Prenatal diagnosis of congenital toxoplasmosis

Article Abstract:

Congenital toxoplasmosis (caused by infection with a protozoan agent) can cause serious disease and death in fetuses; however, if detected, it can often be successfully treated. To learn more regarding prenatal diagnosis of this condition, 50 pregnant women at risk for toxoplasmosis were assessed. Based on the results of blood tests, 15 women had clear signs of toxoplasmosis, and 35 had signs of possible infection. Ultrasound studies (after 20 weeks' gestation), amniocentesis, and funipuncture (sampling fetal blood from the umbilical cord), were performed. Fetal blood samples and tissue from the placenta were evaluated for the presence of the protozoan at delivery; blood samples were also obtained at regular intervals until the infants were 11 months old. Six fetuses were congenitally infected; one died at 14 weeks' gestation. Antibiotic treatment did not prevent the death of another fetus, which died at 32 weeks' gestation despite the mother's receiving drug therapy. Of the remaining four fetuses, two were asymptomatic, although their blood tests indicated infection. The third developed serious disease, and the fourth had chorioretinitis (an eye disease). Ultrasound studies prior to delivery had shown abnormalities for two of the five infants screened. Culture results confirmed toxoplasmosis in four cases. An evaluation of the prenatal tests is presented. Funipuncture and amniocentesis can lead to miscarriage; thus, testing blood samples of mothers at high risk for toxoplasmosis should precede such invasive techniques. The development of a test that can be used earlier than 24 to 26 weeks' gestation, when fetal blood tests can provide definitive answers regarding this infection, would be an important diagnostic aid. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Drug therapy, Fetal diseases

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Detection of congenital toxoplasmosis by chorionic villus sampling and early amniocentesis

Article Abstract:

Congenital toxoplasmosis is a potentially fatal parasitic disease that can be treated if diagnosed early enough in pregnancy. It is diagnosed from samples of blood removed from the fetal umbilical cord; however, this sampling method cannot be safely performed prior to 19 weeks' gestational age. A report is presented of a method that allows earlier detection of the disease: chorionic villus sampling (removing small amounts of tissue from the interface between placenta and uterus) with early amniocentesis (withdrawal of a small sample of the fluid in which the fetus floats). A case report is discussed in which fetal death occurred at 14 weeks' gestation because of toxoplasmosis, in spite of treatment instituted at 9 weeks' gestation. Immediately after death occurred, tissue sampling was performed. Culture of the chorionic villus specimen showed the presence of the organism that causes the disease (Toxoplasma gondii). The merits of using chorionic villus tissue for this diagnosis are discussed; it should be limited to women with signs of recent infection. The sensitivity and specificity of the approach for diagnosing congenital toxoplasmosis need to be evaluated in subsequent studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Amniocentesis, Toxoplasma, Chorionic villus sampling

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Prenatal diagnosis of congenital toxoplasmosis: a multicenter evaluation of different diagnostic parameters

Article Abstract:

The best way to detect congenital toxoplasmosis in pregnant women is to use the polymerase chain reaction to identify the organism that causes it in amniotic fluid. This organism can seriously damage the newborn baby if it is transmitted before or during childbirth.

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