What is a carrier of toxoplasmosis. Carrier of toho during pregnancy what is it

What is toxoplasmosis? Toxoplasmosis and pregnancy.

The illness of the expectant mother during pregnancy is always bad for the baby she is carrying. But there is a group of infections that can cause various developmental abnormalities. This group is called TORCH infections.

Abbreviation - consists of the first letters of the names of the diseases included in the group. Toxoplasmosis / toxoplasmosis comes first, followed by syphilis, rubella, CMV and herpes simplex virus.

Toxoplasmosis is an insidious infection that can be found in the body:

1. Without causing symptoms in the expectant mother, but infecting the fetus and conducting: to disrupt its health, causing serious consequences during development, causing spontaneous abortion.
2. And it can clearly manifest itself in the future mother in the form of visual impairment, psychological and neurological disorders, pneumonia.

Toxoplasmosis - what does it mean? This is a disease caused by a protozoan called Toxoplasma. This pathology affects not only people, but animals, including birds.

Most often, cats infect humans with Toxoplasma. But this is not an obligatory (obligatory) source of infection. Other domestic animals (from hamsters to dogs), rodents and birds can also serve as carriers.

Having donated blood for toxoplasmosis, the doctor examines it for avidity - if antibodies M and G were found in the body of a pregnant woman. This will make it possible to determine the presence or absence of a threat to the development of the fetus. Avidity is an indicator of the activity of antibodies, their ability to bind to antigens (pathogens).

What is the essence of the concept of avidity. Toxoplasma or any other causative agent of the disease enters the body. As soon as the protective cells of the immune system detect an antigen (pathogen), they immediately send a signal "foreign" and an intensive synthesis of IgM antibodies against this type of infection begins. IgM appears in the blood about 10-14 days after infection.

Immunoglobulins M will cope with the task of primary infection, but they will not protect the body from re-invasion, since they will disappear a month after the invasion.

IgG occurs after the disease has passed. They just protect against re-infection and remain in the blood for life. At first, IgGs have low avidity, do not actively bind and neutralize antigens. After a few weeks or months, the antibodies will become highly avian. Highly avid antibodies found in the blood of a pregnant woman indicate that the infection did not occur recently.

Avidity indicators. Avidity is an indicator that indicates whether or not immunoglobulins can interact with foreign microorganisms and destroy them. The higher the avidity indicator, the stronger the body's immunity to this pathogen.

What the digital avidity indicators are talking about:

1. an avidity less than 40 is the presence of a primary acute infection;
2. avidity indicators from 40 to 59 indicate a transition period and are considered unreliable (reanalysis)
3. with an avidity of more than 60, this means that a stable immunity has been developed against the pathogen.

Immediately after the invasion of the pathogen, "early" immunoglobulin IgM is synthesized - it kills the primary infection, a month later, "late" immunoglobulin IgG appears - it develops immunity to infection.

Watch the video to learn more about toxoplasmosis and how it is dangerous for pregnant women.

• acute toxoplasmosis;
• congenital;
• chronic toxoplasmosis.

The number of babies born in the United States with toxoplasmosis (known as "congenital toxoplasmosis") is small, but the infection can be devastating, with the risk of stillbirth or premature birth. What can you do to avoid getting toxoplasmosis?

Causes and pathogenesis of the disease

The risk of primary infection of a pregnant woman with Toxoplasma is very small, because, as a rule, most people are already carriers of the organism. The main routes of infection with toxoplasmosis:

1. Eating inadequately processed meat and homemade sausages;
2. Infection with oocysts through contaminated water, unwashed vegetables and fruits;
3. Vertical transmission from mother to child during pregnancy;
4. Through blood during transfusions or organ transplants (possible only in the acute period of the disease, when the cells of the pathogen circulate outside the cells).

Infection with toxoplasmosis and the circulation of toxoplasma in the blood are often not accompanied by symptomatic manifestations, since the human immune system copes with the disease by suppressing its symptoms. However, some people may experience enlargement of the lymph nodes, liver, and spleen. Patients complain of joint pain and a slight fever.

Animal toxoplasmosis is mainly common in cats. A person is only an intermediate carrier of the disease. In addition, infection is more likely to occur in regions with warmer climates. It is also known that toxoplasmosis in men is found three times less often than in women.

More than 180 representatives of the animal world can be the source of the disease. There are several risk factors for Toxoplasma infection:

• direct contact with infected animals (including domestic cats);
• contact with the excrement of sick animals;
• eating insufficiently fried meat;
• blood transfusion;
• organ and tissue transplantation.

Toxoplasmosis - a disease caused by toxoplasma - occurs in humans easily and without any particular consequences. This infection is only dangerous for pregnant women. With intrauterine infection, the risk of infection of the fetus and the development of serious complications is very high. Outside of pregnancy, a severe course of the disease occurs in people with severely reduced immunity.

The main routes of transmission of toxoplasmosis are alimentary, contact, oral.

How is toxoplasmosis transmitted:

• with insufficient heat treatment of meat;
• with raw unpurified water;
• if the rules of personal hygiene are not followed;
• blood transfusion, organ transplant;
• often toxoplasmosis occurs in summer residents, butchers, agricultural workers.

Animals can spread the infection, most often birds and representatives of the feline family. How can you get toxoplasmosis from a cat? Cysts live in the stool of an animal, so you can get infected when cleaning cat litter, especially if there are scratches on the skin.

Most patients have no clinical signs of toxoplasmosis infection. In some patients, sluggish chronic forms are diagnosed, in a few patients - acute, with severe manifestations.

If a woman has suffered from toxoplasmosis before, immunity to this infection remains for life. In the future, he will protect the child at all stages of intrauterine development.

Expectant mothers who first encounter the disease do not have this protection, although it is believed that the risk of transmission from the mother is not always 100%. With an increase in the duration of pregnancy, the chance of infecting a child also increases, but at the same time, the clinical manifestations of the consequences of toxoplasmosis in children decrease.

Percentage of gestational age with the possibility of fetal infection:

• The first trimester is 15-20%.
• Second trimester - 30%
• Third trimester - 60% and above.

Acquired toxoplasmosis in pregnant women in the first three months of gestation, most often, leads to fetal death and miscarriage. In the embryo, the development of important organs and systems is disrupted, which at this stage of formation is incompatible with life.

If a pregnant woman becomes infected in the second trimester, the baby may well be born alive, but you can hardly call him healthy. Children with congenital toxoplasmosis are born with severe pathologies that are often visible to the naked eye. The clinical signs and symptoms a baby is born with depend on which organ is most affected.

At a later date, symptoms of toxoplasmosis in pregnant women may not appear at all. A child can be born without visible abnormalities and, at first glance, is quite healthy. Obvious violations are detected with the further development of the baby, although it often happens that the infection does not strike the child's body, and it remains completely healthy.

Once in the human body, Toxoplasma multiplies in the epithelial cells of the upper intestine. Then they are carried by the lymphogenous or hematogenous way to various organs. The disease can be acute or chronic.

The incubation period of toxoplasmosis lasts from 5 days to 1 month. This duration depends on the degree of invasion and the state of the body's defense reaction. For the majority of those infected with a good immune response, the initial stage may be asymptomatic and pass into a latent chronic form. In this case, the patient develops non-sterile immunity to toxoplasmosis.

The acute stage develops in the presence of immunosuppressive factors and can move from the exacerbation phase to remission. The invasion in this case is usually accompanied by intoxication, damage to internal organs and tissues.

In severe cases, a person most often develops:

• Cerebral toxoplasmosis.
• Damage to the liver, spleen, myocardium.
• Toxoplasmosis of the eyes.
• Disruption of the musculoskeletal system and cardiovascular system.

In persons with immunodeficiency, the acute stage leads to the development of toxoplasmosis of the brain with severe consequences that threaten a fatal outcome.

Disease classification

Already at this stage, nonspecific signs of toxoplasmosis may appear.

They form cysts in tissues, passing into a state of latent infection. Therefore, there are no symptoms for a long time.

Toxoplasmas are activated under unfavorable conditions for the body, a decrease in immunity. So, toxoplasmosis of the brain develops against the background of focal inflammatory processes (encephalitis), obstruction of the cerebrospinal fluid (leading to hydrocephalus and microcephalus).

If the disease is passed from a pregnant woman to a fetus, the baby is already born with toxoplasmosis. But more often such a disease is acquired (a person can become infected at any age).

Acquired toxoplasmosis has different forms of the course:

• acute (occurs in people with a low degree of immune defense);
• chronic (there are no pronounced signs);
• latent (cysts, pseudocysts are in an inactive phase).

Most patients are diagnosed with chronic toxoplasmosis.

It is impossible to subdivide toxoplasmosis only on the basis of the organ principle, since the development of the disease is not isolated. The defeat manifests itself in several organs and systems at once.

Since the interpretation of the results of these studies can be difficult, it is recommended that all positive results be confirmed by laboratories specializing in the diagnosis of toxoplasmosis.

Research shows that only 15 percent of women of childbearing age are immune to toxoplasmosis. So, if you don't know for sure that you are immune, there are a number of steps you must take to avoid becoming infected. Fortunately, the number of women who get sick directly during pregnancy is very small; not all of them infect the baby in the womb.

If you become infected with toxoplasmosis in the first trimester, the rate that your child will be infected is approximately 15%. By the second trimester, the risk is already 30%, by the third - 60%. In the United States, about 10 thousand babies are born with toxoplasmosis a year.

There is a small chance that a baby will become infected if you yourself get sick three months before pregnancy. To reduce this risk, doctors recommend abstaining from pregnancy for about six months after recovery.

The consequences for your child can range from mild to severe. In some cases, toxoplasmosis results in a stillbirth or infant death shortly after delivery. Congenital toxoplasmosis can affect your baby's brain, causing structural and neurological problems such as delayed motor development, cerebral palsy, and epilepsy.

Other organs, usually the eyes, may be affected, resulting in blurred vision and blindness. Other consequences of toxoplasmosis are jaundice, rash, and lung infections. Enlarged lymph nodes, heart defects.

The vast majority of babies with congenital toxoplasmosis, especially those infected in the later stages of pregnancy, appear normal at birth, but may develop the above problems over time. Therefore, the doctor will suggest that your child be tested for toxoplasmosis in order to minimize the risks.

If your child is infected with toxoplasmosis, then during the first year he will receive antibiotics, even if no external signs of the disease are visible. This will help avoid serious consequences while the child grows up.

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If a woman becomes infected during pregnancy, then the child is diagnosed with congenital toxoplasmosis at birth. Symptoms may appear several days or months after birth.

The most likely signs of congenital toxoplasmosis are constant low-grade fever, edema of the lower extremities, an enlarged liver and spleen, and jaundice.

If a child becomes infected with Toxoplasma by contact or alimentary, then the disease will proceed in a more acute form than in adults - the first symptoms may appear after 3-4 days.

