The management of acute Toxoplasma gondii infection during pregnancy – literature review

Abstract

Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii. When primary acute infection is acquired du­ring pregnancy, the mother can be asymptomatic but the fetus may be congenitally infected, the results being severe neurological and ocular sequelae. The prevalence of con­genital toxoplasmosis is 1-2 cases in 10.000 newborns. The present paper aims at presenting a complete diagnosis and treatment protocol of acute toxoplasmosis infection during pregnancy. International scientific papers and protocols of recent date have been reviewed. The main conclusion is that screening should be offered in every pregnancy, and primary diagnosis should comprise a serologic profile (IgG, IgM, IgA, IgE). In case of a positive serological screening, the testing must be repeated, and treatment (spiramycin) is begun until the second results. In pregnancies over 18 weeks an amniocentesis is indicated to confirm fetal congenital infection. The treatment for acute fetal infection is a combination of pyrimethamine, sulfadiazine, and folinic acid. Studies conducted on fetal sequelae in case of acute toxoplasmosis infection in first trimester pregnancies concluded that therapeutic abortion is not indicated.