According to some experts, on average, 80% of the population has toxoplasmosis on the planet, but its prevalence in different regions varies significantly. So, in France, 84% of carriers, in some Latin American countries - almost 95%, and in Russia only about 20% of the population. But such a “favorable” indicator does not mean that Russians do not have to worry. According to medical reports, toxoplasmosis during pregnancy in our country is diagnosed in 25% of women.
In most cases, it does not make itself felt, so pregnant women do not suspect that they are infected. But even “silent” toxoplasmosis poses a mortal threat to the fetus, because the microorganisms that cause it easily leak through the placenta.
The population has misconceptions about where toxoplasmosis comes from. This leads to the fact that pregnant women try to protect themselves from the unlikely culprit of the infection, without attaching importance to the real source of the threat. The article offers comprehensive information about toxoplasmosis during pregnancy, reveals its causes, symptoms, diagnosis and treatment methods.
Microbe characteristics
There are several tens of microorganisms parasitizing in humans. These are mainly bacteria. There are not so many protists among pathogenic microbes, but those that are can cause serious, sometimes fatal diseases. These are the protists of Toxoplasma gondii (the common abbreviation is T. gondii). Their main owner is cats. Humans, birds and all other mammals are only an intermediate link in the life cycle of parasites.
In the body of cats, their sexual reproduction occurs, and in the human body - asexual. T. gondii invade cells where they form parasitic vacuoles in which the so-called bradyzoids are located. They, like a photocopier, multiply their own kind. When there are too many of them, the cell breaks. Vacuoles create cysts that can develop in the liver, lungs, kidneys, brain, heart and skeletal muscles, and human eyes.
Since T. gondii operate within the cell, the immune system does not “see” them. It begins to work only against those microbes that have just left a torn cell and have not yet entered a new one. Antibiotics act on them selectively.
It is for these reasons that it is difficult to completely get rid of toxoplasmosis.
In cats, T. gondii cysts develop in the stomach and intestines. In the process of sexual reproduction, they form oocysts, which are secreted out along with feces.
Cats other ways of infection
From the foregoing, it is logical to assume that you can catch toxoplasmosis during pregnancy from a cat. However, in reality, the percentage of infection in this way is negligible. Therefore, you do not need to drive cute tailed pets out of the house if you find yourself in an “interesting position”. In defense of these animals, one can say that they become infected with toxoplasma only if they eat raw infected meat or catch a sick mouse. In an extreme case, even before pregnancy, you can carry out laboratory diagnostics for your cat to make sure that he is not a carrier of dangerous microbes, and if he is, then treat him.
Experts believe that being in the house of an infected cat before the pregnancy of the hostess is not so bad, because thanks to this, the woman develops antibodies to parasites that no longer pose a threat to the unborn baby. A cat can be dangerous only if he got into the house of a pregnant woman (for example, he was bought) and infected her.
A good way not to get infected from a pet is to observe personal hygiene, that is, always wash your hands after performing any action with the animal.
The most likely cause of toxoplasmosis during pregnancy is the ingestion of thermally untreated infected meat. It can be pork, beef, lamb, venison, poultry.
Working with such meat (cutting it and other operations) also poses a threat if, after that, a woman does not wash her hands thoroughly.
The classic way to infect parasites excreted in feces is to eat unwashed vegetables and fruits, as well as field work.
It is impossible to catch T. gondii from an infected person at any household and sexual contacts. You can take dangerous protists from it only with a blood transfusion or an organ transplant.
Symptoms
Note that only 10% of women infected with T. gondii experience signs of the development of the disease. In the remaining 90%, it goes unnoticed. Symptoms of toxoplasmosis during pregnancy are manifested in women with low immunity.
The incubation period after infection lasts from one week to three. During this time, a woman can already forget that she ate incompletely prepared meat or unwashed vegetables. Therefore, most often it is impossible to determine the source of infection.
The disease can occur in acute and chronic forms.
In acute symptoms of toxoplasmosis during pregnancy are:
- Heat.
- Overweight, pain throughout the body.
- Headache.
- Enlarged spleen and liver.
- Vomiting
- Paralysis.
In many patients, signs of toxoplasmosis during pregnancy may give the impression that a woman has a cold.
She appears:
- Low-grade fever.
- Headache.
- Pharyngitis.
- Inflammation of the lymph nodes.
- Conjunctivitis.
It is scientifically proven that toxoplasmas affect the behavior of their victim. In pregnant women and other people, this can manifest itself in such changes in the usual condition:
- Broken attention.
- Slow reactions.
- Increased talkativeness.
