.
Highlights
The ubiquitous parasite Toxoplasma gondii (T. gondii) has been known for 80 years for its potential to cause severe damage when acquired in utero as a consequence of a maternal infection during pregnancy [1]
We recently published with US colleagues a paper depicting the differences in managing congenital toxoplasmosis between the United States of America (USA) and France [50]
Would antenatal treatment have changed the fetal outcome? Despite the lack of randomized controlled trials, we have enough evidence to say that antenatal treatment rapidly introduced after maternal infection reduce the risk of fetal infection and the severity of the disease
Summary
The ubiquitous parasite Toxoplasma gondii (T. gondii) has been known for 80 years for its potential to cause severe damage when acquired in utero as a consequence of a maternal infection during pregnancy [1]. In France, an antenatal program is mandatory, in the United States of America (USA) it is not Between these two opposite attitudes recommendations widely vary according to countries, and prenatal surveillance by means of regular serological tests is still controversial. This situation is becoming difficult for pregnant women and care providers both looking for precise information and guidelines. We present the pros and cons regarding regular testing of pregnant women and try to convince the reader to drive congenital toxoplasmosis (CT) out of this shadow situation
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