Therapy for Common Parasitic Diseases in Pregnancy in the United States: A Review and a Survey of Obstetrician/Gynecologists??? Level of Knowledge About These Diseases

Abstract

A number of food- and waterborne parasitic diseases that are common in the United States can adversely impact women during pregnancy. Therapeutic considerations during pregnancy for these diseases are reviewed. Also, the level of knowledge of obstetrician-gynecologists about diagnosis and treatment of these diseases (toxoplasmosis, cryptosporidiosis, giardiasis, amebiasis, cyclosporiasis, trichinellosis, ascariasis, and taeniasis) was estimated by means of a questionnaire developed by the Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG). Of the 1200 obstetrician-gynecologists surveyed, 521 (43%) responded. In general, respondents gave correct answers to questions about toxoplasmosis, but for other illnesses responses, it varied. For example, most (61.4%) respondents gave incorrect answers about treatment of cryptosporidiosis in pregnancy, and many (41.2%) respondents incorrectly identified metronidazole as the safest treatment for giardiasis in the first trimester of pregnancy. Although knowledge among obstetrician-gynecologists about toxoplasmosis is good, there is a wide variation in knowledge about other common food- and waterborne parasitic diseases that are likely to be encountered in the United States. Therapeutic considerations for these diseases during pregnancy are discussed. Obstetricians & Gynecologists, Family Physicians. After completion of this article, the reader should be able to list the various common protozoal diseases, to outline the clinical manifestations as well as route of spread for each of the protozoal diseases, and to outline potential therapies for each of the protozoal diseases.