Signs and symptoms of toxoplasmosis in women

Symptoms and signs of toxoplasmosis in women (if they occur at all) are the same as in men, but the share of danger for the fair sex and the stronger sex is naturally different.

However, although it is rare, the infection can result in a disease, the acute period of which will manifest itself:

• fever (above 38 degrees);
• involvement in the pathological process of the lymphatic and nervous systems, internal organs and muscle tissue;
• damage to the organs of vision by the type of uveitis;
• in some cases, the appearance of a rash (papules and roseola);
• the possible development of myocarditis, endocarditis and other severe conditions;
• with immunodeficiency - severe pneumonia, enterocolitis, irreversible changes in the central nervous system.

In some cases, toxoplasmosis can proceed as a subacute type, then the main manifestations of the infection will be malaise, weakness, low-grade fever, lymphadenopathy.

With the transition of acute toxoplasmosis into a chronic process, there is a prolonged subfebrile condition, organ damage, generalized lymphadenopathy, vegetative-vascular disorders, sluggish myocarditis, and the formation of a convulsive syndrome is possible.

Any woman, suspecting signs of pregnancy, should contact the antenatal clinic for registration, where she will be assigned numerous tests to help predict the course of pregnancy, childbirth and the birth of healthy offspring.

One of these tests is a study of blood serum for the presence of TORCH infections, the group of which is headed by toxoplasmosis. This is where its symptoms will appear in case of infection, the age of which cannot be determined by one analysis.

The very presence of specific immunoglobulins of class G - Toho-IgG will not determine the duration of the disease, therefore, to clarify the time of infection, it is necessary to study IgG in dynamics after 2-3 weeks with the determination of IgG avidity and the presence of specific IgA and IgM.

The earlier a woman visits the antenatal clinic, the earlier a serological test is carried out, the more reliably the time of infection can be determined in order to avoid unnecessary risk.

The specifics of treatment during pregnancy

In most people with normal immunity, infection does not cause the development of symptoms, or it may resemble a common flu-like reaction with fever, lymphadenopathy, headaches and muscle pains.

Toxoplasma is at risk for pregnancy only if it is infected 3 months or less before the intended conception.

In newborns, manifestations of congenital toxoplasmosis may include:

• hydrocephalus,
• microcephaly,
• intracerebral calcifications,
• retinochoroiditis,
• strabismus,
• blindness
• epilepsy
• psychomotor and mental developmental disorders,
• petechiae due to thrombocytopenia,
• anemia.

The risk of transmission in the early stages of pregnancy is no more than 6%, while in the third trimester it ranges from 60 to 81%.

Although transmission of T. gondii during fetal formation is rare, serious consequences can develop later.

In comparison, infection in the third trimester of pregnancy may not affect the newborn in any way. However, with inadequate treatment, these children can develop retinochoroiditis and neurological disorders later in life.

There is currently no evidence of transmission of T. gondii through breastfeeding or direct contact.

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Many healthy carriers of Toxoplasma without clinical manifestations may not even know that they are infected.

Some, however, are diagnosed with flu-like symptoms.

At the moment, vaccination against Toxoplasma for humans is not yet available. With the help of experimental animals, research is underway to develop an inactivated vaccine.

Over the past couple of years, there has been significant progress in the development of a vaccine for toxoplasmosis, and even a live attenuated vaccine based on the S48 strain has been created for veterinary purposes.

However, this vaccine is expensive, has side effects, and is short-lived. Moreover, it can transform into a pathogenic strain, and therefore is not applicable to humans.

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Confirmation of the primary infection is of paramount importance in assessing the risk of transmission to the fetus, deciding whether to initiate antibiotic therapy, and making the right recommendations.

To more accurately determine the likelihood of a recent acquisition of infection, more specific tests are required, such as determining the avidity of IgG antibodies.

The avidity of antibodies indicates the strength of the bond between IgG and Toxoplasma. An upward change in this indicator occurs 5 months after infection.

Thus, patients with acute infection have a low IgG avidity index, which is evidence of infection in the last 5 months, while those infected earlier than this period will have a high index.

Only primary infection with toxoplasmosis is dangerous to the fetus. If a woman has chronic toxoplasmosis during pregnancy, her immune system will protect the fetus from infection. However, in women suffering from immunodeficiencies of any etiology, the risk of infection of the fetus is high in any type of disease. In the first two trimesters of pregnancy, Toxoplasma can lead to miscarriage or premature birth, but the likelihood of such an outcome does not exceed 15%.

When infected in the first half of pregnancy, the child becomes infected in only 20% of cases, but congenital toxoplasmosis will be very difficult. If the infection occurs in the second half of pregnancy, then the infection gets to the fetus almost always, but the pathology will be mild or even asymptomatic. And when laboratory indicators of toxoplasmosis during pregnancy indicate that a woman has been infected for a long time, the risk of problems with the fetus approaches zero percent. The effect of toxoplasma on a child:

• Premature birth;
• Spontaneous abortion;
• Intrauterine growth retardation;
• Seizures;
• Jaundice;
• Hydrocephalus or even microcephaly;
• Hepatosplenomegaly;
• Chorioretinitis;
• Sclerotic changes in many organs;
• Mental retardation.

Unlike signs of rubella, toxoplasmosis does not lead to improper organ laying and other severe embryogenesis disorders. Doctors associate this with the fact that the fetus is able to survive when infected with Toxoplasma after the end of embryogenesis, and before that, infection leads to death and miscarriage.

In addition to the asymptomatic course, toxoplasmosis in pregnant women can manifest similar symptoms to infectious mononucleosis. A woman may develop SARS or brain damage. Moreover, in those who are sick with HIV or other deficiency of the immune system, the disease can lead to numerous abscesses in the brain. Symptoms of toxoplasmosis in humans during pregnancy:

1. Chorioretinitis (in both the woman and the fetus);
2. Regional lymphadenitis;
3. Temperature increase;
4. Enlargement of the liver and spleen, as well as several groups of lymph nodes.

If, during a routine laboratory examination, a woman does not have antibodies to toxoplasma, then she must carefully follow all preventive measures and monitor the slightest changes in health. If signs of toxoplasmosis appear during pregnancy, a woman should immediately consult a doctor.

With toxoplasmosis, laboratory diagnostics are used, including the following tests:

• Indirect immunofluorescence reaction;
• Various immunobiological analyzes.

In addition to tests, a pregnant woman must undergo a consultation with an infectious disease doctor. A blood test for toxoplasmosis during pregnancy is carried out more than once, since the indicators should be assessed over time. In addition, it is necessary to differentiate the acute course of the disease from the chronic one, as well as to establish the transferred toxoplasmosis. Even in the presence of a characteristic clinical picture, the diagnosis of toxoplasmosis in a pregnant woman is made after a double serological study, in which there is a significant increase in the antibody titer.

And depending on the results of the study of the blood of a pregnant woman, various interpretations of the analysis are possible:

1. In the absence of a clinical picture of the disease and negative serology results, the diagnosis of toxoplasmosis is not made. There is also no risk of fetal infection. However, the woman does not have protective antibodies against toxoplasmosis, which means that she is at risk for the disease and should be examined regularly.
2. In the absence of a clinic, but weak or medium positive test results, they are assigned to be repeated. If the dynamics of antibody growth is absent, then the diagnosis of Toxoplasma carriage is made, which does not in any way affect the development of the fetus.
3. The absence of a clinic is combined with positive (even high) serology results. Re-examination showed a significant increase in class M antibodies, indicating an acute primary infection with toxoplasmosis. The risk of infection of the fetus is very high, so immediate treatment is required. In the first trimester of pregnancy, a woman is recommended to terminate it, further therapy is carried out, and the newborn child is also examined for toxoplasma and another 5 years of dispensary observation.
4. With the appearance of a typical clinical picture, positive test results and a significant increase in antibody titer in a repeated study, the diagnosis is made - acute toxoplasmosis. The woman needs urgent therapy, and in the first trimester the issue of abortion is being decided. The born child is also examined for the presence of this disease and is subsequently observed for about 5 years.
5. The clinical picture, combined with high titers of antibodies, which, however, tend to decrease upon repeated analysis, implies the diagnosis of subacute toxoplasmosis. The woman is being treated from the second trimester, and the issue of interruption is resolved early. A newborn child undergoes special examinations and is monitored over time.
6. With a combination of clinical manifestations with positive serology results, in the absence of immunoglobulins M in a repeated study, a diagnosis of chronic toxoplasmosis is made. Treatment is carried out outside of pregnancy, either before or after. Such toxoplasmosis does not threaten the fetus.

Of all the above options, treatment of a pregnant woman is required only for primary infection, acute and subacute toxoplasmosis. Moreover, it starts from the second trimester of pregnancy. In the first trimester of pregnancy, the question of termination of pregnancy is decided, but toxoplasmosis is not an absolute indication, therefore, if a woman refuses an abortion, she is treated with spiramycin. In the second trimester of pregnancy, a full-fledged etiotropic therapy is carried out, which consists in taking antibacterial drugs and sulfonamides. Treatment continues until the end of pregnancy. To reduce the risk of side effects, women should also take folic acid. The scheme of therapeutic measures for toxoplasmosis looks like this:

• From the moment the doctor confirmed the diagnosis and up to the 15th week of pregnancy, rovamycin is prescribed;
• Further, up to 36 weeks, they are treated with a combination of folic acid and sulfonamides;
• After 36 weeks, they switch to rovamycin again, since sulfonamides have a negative effect on the fetus;
• Every week, a woman takes blood and urine tests for dynamic monitoring of the results of treatment;
• A newborn child must undergo all clinical examinations for toxoplasma, and if it is detected, undergo specific treatment. At the same time, a neurologist, an ophthalmologist, a neonatologist and a specialized doctor, that is, an infectious disease specialist, should monitor the child's condition.

Symptoms and signs of pathology in pregnant women

In chronic toxoplasmosis in adults, periods of exacerbation alternate with remission, the symptoms are blurred. The temperature can stay at a subfebrile level for a long time, signs of intoxication are observed. A person can become overly irritable, his memory deteriorates, and he is worried about frequent bouts of diarrhea and nausea.

Signs of chronic toxoplasmosis:

• men develop impotence;
• in women, disruptions in the menstrual cycle begin;
• myositis - when feeling the muscles, you can find seals;
• myocarditis;
• deterioration of vision;
• enlargement of the cervical, occipital lymph nodes;
• weakness, apathy, migraine attacks;
• hypotension, vegetative dystonia, pressing pain in the heart.

Brain damage manifests itself in the form of symptoms of meningitis, encephalitis, convulsive syndrome. A person is tormented by frequent migraine attacks, which are accompanied by nausea, and intolerance to bright light, touch, loud sounds develops. With an increase in intracranial pressure, the pupils become of different sizes, the eyeballs constantly tremble.

With encephalitis, speech, hearing, vision, motor functions, and emotional disorders are impaired. Toxoplasmosis can cause cerebral edema, possibly fatal.

