Toxoplasmosis During Pregnancy

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Toxoplasmosis is caused by a tiny parasite [protozoan] that spends part of its lifecycle in animals and the rest in humans. It is a common infection caused by the one-celled organism Toxoplasma gondii.


Toxoplasmosis During Pregnancy

According to a recent research all pregnant women and newborns should be screened for a serious infection called toxoplasmosis. A pregnant woman has about a 40% chance of passing the infection to her unborn child, according to the March of Dimes. Only about 10% of infants with severe infections show signs of toxoplasmosis at birth. Many infected infants may not show signs until months or years later.

All pregnant women and newborns should be screened for a serious infection called toxoplasmosis.

Sources of Infection

Toxoplasmosis develops when a pregnant woman is exposed to the parasite Toxoplasmosis gondii in



  • Cat litter-Toxoplasma gondii is most easily spread in egg form; eggs can only grow in a cat’s intestinal tract. Once Toxoplasma gondii eggs are excreted in a cat’s feces, they become infectious after 1 to 5 days
  • Undercooked meat such as beef, chicken, and particularly pork or eggs that are infected with the parasite. You can get the infection by touching your hands to your mouth, nose, or eyes after handling uncooked meat or by eating food that’s been contaminated by utensils or a cutting board that came into contact with uncooked meat.
  • Garden soil, that is eating unwashed garden vegetables (grown in an area where an infected cat has left feces).

Symptoms

Most infected women show no symptoms at all, so you may never know whether you were infected or not. Some have mild flu-like symptoms such as fever, chills, headache, sore throat, muscle aches, fatigue, swollen lymph glands, and possibly a rash within one to three weeks after being exposed. If you think you may have the disease, call your doctor or midwife.


Toxoplasmosis During Pregnancy

Diagnosis

Blood testing for detecting past or recent exposure to this parasite is available, but is not routinely done. If you are not tested and you don’t know if you’re immune or not, or if testing does not show immunity from previous infection, you can still take steps to protect yourself and your unborn child. In acute infection, IgG and IgM antibody levels generally rise within one to two weeks of infection.

If your test results suggest that you got toxoplasmosis while pregnant, your practitioner will first treat you with an antibiotic that’s thought to reduce your risk of transmitting the disease to your baby. You’ll then have an amniocentesis to determine if your baby has the infection. (The lab will do a special DNA test on your amniotic fluid to check for the presence of the toxoplasmosis parasite.) You’ll also have a series of ultrasounds throughout your pregnancy to look for any abnormalities in your developing baby.

If your amniotic fluid shows that your baby has been infected or an ultrasound shows a problem, you can consult a genetic counselor about the risks to your baby. Depending on your baby’s gestational age, you’ll be given the option to end the pregnancy. If you continue the pregnancy, you’ll be given other antibiotics to take after you’re about 20 weeks to reduce the risk of problems for your baby.

Effect of toxoplasmosis on the fetus

The fetal immune system is unable to defend against Toxoplasma gondii. Fetal infection can only develop when a woman with no immunity becomes infected with Toxoplasma gondii during pregnancy or up to 8 weeks before conceiving. Fetal toxoplasmosis, particularly in early pregnancy, can cause miscarriage, stillbirth, and birth defects. Possible problems include impaired vision, hearing damage, enlargement of the liver and spleen, jaundice, and pneumonia

The majority of infected infants have no deformities at birth, but without treatment, most will develop serious eye and brain damage and die from massive infection by the end of adolescence.

Toxoplasmosis During Pregnancy

Treatment

During pregnancy, toxoplasmosis is treated with antibiotics.

  • A woman who is newly infected during pregnancy is treated to reduce the risk of severe fetal infection.
  • If fetal infection is diagnosed, additional antibiotics are given to the mother, and the infant is also given antibiotic treatment after birth.

If a fetus is infected early in pregnancy and is diagnosed with brain damage, terminating the pregnancy is considered a reasonable medical option.

Avoiding toxoplasmosis during pregnancy

Here are some tips to help you avoid exposure to toxoplasmosis during your pregnancy:

  • Do not allow your cat to go outside your home where it may come into contact with toxoplasma. If possible, have someone else take care of your cat while you are pregnant.

    Have another family member change the cat litter box and then disinfect it with boiling water for 5 minutes.

  • If you must handle the chore of changing the litter box, wear rubber gloves to avoid contact with the litter and wash your hands thoroughly afterwards.
  • Use work gloves when gardening and wash your hands afterwards. Cover children’s sandboxes when not in use (cats like to use them as litter boxes).
  • Control flies and cockroaches as much as possible. They can spread contaminated soil or cat feces onto food.
  • Avoid eating raw or undercooked meat (or poultry) and unwashed fruits and vegetables. Eat only well-cooked or previously frozen meat, avoid dried meats.
  • Wash your hands thoroughly before you eat and after handling raw meat, seafood, fruits, vegetables, soil, sand or cats.
  • Avoid rubbing your eyes or face when preparing food, and wipe the counter clean afterwards.
  • Avoid eating raw eggs and drinking unpasteurized milk.

  • Health education for women of childbearing age should include information about preventing T.gondii transmission from food and soil. At the first prenatal visit, health care providers should educate pregnant women about food hygiene and avoiding exposure to cat feces.

Toxoplasmosis is devastating for families.


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