Toxoplasmosis in Pregnancy: Symptoms, Risks and Treatment
Toxoplasmosis is a rather common infectious disease that is responsible for the parasitic toxoplasma gondii. More often than not we do not even notice that we have contracted it, because it comes in asymptomatic form or with mild symptoms and very similar to those of a common influence. However, toxoplasmosis in pregnancy can have serious consequences and be dangerous for the child. It is good to pay attention and analyze the causes of transmission of the symptoms, the dangers, the possible prevention, the available tests and the necessary therapies.
Toxoplasmosis in Pregnancy: Causes
Toxoplasmosis is one of the most common parasitic infections in the world. The parasite that is the cause is able to infect different types of warm-blooded animals, including mammals and birds, including humans. The latter can contract toxoplasma by consuming raw food or by coming into contact with excrements of infected animals, especially cats. The cat, in fact, is the definitive host, since it is only in felidae that the parasite in question is able to reproduce. The stool emitted by a cat infected with toxoplasmosis releases oocysts into the environment, that is to say the egg cells that act as infectious agents.
Toxoplasmosis in Pregnancy: Symptoms
Toxoplasmosis infections usually do not cause striking symptoms in adult humans. In most cases, signs similar to those of a normal flu, such as muscle pain, lymphadenopathy, fatigue, fever and headache are found, from one week to one month after the infection. Rarely and almost always in subjects already immunosuppressed, instead, more serious symptoms are manifested, such as asthenia, enlarged liver and spleen, problems with vision and convulsions.
Toxoplasmosis in pregnancy has all the same effects and should not be taken lightly. If the future mother contracted the infection during pregnancy, it is not automatic that the disease is transmitted to the child. If this happens, however, the unborn child may be affected by congenital toxoplasmosis. The consequences of such an occurrence are decidedly unpleasant: if the parasite reaches the fetus through the placenta, it can cause the onset of malformations, damage to the central nervous system that can lead to mental retardation or epilepsy, eye injury due to blindness, or even a premature birth or abortion, especially if the infection occurs in the first months of pregnancy, while the risks are lower in the last quarter.
Toxoplasmosis in Pregnancy:Prevention
The dangers are not few and unfortunately there is not yet a vaccine able to prevent the risk toxoplasmosis, but fortunately it is possible to take precautions to prevent the infection. A myth to dispel is the one according to which it is necessary to get rid of the house cat as soon as it turns out to be pregnant. In fact, it has been shown that the risk of contracting toxoplasmosis in pregnancy simply by being in contact with flat cats is quite negligible.
Domestic cats, in fact, usually have food habits that do not include raw food, the main receptacle of the parasite. In any case, it is good to regulate the feeding of the cat, eliminating raw or undercooked meat. With some small measures there will be no reason to remove your cat from home during pregnancy. For example, you could have some other family member change the litter box, so as to avoid any contact with cat excreta. If this is not possible, just wear gloves while doing so and wash your hands very well immediately with effective detergents. Another precaution can be to change the litter at least once a day, as the parasite oocysts, once expelled with feces, require at least 24 hours to develop spores and actually become infectious. Preventing the cat from spending time outdoors, outside our control, is an additional precaution that must be taken into consideration.
The greatest risks of contracting the disease, however, concern nutrition. To prevent toxoplasmosis it is good to avoid the consumption of raw foods, especially sausages and raw meat. It is essential to consume exclusively cooked meats and carefully observe the most common hygiene rules, such as washing your hands after touching raw meat or eggs. The meat should always be eaten cooked, so you should avoid cold meats and sausages (better not to eat raw ham and bresaola in pregnancy, as well as sausage, salami and sausage), carpaccio or meat too rare. It is allowed, however, cooked ham during pregnancy and also mortadella is not bad, because the high temperatures to which they are subjected in their production will make them safe. It is also advised to avoid drinking milk without first boiling it. The vegetables eaten raw must be washed carefully, perhaps adding to the water of bicarbonate or special food disinfectants. The fruit that grows on the trees is safe, while we must pay more attention to that collected on the ground: for example, it would be advisable to avoid strawberries during pregnancy.
TORCH Complex and Toxo test:
There are laboratory tests to diagnose toxoplasmosis. In addition, pregnant women are prescribed specific tests aimed at ascertaining whether they are immune or sensitive to infection. This is the TORCH Complex and the Toxo test.
The TORCH Complex includes a series of analyzes highly recommended to expectant women, to ensure that future mothers are not carriers of serious infectious diseases, which could transmit to their child, such as toxoplasmosis, but also HIV, rubella and herpes simplex.
The Toxo test is a test that can detect the presence of antibodies against toxoplasmosis in the body. It is carried out through a normal blood sample, which, once analyzed, shows the number of IgG and IgM antibodies, ie immunoglobulins against the parasite. IgM is present when the infection is in place, while IgG indicates that the organism has been affected by the parasite in the past. The results of this investigation can be multiple.
If IgM and IgG are both negative: it means that the infection has never been contracted. Since there are no antibodies, therefore, in this case, the attention to the prevention rules should be double.
If IgM is negative and IgG is positive: it means that the subject has already contracted toxoplasmosis in the past, but the infection is not ongoing. In this circumstance, the woman is immune and there should be no risk for the child.
If the IgM are positive and the IgG negative: we are dealing with a woman who had never contracted toxoplasmosis in the past, but who, at the time of the examination, has the infection in place.
If the IgM and IgG are both positive: it means that the infection has been contracted and may still be underway at present or recently passed. To ascertain exactly when the parasite has been affected, you can undergo a further and more specific test, called a test of greed.
If you want, then, to verify with certainty that toxoplasma has crossed the placenta and infected the fetus, an amniocentesis must be performed starting from the fifteenth week: taking a part of the amniotic fluid, in fact, it is possible to trace any harmful microorganisms to the inside.
Cures and Therapies:
If the result of the tests shows that the future mother is affected by toxoplasmosis, generally, we proceed with an antibiotic therapy, based on spiramycin or sulfadiazine. In this way the possibilities of transmitting the infection to the fetus should be reduced, or at least, if the infection has already occurred, it should be possible to counteract the effect, reducing the harmful consequences for the unborn child. Recall that, in many cases, newborns who have contracted toxoplasmosis in the mother’s womb are born healthy or without obvious symptoms. However, it is always good to monitor the baby for the entire first year of life, intervening, if necessary, with the administration of specific drugs.
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