Symptoms of toxoplasmosis in pregnant women

The incubation period of the disease can last 3 - 21 days. The form of the disease determines the symptoms:

• the acute form is accompanied by fever, weakening and pain in the muscles, enlarged lymph nodes in the armpits;
• with cerebral toxoplasmosis, the temperature rises, the head hurts, the sensitivity of the organs worsens, paralysis and even coma are possible;
• with congenital toxoplasmosis, jaundice, rash and deafness are possible. The fetus may have an enlarged or reduced head size, psychomotor activity slows down;
• ocular toxoplasmosis seriously impairs vision;
• chronic toxoplasmosis during pregnancy causes emotional distress and bowel problems. Happens, myocarditis or myositis.

With erased, atypical and mild symptoms of the disease, diagnosis can be difficult.

The course of toxoplasmosis can be acute, latent or chronic. In addition, a distinction is made between congenital and acquired types of the disease.

The disease is especially dangerous because signs of toxoplasmosis in pregnant women begin to appear only when the immune system is too weakened. The rest of the time, damage to internal organs occurs with practically no symptoms.

When the pathogens of toxoplasmosis enter the human body, many organs and systems are damaged. That is why the disease has a variety of manifestations.

During pregnancy, the symptoms of toxoplasmosis may look like this:

• severe headaches and general weakness;
• drowsiness, problems with sleep and rest, loss of appetite;
• high fever (38 ℃) and chills;
• pathologies of the functioning of the eyes - strabismus, inflammatory processes;
• muscle weakness;
• jaundice;
• pneumonia;
• an increase in the size of the lymph nodes, spleen and liver;
• the presence of a rash on the skin;
• disorders in the central nervous system;
• memory impairment;
• an increase in anxiety and the appearance of obsessions.

It is rather difficult to identify toxoplasmosis for any specific signs. In some cases, the disease goes from one stage to another completely asymptomatic. In others, its manifestations are veiled under other diseases.

Symptoms of toxoplasmosis in humans can be varied, for both acquired and congenital forms. Sometimes they manifest themselves as a cold, less often as an oncological disease. In addition, the carrier of toxoplasmosis can experience varying degrees of severity.

In most cases, toxoplasmosis is asymptomatic. Infection occurs completely unnoticed by a woman. In some cases, the appearance of such symptoms is noted:

• moderate increase in body temperature;
• headache;
• muscle pain;
• swollen lymph nodes.

In severe cases, joint pain, skin rashes, signs of brain damage may occur. This condition occurs mainly in people with congenital or acquired immunodeficiency, as well as in newborns. In healthy adults, the disease proceeds with minimal clinical manifestations.

A pregnant woman who has been diagnosed with toxoplasmosis does not pose a danger to others. This disease is not transmitted from person to person through direct contact.

Many women do not know how dangerous toxoplasmosis is during pregnancy and how to diagnose it on their own. However, in expectant mothers, the disease requires immediate medical intervention.

The following symptoms of the disease are known:

• fever;
• significant deterioration in health;
• regular headaches;
• nausea;
• enlargement of internal organs;
• allergies, which are accompanied by skin rashes and itching;
• unreasonable impairment of hearing and vision;
• nausea and vomiting.

In the event that a girl contracted an infection during pregnancy, the child will have congenital toxoplasmosis. It may not appear immediately.

Toxoplasma cysts enter the human digestive system. After they reach the small intestine, they are activated and already intermediate forms enter the lymphatic and blood vessels, spreading throughout the body. Granulomas can form in the tissues - something like small ulcers. Here Toxoplasma remains until the end of a person's life. Therefore, the diagnosis of chronic toxoplasmosis is valid. Cases of reactivation of infection against the background of immunodeficiency 10-20 years after the initial infection have been described.

The manifestations of toxoplasmosis differ depending on the form of the disease.

• Latent infection... Most common. At the time of infection and the development of infection, a person does not feel any symptoms - there is no fever, malaise, rash.
• Erased (chronic)... It can be clinically similar to ARVI (low temperature, weakness, lethargy, loss of appetite, headache, pain in muscles and joints). In this case, digestive disorders (bloating, constipation, diarrhea, discomfort in the abdomen) occur.
• Acute illness... It is characterized by the appearance of signs of damage to the central nervous system (headache, convulsions, indomitable vomiting, hallucinations, paresis and paralysis). In addition, there is a rash all over the body in small spots, the liver and spleen are enlarged.

The incubation period from the moment of infection can range from several days to two to three months. Therefore, the symptoms of the disease are not always associated with the consumption of raw meat or contact with the soil, cats. Signs of toxoplasmosis during pregnancy are no different from its usual course and depend more on the state of the woman's immunity.

Diagnosis of toxoplasmosis in pregnant women

Toxoplasmosis in pregnant women is most often determined using an enzyme-linked immunosorbent assay for toxoplasmosis (ELISA). With its help, specific antibodies are detected and their quantity is determined. This study also allows you to determine the period of infection (after or before pregnancy).

The body's initial response to toxoplasmosis is the production of early IgM antibodies, which are observed in the blood for about a year and then disappear. After a while, IgG immunoglobulin begins to appear, which will persist until the end of the patient's life.

By the quantitative ratio of these antibodies, one can draw conclusions about the presence of the disease:

• the presence of IgM and the disappearance of IgG in the blood indicates that infection has occurred in recent months, and the body's defenses have not yet been rebuilt. This result of the analysis for the infected is quite dangerous. There is a threat to the health and life of the child. In this situation, a spontaneous abortion is not excluded for short periods of time. Medical advice on voluntary termination of pregnancy is possible.

Late pregnancy means treatment for the disease:

• if antibodies to toxoplasmosis are absent, then the woman is healthy and has never become infected. Preventive measures must be followed to avoid infection;
• if the analysis for toxoplasmosis during pregnancy shows the presence of IgG, and IgM is absent, the person has been ill and has acquired immunity to the disease. In this situation, toxoplasmosis is not terrible for the mother and the child;
• when observing IgG and a small amount of IgM in the blood, the doctor should suggest a re-examination after a few weeks. An increase in IgG indicates an acute stage of the disease, a previous IgG level indicates a recent recovery.

The exact picture of the disease is not always determined using the described test, so sometimes it becomes necessary to take the analysis again, after a month.

The rate of toxoplasmosis in pregnant women is expressed by the presence of IgG immunoglobulin and the absence of IgM or the absence of both antibodies.

In some cases, to detect an infection, it is advisable to take a general blood test, or resort to the PCR method (polymerase chain reaction of blood). The disadvantage of CPR is the inability to determine the period of infection. Sometimes specialists resort to x-rays, diagnose the fundus, or perform a biopsy of the lymph nodes.

The main types of blood tests for toxoplasmosis are:

• enzyme immunoassay (ELISA);
• complement fixation reaction (PCR);
• reaction of indirect immunofluorescence (RNIF).

During the deciphering of the RNIF analysis, deviations from the norm can be seen already from the first days after infection. The maximum rates are observed 2-4 months after the pathogen enters the body and remain unchanged if the patient suffers from a chronic form of the disease.

An analysis for toxoplasmosis during pregnancy by the complement fixation reaction gives positive results as early as 2 weeks of illness. The indicators reach maximum marks in 2-4 months. Such an examination is not very informative if there is latent or chronic toxoplasmosis during pregnancy, since it can show a negative or weakly positive result.

The most informative is the analysis for antibodies to toxoplasmosis during pregnancy or ELISA. It allows you to determine antibodies to toxoplasma of the IgM and IgG classes. After studying the results of this analysis, it is possible to determine and identify one or another form of toxoplasmosis.

IgM and IgG antibodies differ in mode of exposure and time of occurrence. If a person has a positive lgm test, this means that he was infected very recently and does not have persistent immunity to toxoplasma. The immunoglobulins with low avidity of class M are the first to fight against the causative agent of the infection. But the result of the test for toxoplasmosis igg positive during pregnancy indicates the carrier of the pathogen and the presence of stable immunity to it.

General laboratory indicators of toxoplasmosis during pregnancy indicate a decrease in the number of leukocytes or a relative increase in the size of lymphocytes.

Do not eat or drink anything before getting tested for antibodies. This is important, because the results may not be entirely correct if you donate blood after a meal.

Additional diagnostic methods are: lymph node biopsy, X-ray and fundus examination.

Nonspecific symptoms of infection do not allow diagnosing it without a set of laboratory tests.

Immunological methods:

• serological reactions (determine the state of morbidity);
• intradermal test (determines the state of infection).

Serological diagnostic methods:

• RSK - complement binding reaction;
• RNIF - reaction of indirect immunofluorescence;
• ELISA - enzyme-linked immunosorbent assay for the determination of IgM and G-antibodies in blood serum.

Decoding of RSK results:

• in the absence of infection or after 1-3 years after - the reaction is negative;
• after two weeks, the infection becomes positive;
• after 2-4 months - titles 1: 16-1: 320;
• 1-3 years after infection, there may be low titers - 1: 5-1: 10.

RNIF decoding:

• titers become positive from the first week of infection;
• after 2-4 months - maximum indicators 1: 1280-1: 5000;
• for almost 20 years, low titers can remain - 1: 10-1: 40.

The most objective analysis for toxoplasmosis is ELISA. It can be taken 2-4 weeks after infection.

Decoding the results:

• IgG antibody titer - positive, IgM - negative (healthy carriage of antibodies, infection took place in the past);
• IgG and IgM are absent in the blood (there was no infection);
• IgM titers - positive, type G antibodies are absent (infection occurred recently, several weeks - several months ago);
• IgM and G are found in the blood.

Even positive IgM titers are not 100% indicative of an infection requiring treatment. IgM growth is due to recent exposure to Toxoplasma, but the indicator may be wrong.

If the IgM and G titers remain the same, there has been no recent infection. IgM result is false positive.

If a pregnant woman has a positive reaction, the mother and baby are tested for the first three months after the birth of the baby.

Type G antibodies are transmitted to the fetus through the placenta. Therefore, positive titers do not provide a basis for a diagnosis; decoding will be premature. To confirm congenital toxoplasmosis, the Remington test (RIF variant with IgM determination) is used. Titers of type M do not pass through the placenta. Antibodies are found - the fetus is infected.

When planning a pregnancy, it is important for a doctor not only to determine the presence of an infection in the body, but also to determine whether it is fresh or old. For this, immunoglobulins of class M and G (IgM and IgG) are determined in the blood.

If IgM is detected, but IgG is not, this is the most unfavorable situation, since it indicates that the infection has occurred recently.

If both IgM and IgG are present, then the infection occurred within a year (in this case, it is recommended to repeat the study after 3 weeks. An increase in IgG indicates an acute process).

The most common situation is IgG, no IgM. This suggests that sometime in the past there was contact with an infection, at present it does not pose a danger, since you have immunity.

If immunoglobulins are not found at all, then you do not have immunity to toxoplasmosis, and all precautions should be taken so as not to become infected with them during pregnancy.