- Anxiety, doubts about every (even the most harmless) reason.
Pregnancy Toxoplasmosis Test
If a disease is suspected, the attending physician in the antenatal clinic collects an anamnesis, and also finds out under what circumstances an infection could occur. However, the most important is a serological analysis, in which blood is taken for toxoplasmosis during pregnancy. This study is conducted in the first trimester for all women, regardless of whether they have symptoms or not. For this, blood is drawn from a vein. In her serum, the level of toxoplasma-specific antibodies LgM and LgG is determined. The results should answer whether the woman is infected, and if so, how long ago. If the infection occurred recently, it is very important to determine whether it happened before or after conception.
In case of doubtful results, additional testing is carried out.
When performing an analysis for toxoplasmosis during pregnancy, indicators may be as follows:
- LgM and LgG are negative. This means that there is no infection, but it can occur, since the immune system is weakened.
- LgM (-), LgG (+) - there is no infection threatening the fetus, and the protective functions work well. This may mean that the woman was infected a very long time ago (possibly in her childhood), so the body has already developed immunity. To confirm this, appoint an analysis of PCR and avidity.
- LgM (+), LgG (-) - there is a primary infection, there is no immunity. This analysis result is the most alarming, since the fetus is in danger. A woman is prescribed a second test after 2 weeks, as well as PCR and ELISA.
- LgM (+), LgG (+) - perhaps there is a disease of toxoplasmosis. To confirm this, tests for avidity and PCR are prescribed.
Other diagnostic methods
Pregnancy toxoplasmosis tests also include ultrasound. It is carried out to determine the condition of the fetus. This does not mean that an ultrasound scan will necessarily show abnormalities in the structure of the body or the like. Such a diagnosis helps to determine whether or not there are intrauterine growth retardation. If significant abnormalities are found, termination of pregnancy is recommended.
If it is confirmed that the woman is infected with T. gondii, an amniocentesis is performed to find out if the fetus is infected or not. This analysis involves the puncture of amniotic fluid. Its reliability is 90-95%. For the fluid taken by puncture for this test, PCR is performed. Such a study can be performed for a period of more than 18 weeks.
They also do a general blood test to determine mom’s health status.
An auxiliary test is a skin test. It is carried out when 3-4 weeks have passed since the alleged infection. Signs of the presence of toxoplasma in the body are swelling and redness of the papule, as well as inflammation of the lymph nodes.
It should be noted that only the initial infection of the mother's toxoplasma will be dangerous for the baby. If she was a carrier of microbes before pregnancy, then immunity against these parasites has already been developed in her body. The consequences of the infection for the child are closely related to how long it happened.
If in the first trimester, when the embryo is laying all its organs, toxoplasmosis is detected during pregnancy, the consequences for the fetus are serious, since there is a high probability of congenital anomalies. Very often during this period, miscarriages or freezing of the fetus occur.
Infection in the next 3 months can lead to abnormal development in only 5% of cases. If the mother became ill in the second trimester, the baby may have vision problems, including blindness, hydrocephalus, deviations in the brain, in the work of the kidneys, liver, heart, spleen, and digestive tract. A woman who has become ill during this period may begin a premature birth.
If toxoplasmosis occurred during the last three months during pregnancy, the consequences for the fetus are most favorable, since by this time all the systems of the body have already been formed. In this case, the baby will be born without visible abnormalities, but he cannot avoid congenital toxoplasmosis. He may experience skin rashes such as hives, diseases of internal organs, poor eyesight. All these problems can be solved with the help of proper treatment.
Treatment
If a non-pregnant woman has become infected with T. gondii, and she does not have serious symptoms, such as fever, vomiting, inflammation of the internal organs, retinal lesions, then treatment is not carried out, as toxoplasmosis passes on its own, leaving a stable immunity.
If you have toxoplasmosis detected during pregnancy, what should I do? This is the first question women ask after a positive serological test. There are several options for the development of events:
1. T. gondii was not found in amniotic fluid. In this case, "Spiramycin" is prescribed. It is able to accumulate in the placenta, thereby preventing infection of the baby.
2. T. amondii was detected in amniotic fluid. Treatment of toxoplasmosis during pregnancy in the second trimester is performed using the drugs "Sulfadiazine" and "Pyrimethamine." As a prevention of problems in a child with bone marrow, folic acid is simultaneously prescribed.
Treatment in the first trimester of pregnancy is carried out at the discretion of the doctor and according to the indications (the woman has an acute or latent form of toxoplasmosis). Most often, during this period, doctors advise abortion.
