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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Toxoplasmosis During Pregnancy
What is toxoplasmosis?
Toxoplasmosis is an infection that babies can get from their
mothers before birth. If you have this infection during
pregnancy, it can harm the baby.
How does it occur?
Tiny organisms called Toxoplasma gondii cause the disease.
These organisms are protozoa, not bacteria. People are most
commonly infected by eating raw or undercooked meats that
contain these organisms. Approximately 14% of pork meat and
10% of lamb meat contains Toxoplasma gondii. The bowel
movements of some cats and insects in the soil also contain
the organisms. You can become infected by not washing your
hands after handling a cat or cleaning a litter box.
An unborn baby may be infected anytime before delivery. The
infection passes to the baby through the placenta. The
earlier the baby is infected, the more severe the effects
are. Also, the later in the pregnancy that the mother is
infected, the more likely it is that the baby will become
infected.
If you are exposed to toxoplasmosis more than 6 months
before you become pregnant, you are not likely to pass the
infection to your baby. However, if your first exposure
occurs a few months before your pregnancy or while you are
pregnant, your baby has a high risk of becoming infected.
There are tests you can have to see if you were exposed
earlier.
What are the symptoms?
In most cases the mother's symptoms of the disease are mild.
Sometimes there are no symptoms. If symptoms appear, it is
usually about 10 days after exposure to infected, poorly
cooked meat or contact with an infected cat's bowel
movements. Symptoms the mother may have are:
- rash
- fever
- weakness
- swollen glands
- night sweats
- muscle pain.
Many infected babies do not show any symptoms at birth, but
most develop problems later. If a newborn has been infected
with toxoplasma, some possible symptoms or problems are:
- fever
- rash
- loss of hearing
- enlarged liver and spleen
- jaundice
- inflammation in the eyes
- extra fluid that puts pressure on the brain
- a small brain
- chills
- muscle pains
- swollen glands
- calcium deposits in the brain
- mental retardation
- seizures.
Toxoplasmosis may cause miscarriage or stillbirth.
How is it diagnosed?
The health care provider will ask about your symptoms and a
examine you. Blood tests will be done to see if you are
infected.
The following tests and exams may be done to diagnose the
infection in a baby:
- ultrasound scan to look for slowed growth, calcium
deposits in the brain, a very small brain, and swelling
of the abdomen
- blood test
- x-rays of the head
- lab tests of fluid from the brain or spine
- an eye exam.
How is it treated?
If you are less than 3 months pregnant, you will not be
given medicine. The medicine can be especially harmful to
the baby during this time and can cause birth defects.
If you are more than 3 months pregnant, you may be given
medicine. Even at this point the medicine may harm the
baby. If you are taking medicine, it is usually stopped 4
weeks before delivery.
A newborn's infection can be treated with medicine.
However, the medicine may not cure damage to the brain or
nervous system.
How long will the effects last?
Most toxoplasma infections are cured within a few months
after treatment.
If a baby is infected late in the pregnancy, the baby may
have a mild form of the disease and may not have any
symptoms.
If a baby is infected early in the pregnancy, the baby may
suffer severe permanent effects, such as:
- blindness
- mental retardation
- seizures
- death.
How can I help prevent toxoplasmosis?
To help prevent getting toxoplasmosis while you are
pregnant:
- Eat only well-cooked meat.
- Avoid handling cats, especially outdoor cats. If you
have contact with a cat, wash your hands thoroughly
afterward.
- Avoid contact with cat litter and soil that may contain
cat bowel movements. Have someone else clean the litter
box every 24 hours.
- Wash your hands thoroughly after working in the yard or
with soil.
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