To diagnose toxoplasmosis, blood PCR is sometimes prescribed. Diagnostics by PCR method is quite accurate, but its disadvantage is that it does not indicate the age of infection.

In order to accurately determine whether the fetus is infected (when a primary infection is detected in the mother), it is recommended to study the amniotic fluid by amniocentesis (the fetal bladder is punctured with a thin needle through the anterior abdominal wall). However, it should be remembered that Toxoplasma enters the amniotic fluid a month after the mother is infected, therefore, the fetus can be diagnosed only after this period.

According to ultrasound, an enlarged liver and spleen, expansion of the ventricles of the brain, and intracranial calcifications can be determined in an infected fetus. The placenta can be thickened, and calcifications can also be determined in it.

In some cases, the doctor, even after learning that a cat has been living in your house for many years, may not send you for analysis. The fact is that in 90% of cases, cat owners have immunity to toxoplasmosis (the longer a cat lives, the more likely it is to be immune). Therefore, if the doctor, on the contrary, begins to insist that you part with a cat that has been living in your house for 5 years and is a member of the family, then it will be easier to part with the doctor.

Many doctors advise expectant mothers, registering with a gynecologist, to be tested for toxoplasmosis during pregnancy. Unfortunately, in the medical practice of many antenatal clinics, such an examination is not included in a number of mandatory procedures.

To diagnose the condition, the patient is assigned the following tests for the presence of toxoplasmosis in pregnant women:

• Indirect immunofluorescence reaction (RNIF). Sensitivity to it appears after a week from the moment of infection.
• Compliment binding reaction (PCR). Sensitivity is determined from the second week after infection.
• Enzyme-linked immunosorbent assay (ELISA). Antibodies to toxoplasmosis of the IgM and IgG classes are detected.

The most reliable is the study of blood for toxoplasmosis using ELISA. Thanks to this method, it is possible to identify the infection and differentiate it from other diseases. In addition to diagnostics, allergic skin tests are used. A positive result is detected from the fourth week after infection.

What tests are needed?

There are several techniques that can diagnose toxoplasmosis in pregnant women. These include:

• ELISA (enzyme-linked immunosorbent assay);
• RNIF (the test is based on the reaction of indirect immune fluorescence);
• RSK (complement fixation reaction);
• PCR (polymerase chain reaction), allows you to establish even DNA fragments of a foreign agent;
• allergy skin test with toxoplasmin (additional method).

The most commonly used enzyme immunoassay. With its help, the presence of certain immunoglobulins to Toxoplasma (M and G) is determined. Decryption is carried out by a doctor, the result can be briefly described as follows:

1. The result is negative if both immunoglobulins are absent in the blood. This is the norm, there was no infection.
2. The presence of only IgG in the blood indicates that the infection has taken place, and the woman has antibodies to toxoplasma. This is evidence of non-sterile immunity or a latent process, which means that the infection took place before conception. And the woman's body has developed antibodies to a foreign agent. Treatment in this case is usually not required. If in doubt, additional PCR analysis can be done to confirm that this is not the primary infection.
3. Analysis for toxoplasmosis during pregnancy with the detection of IgG IgM or only IgM, a situation that is dangerous for the fetus. This result suggests that the infection may have been primary. In this case, you need to contact your doctor for additional diagnostics and treatment.

The word "possibly" is present in the description because immunoglobulin type M in trace concentrations can persist in the blood of an infected person from 3 months to 2 years.

To clarify the diagnosis with a positive reaction to IgM, PCR is performed. If IgG IgM is detected - avidity test and PCR.

Avidity is a reaction that reveals the stability of the antigen-antibody complex, with its help it is possible to determine in what phase the disease is (the acute phase indicates a recent infection).

If intrauterine infection has occurred, then during ultrasound of the fetus and placenta, the following changes can be detected:

• enlargement of the internal organs (liver and spleen) of the fetus;
• expansion of the ventricles of the brain and the detection of calcifications in them;
• Ultrasound signs of early maturity of the placenta.

To confirm infection of the fetus, an amniocentase procedure is performed. Any procedures: amniocentesis, toxoplasmosis therapy or such a radical measure as termination of pregnancy, are carried out exclusively with the written consent of the pregnant woman.

1. Linked immunosorbent assay;
2. PCR diagnostics.

The more common enzyme immunoassay for the presence of antibodies to the causative agent of Toksoplasmosis. IF-analysis is characterized by high specificity and sensitivity. It is used for screening and diagnostic studies.

PCR diagnostics is aimed at detecting DNA particles of the simplest. It is more accurate, but expensive, and not every laboratory has the ability to carry out this analysis. Prescribe PCR in the case when it is necessary to clarify the information obtained as a result of enzyme-linked immunosorbent assay. For PCR, you can use both blood and urine samples, amniotic fluid.

When any infection enters the body, then after a short period of time antibodies to the pathogen appear in the blood, which bind it and neutralize the pathogen antigens. This is how a healthy immune system works.

Antibodies are immune protein cells. They are produced by the lymphatic system. When released into the bloodstream, they create a common bond with red blood cells and are carried throughout the body.

When meeting with foreign organisms (TORCH infections), antibodies perform a positive function - they destroy the causative agent of the infection. Immunoglobulins (antibodies) can also perform a negative function, perceiving the fetus as a foreign body. In this case, they begin to reject the fetus, which poses a threat to the bearing of the unborn child.

As soon as a woman finds out about the onset of pregnancy, doctors strongly recommend donating blood for TORCH infections. With the help of this analysis, you can identify the most dangerous infections for a pregnant woman:

• herpes;
• hepatitis B and C;
• rubella;
• cytomegalovirus.

This analysis will give an idea of ​​whether a woman is immune to toxoplasmosis. You can decode the result yourself. The analysis shows two types of immunoglobulin: IgM and IgG. The IgM indicator is the presence of toxoplasmosis in the blood, IgG is the presence of immunity to it.

Accordingly, if IgM is positive, and IgG is negative, this means that an infection first entered the body. But to find out how long ago this happened, you will need to do a few more tests. If both indicators are negative, the pregnant woman is at risk. Since I have never encountered a disease. In this case, careful observation by doctors and strict adherence to all preventive measures for the disease is necessary.

If two indicators are positive, there is nothing to be afraid of. This indicates that the disease has long become chronic. Chronic toxoplasmosis during pregnancy is not dangerous, since immunity to it has developed and reliably protects the unborn baby from negative consequences.

If the woman does not have antibodies to toxoplasmosis, the analysis should be carried out every month. If, despite caution, a woman becomes ill with toxoplasmosis during pregnancy, treatment involves the use of potent antibiotics.

A week or two after the penetration of the pathogen, the body gives the first immune response (humoral): it begins to produce specific immunoglobulins of class M (Toho-IgM), the maximum concentration of which will reach only 3-4 weeks from the onset of infection, then the level of these antibodies will begin to decrease and by 3-4 months, in most cases, they disappear altogether. True, sometimes Toho-IgM can circulate in the blood for up to a year.

Immunoglobulins of class A (Toho-IgA) appear in the serum after 2 weeks, after a month they show the maximum concentration, and after six months they practically disappear.

As for immunospecific antibodies to toxoplasmosis IgG, their concentration increases during the first 2-3 months of infection and remains unchanged during the year, then slightly decreases, which, however, does not give an exact answer about the duration of infection. In such cases, it is customary to use the avidity index (AI) of class G immunoglobulins to Toxoplasma.

Avidity is a measure that indicates how tightly specific antibodies are bound to the corresponding antigens. When the immune response is just beginning to form, the first to appear are Toho-IgGs of low avidity, which cannot yet firmly bind to antigens.

From 2 months to six months (from the onset of infection), the avidity index will increase. Primary infection in the acute phase will be manifested by the presence of low avidity IgG together with specific immunoglobulins of classes A and M. Other variants of the distribution of antibodies can be represented as follows:

• Toxo-IgM, Toxo-IgA plus highly avid Toxo-IgG will indicate prolonged persistence after the end of the acute phase of the primary infection or a secondary immune response (Toxoplasma reinfection);
• the presence of highly avid Toho-IgG, the absence of Toho-IgM - evidence of persistent lifelong immunity;
• the presence of low-avidity Toho-IgG and a negative result of Toho-IgM can be detected if the infection occurred more than three months ago.

Particular difficulties arise in the diagnosis of toxoplasmosis in patients with immunodeficiency, since an increase in the concentration of class G immunoglobulins and the determination of IgM and IgA are rare, therefore, in such cases, PCR diagnostics is performed to detect T. gondii DNA.

Ways of transmission of toxoplasmosis

Since T. gondii is released only in feline feces, wild and domestic cats are the focus of infection.

But if your immune system is weakened by illness or a certain type of medication, the infection can recover, leading to even more severe complications.

Toxoplasmosis can be transmitted in the following ways:

1. Contact. It is possible to become infected with toxoplasmosis upon contact with infected animals, their feces. Humans and animals can only act as intermediate hosts of Toxoplasma gondii. The final owner is the cat.
2. Food. Eating poorly processed meat products. It is known that pork - 25%, lamb - 25%, beef - 1% contain Toxoplasma cysts.
3. Unprocessed fruits and vegetables, eggs, unboiled milk, dirty dishes, unwashed hands can lead to infection.
4. Parenteral. Blood and organs during transfusion and transplantation are often the cause of infection.
5. Transplacental. Infection directly in the womb.

Contrary to popular belief, toxoplasmosis during pregnancy can be contracted not only from domestic cats, but also from other animals - cows, pigs, sheep, rabbits, guinea pigs, domestic or wild dogs, rodents or some predators. A person who has eaten poorly fried meat, neglected the rules of personal hygiene, for example, did not wash his hands after cleaning the stool from sick animals, may be infected. In addition, since the mother is the main carrier of toxoplasmosis during pregnancy, the infection can be transmitted from her to the growing baby inside, or through organ transplants or blood transfusion.

When infected, the first symptoms of the disease are cysts that form in the intestines. They do not react to high and low temperatures, or to fluctuations in ambient humidity.

Getting out of its carrier, Toxoplasma actively infects people and animals.It is easy to understand whether toxoplasmosis is transmitted from person to person. Considering all of the above, the answer is only yes.

But this reproductive pathway of Toxoplasma reproduction can be carried out only in the internal organs of cats. Only one cat in 14 days is capable of throwing up to a billion cysts into the external environment, capable of living independently for almost two years.

With feces, cysts enter the outside world. This is how the disease is transmitted to other organisms.

Toxoplasma transmission routes:

You can get infected as a result of:

In other situations, the disease is not spread from person to person. You can only get infected through soil, meat and from animals.

Human infection occurs either when eating the meat of infected animals, or when the feces of an infected cat enter the human body (most often from street dust or from the ground).

