Toxoplasmosis Infection During Pregnancy
Özet
Toxoplasmosis is the most common congenital parasitic infection. The birth prevalence of congenital toxoplasmosis varies between 1 and 10 in 10,000 live births. While 74-81% of infected fetuses have only subclinical infection, up to 19-26% develop fetal/childhood disease even with treatment. Fetuses with congenital toxoplasmosis usually appear normal on prenatal ultrasound. Ultrasonographic findings suggestive of congenital disease include intracranial calcifications, ventriculomegaly, hepatic enlargement, ascites, and increased placental thickness. Neonatal clinical manifestations of congenital toxoplasmosis are highly variable. They include hydrocephalus, microcephaly, intracranial calcifications, chorioretinitis, strabismus, blindness, epilepsy, psychomotor or mental retardation, petechiae due to thrombocytopenia, and anemia. The classic triad of chorioretinitis, hydrocephalus, and cerebral calcifications is extremely rare. None of the findings described in neonates with congenital disease are pathognomonic of toxoplasmosis and may mimic congenital infection with other pathogens, such as cytomegalovirus, herpes simplex virus, rubella, and syphilis.
Diagnosis is usually confirmed by toxoplasma DNA PCR from amniocentesis material after 18 weeks of gestation. Prevention has been shown to reduce the incidence of disease and remains the most important intervention. A more careful follow-up process can be established by careful monitoring of ultrasonographic markers.
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