It was found that the placenta misses pathogens in the first trimester in 15% of cases, in the second in 30% of cases, and in the third in 60%.
The famous pediatrician Komarovsky says that if T. gondii was found in the amniotic fluid during pregnancy, with any treatment for the mother, the child has no chance of being born completely healthy. The difference will consist only in the degree of damage to its organs.
Family planning
Toxoplasmosis, which infected more than half of the world's inhabitants, does not cause any problems for people with good immunity. It is dangerous only for certain categories of citizens, including pregnant women. According to many doctors, the treatment of toxoplasmosis does not give a 100% guarantee of the birth of a healthy baby, therefore preventive measures are extremely important for this disease.
Knowing the danger of toxoplasmosis during pregnancy, it is very advisable to plan the birth of a child, and not let things go by themselves. Women who are about to become mothers should be tested for toxoplasmosis.
If the result showed that LgG antibodies are present in their blood plasma, then they already have immunity against T. gondii. Therefore, no cats are afraid of their baby.
If LgM antibodies were found as a result of the test, and the analysis showed that they appeared in plasma recently, this is also a good indicator. It means that a woman needs to wait about nine months (preferably a year) with pregnancy. During this time, she will develop a stable immunity that will protect her baby.
If the test answer is negative, this indicates that the woman will have to be on the alert throughout the entire period of pregnancy and protect herself from infection in every possible way.
Prevention
In addition to passing the test for toxoplasmosis, there are other measures to protect against T. gondii infection. They are as follows:
- Observe hygiene, which means washing your hands thoroughly. This should especially be done after field and garden work and after cutting raw meat.
- Exclude meat dishes from the diet if there is thermally unprocessed meat among their ingredients. This also includes a ban on raw minced salt and other spices.
- Be sure to wash vegetables and fruits before eating.
- Do not drink raw water from open sources, including wells located in the courtyard of the house.
- Examine domestic cats for toxoplasmosis. Exclude raw meat from their diet.
Chronic Toxoplasmosis
Some doctors believe that it’s not bad if a woman in childhood or adolescent was ill with acquired toxoplasmosis, as in her body a stable immunity against this disease appeared throughout her life. This immunity will protect her baby during pregnancy and a whole year after birth.
However, in many who encounter tocoplasmas, microorganisms do not disappear from the body, but in the form of cysts settle in the tissues of various organs. They do not bring anxiety, while their owner has a strong immunity. If it decreases, they "wake up." For this reason, exacerbation of toxoplasmosis occurs. During pregnancy, this phenomenon is not uncommon, since the very “interesting position” of a woman already affects the weakening of the body's protective functions. In addition, a relapse of chronic toxoplasmosis can cause:
- Stress, worries.
- Past diseases (any, even a mild cold).
- Poor, vitamin-poor nutrition.
- Fatigue due to a busy schedule.
Symptoms of exacerbation of chronic toxoplasmosis during pregnancy depend on which organ toxoplasma was activated in. Possible signs:
- Fever (subfebrile values).
- Inflammation of the lymph nodes.
- Dizziness, weakness.
- Mental disorder (anxiety, obsessive fears, irritability).
- Insomnia, tired in the morning with a good night's sleep.
- Memory impairment, concentration of attention.
- Visual impairment (its sharp deterioration).
- Decreased appetite, dull abdominal pains, nausea, difficulty with bowel movements, flatulence (if the microbe is activated in the digestive tract).
- Inflammation of the pancreas, kidneys.
- Endocrine Disorders
- Muscle pains.
- Myocarditis.
The expediency of treating pregnant women with exacerbated toxoplasmosis is decided by the attending physician on the basis of additional tests.
Opinions of women
Now you can find a lot of information about the danger of T. gondii microbes for the fetus and newborn baby. However, reviews of toxoplasmosis during pregnancy of women giving birth are full of optimism. Cat lovers are not going to part with them for the period of their “interesting situation”, but they are advised not to give raw meat to the pets and check them for toxoplasma. It is also recommended to entrust the cleaning of the cat pot to one of the family members.
In the reviews there are reports of women who had no contact with cats and did not eat raw meat, but who suffered from toxoplasmosis, tasting a salad of raw vegetables stored in a warehouse where there were mice.
Women are advised not to be afraid of infection, it is imperative to take tests before pregnancy, and if immunity to toxoplasma is not found, be very careful in choosing dishes and in close contact with animals.
If there is immunity, women who have given birth to babies are advised to eat well, relax more, not be nervous, and protect themselves from any diseases that can reduce immunity or somehow affect the health of the unborn child.