In general, sadly, cat excrement with Toxoplasma surrounds us everywhere, and it is extremely difficult to protect ourselves from the disease. But this has its advantages: most women, even before pregnancy in a latent form, had had toxoplasmosis, have immunity, and now, even while expecting a baby, they are not afraid of any cats.

It is worth noting that fresh faeces are not contagious. To acquire the ability to infect, the pathogen needs maturation in the external environment. Therefore, fresh cat feces are not dangerous. If you clean the litter box right away and wash it clean with soap (and not just shake off poop down the toilet), then you will not get infected this way.

The cat itself becomes infected with toxoplasmosis by eating infected mice and birds, raw pork or lamb, kindly offered by the owner. Veterinarians believe that most cats that have ever walked outdoors are infected with toxoplasmosis. The main source and distributor of toxoplasmosis are cats that walk by themselves, eat rats and poop in children's sandpits and in vegetable gardens. It is from such walkers that our decent domestic cats can become infected (for example, by eating grass, near which the "bad" cat has arranged a toilet).

Only cats infected with toxoplasmosis within the past three weeks are contagious. But it is worth remembering that a cat can be infectious for some time with each new infection. Nevertheless, in defense of cats, I would like to say that infection rarely occurs directly from a sick animal. The main source is still uncooked meat and street dust. When cat feces enter the external environment, the pathogen remains active for up to two years.

1. Eating contaminated meat. According to the research, it became clear that Toxoplasma is found in 25% of raw meat. However, with high-quality heat treatment, all the larvae die and the product becomes suitable for consumption.
2. How is toxoplasmosis transmitted from a cat to a pregnant woman? The larvae enter the human body through the fecal-oral route. You can get sick in this way at any time, since the feces of cats are everywhere:

• poorly washed vegetables and fruits that have gotten feces;
• inhaling larvae while cleaning the litter box;
• the pathogen can infect a person if it gets on the mucous membrane or wound;
• if an infected cat scratches a person.

Although there is still insufficient evidence to prevent transmission of infection to the fetus when treating mothers with seroconversion during pregnancy, treatment can reduce the severity of congenital toxoplasmosis.

If primary infection with T. gondii is confirmed during pregnancy, treatment is used to prevent and reduce the severity of the disease.

If the mother has an infection and the fetus is absent, Spiramycin is used to prevent transmission of the virus. Spiramycin is a macrolide antibiotic that does not cross the placenta, but can accumulate in it.

It is given in a dose of 1 g by mouth every 8 hours during pregnancy if amniotic fluid PCR is negative for T. gondii.

Pyrimethamine and sulfadiazine are used in cases of confirmed fetal infection, but only with full confidence, due to teratogenic and toxic effects on bones in both the mother and the fetus.

Prenatal and postnatal treatments have been shown to be effective in reducing the risks and severity of disease in the long term.

Nevertheless, even after the end of treatment, it is necessary to regularly undergo clinical and ophthalmological examinations for several years to identify possible complications.

A positive test for the disease is a reason for termination of pregnancy up to 24 weeks. This decision is made due to the adverse effect of the prescribed antibiotics on the child.

After the 12th week of pregnancy, toxoplasmosis can be treated.

When a woman becomes ill with toxoplasmosis, experts resort to emergency treatment, which, however, does not guarantee the birth of a normal child, but only reduces the risk several times. If, after birth, the child has no signs of abnormalities, he is under the supervision of specialists for up to five years.

Treatment takes place according to certain schemes in several stages under the supervision of doctors. Due to the harmful effects on the fetus, some drugs can be used from 12, 16 and even 27 weeks of pregnancy. It is impossible to completely destroy the pathogen, the main thing is to reduce its activity.

Most often, treatment occurs with Pyrimethamine, antibiotics, macrolides and immunomodulators.

Some difficulty lies in the fact that infected women can begin to be treated only from 12-16 weeks of pregnancy. Otherwise, drugs can show negative effects on unborn babies. If expectant mothers are no longer contagious and have had toxoplasmosis before pregnancy, treatment is not prescribed at all.

Often, for the treatment of toxoplasmosis, pregnant women are prescribed the antibiotic Rovamycin or Spiramycin. According to reviews, it is well tolerated by patients and is highly effective.

An additional drug for toxoplasmosis in pregnant women is Fansidar - the active ingredient is pyrimethamine and sulfadoxine. In parallel with the drug, folic acid is usually prescribed to increase hematopoietic function. The remedy also combines well with immunomodulators, however, the intake of such funds should be performed according to the doctor's prescription.

Treatment is carried out only with primary infection!

Drugs that affect Toxoplasma can only be used after 12 weeks of pregnancy (some only after 16 weeks), since they themselves can have a harmful effect on the fetus. Usually, the pathogen is not completely destroyed; treatment is aimed mainly at reducing its activity.

Newborns with infection of the mother and her subsequent treatment must be examined even in the absence of clinical manifestations.

Preparations for pregnant women are selected with extreme caution. Rovamycin is considered the most suitable. It reduces the possibility of transmission of infection to the fetus and is quite easily tolerated by women during the period of gestation.

In later stages of pregnancy, with an acute form of toxoplasmosis, Fansidar (Pyrimethamine) may be prescribed. Since it can affect the function of hematopoiesis, folic acid is prescribed in addition to it.

In special cases, when drawing up an individual treatment regimen, immunomodulators are prescribed.

Drug therapy at the beginning of pregnancy is strictly prohibited. The drugs are made up of chemicals, so they will negatively affect the development of the fetus. As a rule, a specialist recommends starting treatment in the second trimester of pregnancy. By this time, almost all organs and systems of the child are formed, therefore, there is less chance of pathological complications.

Medication always includes antibiotics. Usually the doctor recommends the following drugs:

• Rovamycin - prevents fetal infection;
• Spiramycin - well tolerated by patients.

At the first sign of infection, a woman needs to see a doctor. He will tell you how to treat the disease and give qualified recommendations. It is forbidden to independently select drugs, as this has serious consequences for the mother and child.

With the development of toxoplasmosis in the first and second trimester and the identification of serious fetal anomalies, termination of pregnancy is recommended. The choice of method will depend on the condition of the woman and the gestational age. Artificial termination of pregnancy is carried out before 22 weeks.

If a woman decides to keep the pregnancy, she should be treated with antibacterial drugs. In the first trimester, antibiotics are not prescribed. Therapy begins after 14 weeks. With toxoplasmosis, drugs from the group of sulfonamides and macrolides (pyrimethamine, spiramycin, etc.) are prescribed. The course of treatment lasts at least 4 weeks. When carrying out therapy in the third trimester, drugs from the sulfonamide group are canceled 2 weeks before the upcoming birth.

Some drugs used to treat toxoplasmosis adversely affect bone marrow function. To prevent serious complications caused by this condition, folic acid is prescribed at a high dosage (5 mg / day). Folic acid intake is necessary throughout the course of antibiotic therapy.

During treatment, the woman's condition is monitored. A weekly blood and urine test is prescribed, and weight gain and blood pressure are assessed. The condition of the fetus is monitored using ultrasound. After 32 weeks, the fetal heart rate is monitored weekly using CTG.

A child born to a woman with toxoplasmosis is examined in the first days of life. When the diagnosis is confirmed, specific antibiotic therapy is performed in alternating courses lasting up to 4 weeks. The child's condition is monitored by a neonatologist and infectious disease specialist. An examination by a neurologist and an ophthalmologist is indicated to exclude malformations of the nervous system and the organ of vision.

After the baby is born, the child is examined. He may have toxoplasmosis with no visible symptoms.

• During pregnancy, it is important to carefully follow the preventive measures until the moment of birth. Gloves should always be worn when working in the garden. They protect the skin, where microscopic cracks may be present, from the ingress of toxoplasma.
• Fruits, herbs and vegetables must be thoroughly processed prior to consumption. It is categorically impossible to eat them dirty.
• When preparing food with added meat and offal, it is important to wear special gloves or at least thoroughly clean your hands after cooking.
• Cats live in almost every house. It is better that the litter in the pet's toilet is changed not by a pregnant woman, but by someone else.

• It is undesirable to kiss your pet. The infection can also be found in the saliva of the animal.
• Often, doctors recommend taking a cat's feces for analysis to find out if the pet is a carrier of toxoplasmosis. In the absence of infection, you can safely contact the animal. However, it is necessary to protect it from the onset of the disease. To do this, it is strictly forbidden to give the pet raw meat, and it is also required to limit its communication with other representatives of the feline.

Toxoplasmosis is an infectious disease that entails negative consequences when it occurs in a pregnant woman. A girl who has not previously had toxoplasmosis should carefully observe preventive measures.

To find out if a fetus is infected, doctors use amniocentesis, a method for diagnosing toxoplasmosis. For this, a part of the amniotic fluid is examined. The presence of toxoplasma in it indicates that the cells of the pathogen have penetrated the placenta. You can also diagnose toxoplasmosis in a fetus using ultrasound.

Therapy for toxoplasmosis includes strong antibiotics:

• Spiramycin (Rovamycin) is prescribed after 16 weeks of gestation for the treatment of acute toxoplasmosis;

• Pyrimethamine (Daraprim). It should be taken only in combination with folic acid;

For the prevention of congenital toxoplasmosis, Chloridine (after 16 weeks) and Aminoquinol (after 9 weeks) are prescribed.

Should I get rid of the cat?

You've probably heard that the fur of cats can be a source of the virus, but this does not mean at all that you need to get rid of your beloved animal. You just have to take some precautions, wash your hands more often, clean up after the animal with gloves and a scoop.

Toxoplasmosis therapy

Treatment of infection in the acute period is carried out with chemotherapy drugs:

• Delagilom,
• sulfonamides,
• Fansidar and others.

1-2 courses are held. Also, the patient is shown antibacterial treatment. You can use lincomycin hydrochloride, metacyclin hydrochloride, rovamycin (used in the therapy of pregnant women).

Folk recipes can weaken the manifestations of symptoms. But they cannot replace traditional therapy.

How to treat chronic toxoplasmosis:

• Since chemotherapeutic agents fail to achieve the desired effect, hyposensitizing and immunomodulating treatment is used.
• The complex of therapeutic procedures includes vitamins, lidase, desensitizing drugs, etc.
• Treatment of chronic infection with Levamisole has shown positive results. The drug is prescribed at a dosage of 150 mg for 3 days. In total, you need 2-3 courses with a break per week.

With chronic toxoplasmosis, treatment with folk remedies is quite effective.

To avoid irreparable consequences, treatment must be timely. To prevent toxoplasmosis, you must follow simple rules:

• Exclude any communication with cats during planning and carrying a child.
• Get tested for toxoplasmosis just before conception.
• Maintain personal hygiene.
• Process meat and milk thermally.

Faced with this problem, many are wondering - how to cure congenital toxoplasmosis? The result depends on the degree of damage to the child's brain and nervous system.

It was previously believed that a child with congenital toxoplasmosis does not respond to treatment, and in rare cases, lives up to five years. Today, doctors are successfully fighting this disease, which makes it possible to stabilize the baby's condition, or completely eliminate the infection.

