Toxoplasmosis as a cause of foetal death.

Abstract

Four of 523 mothers with stillborn infants were positive in the toxoplasma complement fixation test and had a dye test titre of 256 or higher. In 1 instance, the autopsy findings were suggestive of intrauterine toxo­ plasma infection, whereas in the other cases the available data did not support this diagnosis. The activity of the maternal health service in Fin­ land is directed to a considerable extent to the prevention of congenital syphilis and isoimmune haemolytic disease. However, the occurrence of infectious syphilis among pregnant women is quite low (5), and the rate of maternal isoimmunization will undoubtedly be reduced by the anti-Rh serum prophylaxis. The organization of the maternal health ser­ vice provides the opportunity to make use of it for other purposes. One possibility in this respect is presented by congenital toxoplasmosis. It results at least in most instances from a toxoplasma in­ fection acquired during the second half of preg­ nancy. An early infection may give rise to abor­ tion, but there is no clear evidence that it will cause developmental anomalies. Congenital trans­ mission from chronically infected mothers is ob­ viously very rare, if it takes place at all. Auto­ mated complement fixation systems are available for mass screening of serum specimens, and there is at least some treatment for the disease. About one fourth of the Finnish female popula­ tion of childbearing age have toxoplasma antibo­ dies as measured by the dye test (2). Since residual titres persist for many years, if not throughout the whole life, the incidence of toxoplasma infec­ tion during pregnancy may be of the order of 5 per 1 000. However, there is no information on the frequency of congenital toxoplasmosis in Fin­ land. The aim of the present work was to evaluate the role of toxoplasmosis as a cause of foetal death.