Knowing how dangerous toxoplasmosis is for an unborn child, the doctor, as a rule, suggests terminating the pregnancy at an early stage. In case of infection with the repeated conception of a child, the development of the disease will not threaten.

Treatment for toxoplasmosis in adults depends on the presence of complications. The acute form of the acquired disease requires compulsory therapy.

In the presence of symptoms of toxoplasmosis, treatment is complex and is prescribed according to the following scheme:

• The acute form is tetracycline antibiotics and sulfonamides. For example, Sulfadimezin and Chloridinamine. The duration and dosage of the medication for toxoplasmosis are calculated individually.
• Chronic form - Tetracycline, antihistamines, immunostimulants (for example, Delagil), a complex of vitamins.

It takes a lot of effort to recover from the chronic form of toxoplasmosis. Therapy may also include Lidase and Cerebrolysin.

Folk recipes

Treatment of infection with folk remedies is carried out with the help of poisonous plants, therefore, it is only suitable for adults. When choosing and using a prescription, you should consult your doctor.

• Infusion of mad cucumber herb. Proportions - 1 tsp for a glass of boiling water. First, incubate in a water bath for 15 minutes, then at room temperature for 45 minutes. Treatment - 3 times a day, 1 tbsp. l. before eating.
• Infusion of dry leaves of the arctic plant. Prepare and take - as in the previous recipe.
• Infusion of yellow jaundice seeds. Prescription and treatment - see above.
• Grind the hoof roots into powder. Consume 0.5 g 3 times a day before meals.
• Broth of buckthorn fruits. For a glass of boiling water - 1 tbsp. l. raw materials. First, insist on a water bath for half an hour. Then - 10 minutes at room temperature. Treatment - drink 3 times a day, half an hour before meals, ¼ glass.

You can also defeat toxoplasmosis with other folk remedies: grass and grassland juice, medicinal roots, knotweed, milkweed, mistletoe, black nightshade, common tansy (used internally and in the form of enemas) and other medicinal plants.

You can only protect yourself from infection through prevention. Vaccination against toxoplasmosis has not been developed. And the symptoms of the disease are absent for a long time. Therefore, the diagnosis, therapy with pharmacological drugs and folk remedies are late.

Possible consequences

If you get the infection for the first time right before or during pregnancy, you can pass the infection on to your baby (congenital toxoplasmosis) even if you yourself are asymptomatic.

The greatest risk of contracting toxoplasmosis in a child arises if the mother is sick in the third trimester and the lowest during the first.

However, the earlier the infection occurs in pregnant women, the more serious the outcome for the infant. Often, early infection results in prematurity or stillbirth.

If childbirth is still allowed, then the consequences for the fetus with toxoplasmosis during pregnancy will be dire:

• convulsions;
• enlargement of the spleen and liver;
• yellowing of the skin and eyes;
• severe eye infections.

Only a small number of babies with toxoplasmosis show signs of illness at birth.

For many, they will show up as they reach adolescence in the form of hearing impairments, intellectual disabilities, or eye infections.

www.mayoclinic.org

Why is toxoplasmosis dangerous for you, expectant mothers, and your children? The question, or rather the answer to it, is not unambiguous.

Toxoplasmosis in the gestational period threatens the baby not only with the manifestation of the general clinic of the disease, but also with the development of hydrocephalus, problems with the organ of vision (small size of the eyeballs, chorioretinitis), thrombocytopenia, an increase in the size of the liver and spleen (hepatosplenomegaly), and a tendency to seizures.

Primary toxoplasmosis during pregnancy is not as terrible for a woman as for her unborn child. The severity of the consequences depends on at what stage of pregnancy the infection entered the mother's body.

The most dangerous and unfavorable is the first trimester of pregnancy and 2-3 months before conception. When the embryo is just beginning to develop, Toxoplasma can cause irreparable damage to its central nervous system. This will lead to abnormal fetal development. Unfortunately, in such situations, medicine cannot help. It is impossible to treat toxoplasmosis at this stage, since antibiotics during this period can do more harm than good. It is in such cases that doctors strongly advise to terminate the pregnancy.

Even if a woman refuses to have an abortion, she will have very little chance of a successful pregnancy. The vast majority of babies affected by this infection in the first months of their development die before birth.

Infection in the second trimester of pregnancy is more favorable for the unborn baby. At this stage, treatment can already be carried out. Although, no doctor will give a full guarantee that the child will be born healthy. Statistics show that most children infected with toxoplasmosis in the womb at 4-6 months are born with serious disorders of the cardiovascular and nervous systems, lesions of the retina of the eyes, liver and spleen.

If the presence of toxoplasma is detected in the last months of bearing a child, the consequences will not be so sad. In these cases, the child is born without visible abnormalities, most often absolutely healthy. However, over time, he may have minor disorders in the brain area and, as a result, mental retardation. Therefore, it cannot be said that toxoplasmosis does not leave behind any consequences. Children with congenital toxoplasmosis need constant monitoring by doctors throughout their lives.

As a rule, acquired toxoplasmosis passes imperceptibly, leaves a strong immunity that protects a person in later life. As for the congenital disease, the situation here is somewhat different. Toxoplasmosis transferred during pregnancy will, to a greater or lesser extent, result in consequences for the fetus.

If the mother is infected with Toxoplasma gondii at the very end of pregnancy, then it is possible that a child will be born with an acute form of the disease (fever, rash, damage to the brain, liver, organs of vision).

In other cases of congenital toxoplasmosis, the disease will have a latent or manifest (with exacerbation) course. At first glance, the normal development of a child with a detailed examination turns out to be imaginary, since lesions of the central nervous system, hearing and vision organs are still detected. Mental retardation, epilepsy, blindness can manifest themselves later, which happens if the latent course accompanies the child until adolescence, when hormonal changes begin.

This insidious pathogen is remembered only during pregnancy, and even then not the expectant mothers themselves. Fortunately, the obligatory analysis for TORCH infection does its good deed and many troubles can be avoided.

However, it would be great if women planning pregnancy were worried and examined in advance, and in the absence of immunity, increased precautions. It is very simple, such an analysis can be done in any antenatal clinic.

• carriage of toxoplasmosis- does not affect the baby in any way, does not require treatment;
• the first episode of the disease in the early stages- the development of defects, pregnancy fading, violation of the formation of the placenta is possible;
• the first episode of the disease at a later date- the risk of consequences for the fetus is small, since all organs and systems are already formed, but intrauterine death of the baby or premature outpouring of water is possible;
• re-infection at any time- is not essential, since it does not lead to active infection.

Toxoplasmas have an affinity for the cells of the nervous system. Therefore, developmental defects are often associated with this. These include:

• blindness and deafness- due to damage to the central nervous system;
• microcephaly - reduced brain size, mental retardation;
• hydrocephalus - the accumulation of fluid in the structures of the brain;
• anencephaly - complete absence of the brain.

Prevention of toxoplasmosis

To avoid problems during pregnancy, the best means of prevention is planning and preliminary examination for toxoplasmosis.

The main measures for the prevention of congenital toxoplasmosis:

1. Careful adherence to hygiene rules (washing fruits, vegetables);
2. Drinking only proven pure water;
3. Thorough processing of meat and refusal of homemade sausages;
4. If you have a cat at home, it should be examined for toxoplasmosis (if there is a disease, then contact with it during pregnancy is prohibited, and if there is no pathology, then you cannot let it go outside, and you can only feed it with well-processed foods and high-quality food);
5. Examination during pregnancy and fulfillment of all doctor's prescriptions when an infection occurs.

In general, the danger of toxoplasmosis in pregnant women is greatly exaggerated, since acute infection is quite rare. The spread of toxoplasmosis is so great that by the time of planning a child, most women already have antibodies against this infection. A special risk group is made up of people with immunodeficiencies.

• communicate less with domestic cats, and not touch his toilet;
• work with the soil after wearing gloves;
• do not eat food directly from street stalls;
• carefully process plant foods;
• it is necessary to wash your hands and kitchen utensils after touching raw meat, it is strictly forbidden to taste it;
• if there is a cat in the house, it should be checked for infection. If the cat is a carrier of toxoplasmosis, it is worth getting rid of the animal, if not, take all measures to exclude its infection.

The most reliable way to keep both the baby and yourself healthy is to prevent toxoplasmosis. In order not to get sick, it is enough to wash your hands, handle meat products well and delegate the care of the cat (in particular, cleaning the tray) to other family members during pregnancy.

The first priority is to prevent toxoplasmosis in pregnant women who have not previously suffered from this ailment. At the same time, the doctor must do everything possible to explain to the patient how important it is to adhere to the rules of hygiene in order not to get sick with toxoplasmosis. It is advisable that pregnant women try to find photo and video materials illustrating the consequences of toxoplasmosis for both the mother and the newborn baby.

Prevention is most important during pregnancy, and for those women who have never met with Toxoplasma before and do not have immunity to it.

• Wear gloves when working in the garden to keep the dirt off your skin. There may be microcracks on the skin, and toxoplasma in the ground. Wash vegetables and fruits thoroughly.
• It is also better to cut raw meat with gloves, at least after that you need to wash your hands. Thoroughly fry or boil meat, avoid steaks with blood during pregnancy.
• If you have a kitty, entrust the cleaning of her toilet to someone else, or suddenly there are traces of old feces on the cat bath.
• Do not kiss your beloved pet, as in case of acute infection of a cat, Toxoplasma can be excreted from it with saliva and nasal discharge.
• Cat feces can be tested to determine if it is infected with toxoplasmosis. If your kitty turns out to be so clean that she has never encountered toxoplasmosis, then it is necessary to protect her from the disease in the future (at least for the period of your pregnancy): do not feed raw meat, do not let her communicate with relatives and do not let her go outside.

To avoid infection with toxoplasmosis, women who are not immune to it need to observe increased requirements for personal hygiene. This should be done both before and during carrying a child.

Preventive measures:

• Do not eat foods that are not thermally processed enough.
• Eliminate foods containing raw meat from your diet.
• Have no contact with raw meat. If this cannot be avoided, hands should be washed thoroughly.
• Limit contact with pets, especially a cat.
• After interacting with an animal or cleaning its tray, wash your hands with special diligence.
• If possible, examine your pet for toxoplasmosis.

If a cat has been living in the house for a long time, then, most likely, the woman's immunity has already been developed.

If a woman observes the above simple rules, then even without immunity to toxoplasmosis, you can protect yourself and the child. It is worth noting that the disease is not dangerous for girls who once had Toxoplasma qondii. The body has developed immunity to this infection, so it is not scary. However, in any case, it is important to be careful, since a woman is already responsible not only for her health, but also for the health of the unborn baby!

To prevent Toxoplasma infection, following these simple rules will help:

1. Don't eat poorly cooked meat.
2. Do not taste raw meat as you cook it.
3. Only use gloves when carving raw meat.
4. Wash fruits and vegetables thoroughly before eating.
5. Keep your hands clean when working in the garden or in the country. Do not forget to wear protective gloves when working with the ground.
6. Use gloves when caring for pets (do not touch the excrement with your bare hands). Your best bet is to outsource the cleaning of the litter box to other relatives for the duration of your pregnancy.
7. Keep domestic cats outside.
8. Prevent cats from sleeping on your bed.
9. Do not feed raw meat to domestic cats. Use only dry food or canned food.
10. Check if your cat is infected with toxoplasmosis (get tested at a veterinary clinic).

If you suspect toxoplasmosis, you should contact an infectious disease specialist or gynecologist.

Minimum precautions must be taken to avoid contamination.

The main methods of prevention:

• wash hands after gardening, going to the toilet, before eating;
• pour boiling water over vegetables and fruits;
• drink only purified water, boil goat and cow milk;
• wash knives and cutting boards thoroughly;
• do not eat meat with blood, raw shellfish - all pathogenic microorganisms die after 20 minutes of heat treatment;
• Toxoplasma dies at low temperatures, so it is better to keep the meat in the freezer for several days before cooking.

If there is a cat in the house, its toilet must be cleaned daily, treated with antiseptic agents. The animal must be regularly seen by the veterinarian, especially if it is walking outside.

In AIDS, the above drugs are prescribed in higher doses and are calculated for longer use.

The best way to combat Toxoplasma gondii is to prevent it, which comes down, in general, to elementary norms that everyone knows:

• thorough washing of greens from the garden;
• sufficient heat treatment of meat products;
• purchase of meat only after veterinary control.

In addition, one should not forget that you can get infected both from water from open reservoirs, and from excessive love for yard cats.

First of all, preventive measures concern pregnant women, in whose blood there are no antibodies specific to toxoplasmosis, because this indicates a lack of immunity to the pathogen as well.

Vaccination before pregnancy

Doctors say there will never be a vaccine for toxoplasmosis. This is due to the following factors:

I think that you are interested in real reviews of those who had toxoplasmosis during pregnancy, what they did and what kind of child was born to patients with acute toxoplasmosis in the late stages of pregnancy, in the third trimester, at 33 weeks - and other periods of infection in pregnant women. On the pregnancy forum, the listed problems are shared by those who are expecting a baby and those who have already given birth to a baby.

On this forum you can read that in Russia there is professor Vasiliev V.V., who specializes in admitting pregnant women with acute toxoplasmosis (in St. Petersburg). I liked his gentle attitude to the problem. There, the mother describes her entire path from infection to the birth of a normal child.

The article describes the analysis for toxoplasmosis during pregnancy, its decoding, antibodies for toxoplasmosis M and G, what is positive, negative toxoplasmosis and its rate, whether it is necessary to be treated with carriage (doctor's opinion), is there an effective vaccination against toxoplasmosis in pregnant women, and links are given to forums where there are reviews of real people when infected with acute toxoplasmosis during pregnancy.

How to treat toxoplasmosis during pregnancy and how to get tested during pregnancy will be discussed in separate articles.

2014-01-10 13:59:53

Julia asks:

Hello, my husband and I are 27 years old. Gr. blood 2 pos., her husband 3 negative. There were no abortions and inflammatory ones, the pregnancy was the first. I was saved at 7 weeks with brown discharge, then there was a frozen pregnancy at a period of 9 weeks, vacuum aspiration was done. Histology: incomplete reverse development of the endometrium, chorionic villi with pronounced degenerative changes. They underwent anti-inflammatory, antibacterial, contraction and physiotherapy in the same hospital. they said that the corpus luteum at 7 weeks was only 1.2 cm, and that because of this there was a lack of progesterone. after she was at the reception of a gynecologist, ultrasound of the uterus and appendages of transvaginal pathology was not revealed. There is ovulation, the cycle recovered after 2 months. I also have hypothyroidism, I have an endocrinologist, then I allowed to become pregnant - I take levothyroxine 35 mg, iodomarin 150, ultrasound of the thyroid gland is normal. And at the age of 15, she suffered mononucleosis, the liver was enlarged, and the doctors say that perhaps because of it, later on the liver turned out to be a benign adenoma of the left lobe, the operation in 2008 was a liver resection. Analyzes three months after the frozen ones: PCR DNA of cytomegalovirus (urogenital smear) was not detected, cytomegalovirus serum IgM 0.17 negative, cytomegalovirus blood serum IgG 9.36 positive (carrier), toxoplasmosis IgM 0.02 negative, toxoplasmosis IgG Normoflora - Lpp. 6.10
Gard / Pre / Porph 5.00, Ureaplasma_spp not detected, Candida_spp. not detected, CME 4.70, M.hominis not detected, M.genitalium not detected, T.vaginalis not detected, N.gonorrhoeae not detected, C.trachomatis not detected, HSV-1 not detected, HSV-2 not detected, CMV not detected, Key cells not found. Microorganisms p. Mobiluncus sp. not found, Microorganisms p. Leptotrix sp. not detected, Gonococci were not detected, Leukocytes 5-10 in the field of view. Blood test: direct bilirubin 2.70 (μmol / l), total bilirubin 10.30 (μmol / l). Before pregnancy, my husband and I also passed on chlamydia, herpes 1,2, HIV, ureaplasma, mycoplasma - all negative. I also have Rubella virus Ig G antibodies. (vaccinated long before pregnancy), ig M neg. Spermogram of the husband: everything is normal, except for agglutination + mild. Ultrasound of the kidneys, adrenal glands and urinary bladder + CDC- No pathology was revealed. Ultrasound of the prostate - Dimensions: 2.5 x 3.3 x 3.8 cm, volume 16.3 cm3, within normal limits. The contours are even, clear, the echo is common, the structure is heterogeneous (hyperechoic inclusions in the left lobe). CDC: the intensity of blood flow is normal. Focal changes: not found, the diagnosis is signs of prostatitis. Ultrasound testicular pathology was not revealed. Tell me, please, what other tests do we need to pass and what actions to take so that we can safely get pregnant and give birth again? can the undergone operation on the liver be the cause of miscarriage? they also prescribed APS and lupus anticoagulant by ELISA. besides this, is it still necessary to take a coagulogram, an analysis for Staphylococcus aureus, and what tests are still needed for the autoimmune status (and is it necessary at all for it?) Do you need antibodies to hCG, glycoprotein, fetal antigens, etc.? and homocysteine ​​levels?

Answers Palyga Igor Evgenievich:

According to statistics, 10% of pregnancies end in fading in the early stages, unfortunately, and it is not always possible to establish the reason for this. If one pregnancy ended in fading, then this is not yet a reason to be examined in detail. You have checked the infections, they are not, and thank goodness.
Checking the karyotypes and immune status, but at the moment I do not see the need, this should be done if the situation repeats itself. It is necessary to be monitored by an endocrinologist, regularly take tests and take corrective therapy, because thyroid problems can affect carrying a pregnancy. If you become pregnant without any problems, then you do not need to take APS and lupus anticoagulant, but this is my personal opinion.
I advise you to plan your next pregnancy and, after its onset, donate blood for progesterone in order to know what dose of progesterone to prescribe in maintenance therapy.
I wish you success and health!

2013-07-15 09:15:20

Olga asks:

Hello! I am 21 years old and 34 weeks pregnant. After lying in a day hospital with premature maturation of the placenta, I was discharged after a week and a half and was given a discharge summary, where it was written that I was a carrier of toxoplasmosis IgG 120 IU / m. Although the doctor at the hospital did not say anything about it. Today I came to the LCD for an appointment and when I myself asked for an explanation with the epicrisis about toxoplasmosis, the doctor told me that now it is too late and we will hope for the best. And she did not even appoint me to retake this analysis. I certainly hope for the best and I believe that everything will be fine with us. Every time our doctors are shocked ... But please, maybe you can explain something to me? Thanks in advance...

Answers Sukhov Yuri Alexandrovich:

Hello Olga.
Alas, I, too, sometimes "am surprised at them" ... It is necessary to study the dynamics of indicators of serological diagnostics of toxoplasmosis, you are absolutely right, it is possible to make control in another laboratory. The consolation is that according to your results, no big problems are visible. Did you get tested during preparation for pregnancy?
With SW., Yu. Sukhov.

2013-06-26 08:59:27

Olga asks:

Good day!!! Can you please tell me what the carrier of toxoplasmosis, CMV, herpes, worms means ??? How will this affect the child ???

Answers Consultant of the medical laboratory "Sinevo Ukraine":

Good afternoon, Olga.
I can only assume that we are talking about detecting IgG antibodies to all of the above infections. In the case of toxoplasmosis and rubella, we are talking about the fact that you previously suffered these diseases, immunity was formed. Now you yourself will no longer be able to get sick with toxoplasmosis and rubella, and all your future babies will be protected from them throughout pregnancy and 6-12 months after childbirth (as long as your IgG antibodies to rubella and toxoplasma virus circulate in their blood).
The detection of IgG antibodies to HSV1 / 2 and CMV is only evidence that you, like most adults, are a lifelong carrier of HSV1 / 2 and CMV. Carriage of these viruses in itself is not dangerous, does not cause harm, and does not require treatment. Treatment may be required only if activated.
Take care of your health!

2011-05-26 12:05:38

Bogdan asks:

Good day! I am starting to prepare for pregnancy and I also dream of having a kitten knowing that cats are often carriers of toxoplasmosis, I was tested for TORCH and here are the results:
Anti-HSV1.2 IgG - detected (k- 2.3)
Anti - CMV IgG - detected (k-5.1)
neg. less than 0.9 diagn. meaning title (then there are two incomprehensible sticks) 5.0

Anti TOXO IgG - detected
at the end 125 ME \ ml from up to 10ME \ ml
As I understand it, I have antibodies to toxoplasmosis. In the near future I want to get tested for IgM. From here I have a question:
Can you please tell me if IgM to toxo is negative, can I have a kitten with peace of mind not long before planning a pregnancy?

2008-11-21 09:04:56

Elena asks:

Dear Doctor, I have a question about toxoplasmosis. When I was pregnant in 2000, I was not diagnosed with toxoplasmosis, as well as other infections. However, my child suffers from strabismus, he has a slight delay in development, speech, nervous excitability (and all this can be signs of congenital toxoplasmosis). In 2007, I underwent an analysis and was diagnosed with toxoplasmosis. The doctor said that I am a carrier of toxoplasmosis, but it is not dangerous for me and it will only need to be treated if I decide to get pregnant.
And now I have a suspicion that earlier, when I was pregnant, I could simply not be mistakenly diagnosed with toxoplasmosis.
Tell me how to determine if my son's problems (especially strabismus) are the result of toxoplasmosis or am I wrong? Thank you very much in advance for your answer!

Answers Batsyura Anna Vladimirovna:

Hello! Elena, to resolve your doubts, you need to examine your son for TORCH infections, which includes toxoplasmosis. The examination plan will be determined by your pediatrician or infectious disease specialist.

2013-12-05 09:32:32

Oksana asks:

Good day! An infectious disease specialist who was sent for an MRI was said to have toxoplasmosis. Zdal analyzes for IgG showed:

Toxoplasma gondii, IgG antibodies IU / mL
Up to 9.0 - negative result
10.0 - 11.0 - questionable result
More than 12.0 - a positive result
What does this mean and can it be treated ???? (Moreover, he is a carrier of HIV, he has 4 CD4 cells) Thank you very much !!!

Answers Sukhov Yuri Alexandrovich:

Hello Oksana. This means that your husband was not on ART or that it was not effective. A positive result can be only if it is possible to increase the SD 4 to 150 - 250 and above. Be sure to examine yourself. From SW., Yusukhov.

2013-06-20 14:11:00

Nadezhda asks:

Hello! I already asked a question on the site:

June 17, 2013
Good afternoon. I am 24 years old, in 2011 there was an antenatal fetal death for a period of 17-18 weeks, the cause was not identified. At the moment, I have 2 infections - Cytomegalovirus IgG - 3.156, IgM negative and Toxoplasmosis IgG - 0.901, IgM analysis is not done, unfortunately there are no laboratory standards. I turned to 5 doctors and they all unanimously say that it is necessary to treat, if the fetus is not treated, there will be deformity. I am interested in the following, does not the presence of class G toxoplasmosis speak about the carrier? How to be, what can you advise. Thanks in advance for your reply.

I answered it
June 19, 2013
Serpeninova Irina Viktorovna:
obstetrician - gynecologist

Of course, the presence of immunoglobulins G is just an indicator of carriage, but you do not know the titer of immunoglobulins M, which is probably why you are supposed to undergo treatment. But even in the absence of this result, I would argue with the necessity of prescribing treatment. Have you been tested for other infections - mycoplasmosis, ureaplasmosis, chlamydia? Has your husband been examined by a urologist?

Thanks for answering.
I was tested for TORH infections, of which cytomegalovirus and toxoplasmosis were positive, which I wrote about earlier, all the rest were negative. My husband was tested only for chlamydia, right after my unsuccessful pregnancy. At that time, he had it +, I had -. How is this possible? But we got treatment anyway. The urologist is periodically observed, because suffers from chronic prostatitis. How can it affect conception? What tests should my husband take? I have adhesions after surgery to remove the cyst of the right ovary, the ovary was saved. I went through various physical. procedures for their resorption. This operation took place before the first pregnancy. What can you advise? Should cytomegalovirus be treated? And when can we plan? I will wait for an answer. Thank you.

Answers Serpeninova Irina Viktorovna:

The husband needs to undergo PCR for STDs, prostate juice. The detection of an infection in one of the partners speaks only of the imperfection of laboratory diagnostics, therefore it was absolutely correct to be treated together. Cytomegalovirus does not require treatment, because after a decrease in the titer, the onset of pregnancy, as a state of immunosuppression, will cause it to rise again. Of the physiotherapy procedures, laser therapy for the lower abdomen is best.

Toxoplasmosis is included in the list of TORCH infections (those that are transmitted intrauterinely). Practically safe for the average person, toxoplasmosis during pregnancy leads to fetal malformations.

Symptom-free examination Signs
Method of treatment pregnant level
the doctor's nursing exercises

What is it and what is the threat?

• cold symptoms - headache and muscle pain, weakness, fever, enlarged lymph nodes (this disappears after a week);
• very rarely, with severely weakened immunity (including AIDS), various organs are affected - the brain, eyes, muscular system, heart;
• in very severe cases, infectious and inflammatory diseases of the brain, for example, meningoencephalitis, develop.

Manifested by headache and fever

The form of toxoplasmosis determines symptoms and signs, including during pregnancy:

• acute is manifested by enlarged lymph nodes, fever (more than 38 degrees), muscle pain;
• cerebral - headache, numbness, paralysis, coma;
• congenital, received from the mother, manifests itself as rashes, deafness, underdevelopment, increased or decreased head size;
• eye - pain in the eyes, decreased visual acuity, blindness.

During pregnancy, chronic toxoplasmosis can develop, in which myocarditis, disturbances in the functioning of the digestive and nervous systems, and memory impairment are observed.

Difficult to spot in early stacks

According to statistics, only one fetus in a thousand is affected by the disease. Considering the danger of toxoplasmosis, it is still better not to allow it to become infected during pregnancy.

Prevention and examination

Cats are, of course, the main vectors of infection. But this is not a reason to get rid of the darling, who has been living in the house for several years now, and has become practically a member of the darling's family. Most likely, everyone has already been ill and received immunity. This can be easily checked by donating blood (your own and your cat's) for tests.

Regular checks of the expectant mother and pets are required

Similar tests are performed on women planning to have a child. This is a blood test for toxoplasmosis, which suggests the risk of developing it during pregnancy. In addition to planning, such a study is assigned:

• with lymphadenopathy and the absence of such studies before;
• in the presence of immunodeficiency, including HIV;
• in case of suspicion of intrauterine infection of the born child.

The blood serum is examined for the content of immunoglobulin G and immunoglobulin M. There are four possible results.

1. Two-thirds of adults show the presence of IgG and the absence of IgM. This indicates that there is immunity to the disease. It makes no sense to conduct further research, as well as to take preventive measures. Such a woman will not get sick with toxoplasmosis during pregnancy.
2. If IgG is absent and IgM is present, then infection is possible, and for the first time. Transmission to the fetus is also possible. Then blood and urine are taken for Toxoplasma, after a couple of weeks the blood serum test is repeated. The same result indicates the erroneousness of the first, if IgG is found, then treatment is prescribed.
3. When both immunoglobulins are present, this is also the possibility of primary infection, but at the same time, such laboratory parameters during pregnancy are observed up to two years after the first infection with toxoplasmosis. For clarification, blood and urine are taken for Toxoplasma, and the severity of the infection is analyzed to determine the time of infection.
4. The absence of both types of antibodies is the absence of both infection and immunity. This situation means that it is necessary to adhere to the rules for the prevention of the disease so as not to become infected with it. You also need to repeat the analysis every trimester.

In order not to get toxoplasmosis during pregnancy, the following prevention rules are observed.

1. Do not eat raw (for example, minced meat) or semi-raw meat (by the way, this includes not only steak with blood, but also shashlik, pasties).
2. Rinse fruits, vegetables, herbs thoroughly.
3. Disinfect the litter box (remembering that oocysts mature only on the third day, if you clean up the cat every day, there is no danger). It is better, nevertheless, to entrust this matter to another person.
4. It is good to wash your hands, especially after working outdoors.
5. Undergo examinations prescribed by your doctor.

The consequences of toxoplasmosis during pregnancy do not necessarily affect the baby. Therefore, the detection of a disease in a pregnant woman is not yet a reason for an abortion. First, it is necessary to conduct research to determine whether the infection has penetrated the fetus.

1. The main analysis method is ultrasound. It is carried out no earlier than a month after the mother is infected.
2. From the 16th week, amniocentesis can be performed - the collection of amniotic fluid.

Only if the decoding of the tests for toxoplasmosis shows infection of the fetus during pregnancy, it is recommended to terminate it. This is done only with the consent of the woman, otherwise treatment is prescribed.

Methods for treating the disease

After the tests for toxoplasmosis have been passed, infection can be detected during pregnancy. If there are no manifestations, no treatment is prescribed.

It is unlikely that it will be possible to completely cure the infection, but drugs significantly reduce the risk of infection of the fetus. This reduces the likelihood of adverse effects.

Rovamycin is prescribed for up to 15 weeks, since other drugs for symptoms of toxoplasmosis in humans during pregnancy can cause even more harm to the fetus. Further, and up to 36 weeks, sulfonamides, pyrimethamine, leucovorin and folic acid are prescribed for a month in order to compensate for the effect of the first three drugs. After 36 weeks, rovamycin is taken again.

Rovamycin tablets

Children born to mothers who have definitely had toxoplasmosis during pregnancy do not necessarily have any deviations.

In humans, the disease in most cases is asymptomatic or manifests itself with such nonspecific symptoms as fatigue, slight fever, headache, swollen lymph nodes (most often cervical and occipital). However, such phenomena can be signs of a common cold, therefore, in most cases, infection with toxoplasmosis goes unnoticed, and the person does not even suspect that he has had this disease.

In severe cases, the disease is accompanied by fever, joint and muscle pain, and a spotted rash. The most dangerous damage to the nervous system by toxoplasmosis (development of meningoencephalitis). The acute form of toxoplasmosis is most often seen in people with immunodeficiency (eg, HIV infection).

If a cat is infected with toxoplasmosis for the first time, it may have enlarged lymph nodes; in acute form, there may be nasal discharge, redness of the eyes, and short-term diarrhea. However, in most cases of cats, toxoplasmosis is also asymptomatic.

Toxoplasmosis during pregnancy

Many people have heard about the danger of toxoplasmosis in pregnant women. Hence the advice to throw the cat out of the house, and panic from any scratch. However, not everything is so scary.

The risk to the fetus is only the primary infection of the mother with toxoplasmosis during pregnancy. That is, if you have had it long ago, then it will not have any effect on the fetus. Moreover, even with primary infection, the risk of fetal infection is not 100%. In the first trimester, the risk of infection with a mother's disease is 15-20%, in the second - 30%, in the third - 60%. However, although the risk of infection increases with pregnancy, the severity of clinical manifestations decreases.

When infected with toxoplasmosis in the first trimester, in most cases, the child has malformations incompatible with life, and when infected at the end of pregnancy, severe clinical symptoms may be absent altogether. In the event that infection occurs before 24 weeks, termination of the pregnancy is recommended. If a woman refuses it, treatment is possible.

After the initial infection with toxoplasmosis, pregnancy can be planned in six months.

How does toxoplasmosis infection occur?

Human infection occurs either when eating the meat of infected animals, or when the feces of an infected cat enter the human body (most often from street dust or from the ground).

In general, sadly, cat excrement with Toxoplasma surrounds us everywhere, and it is extremely difficult to protect ourselves from the disease. But this has its advantages: most women, even before pregnancy in a latent form, had had toxoplasmosis, have immunity, and now, even while expecting a baby, they are not afraid of any cats.

It is worth noting that fresh faeces are not contagious. To acquire the ability to infect, the pathogen needs maturation in the external environment. Therefore, fresh cat feces are not dangerous. If you clean the litter box right away and wash it clean with soap (and not just shake off poop down the toilet), then you will not get infected this way.

The cat itself becomes infected with toxoplasmosis by eating infected mice and birds, raw pork or lamb, kindly offered by the owner. Veterinarians believe that most cats that have ever walked outdoors are infected with toxoplasmosis. The main source and distributor of toxoplasmosis are cats that walk by themselves, eat rats and poop in children's sandpits and in vegetable gardens. It is from such walkers that our decent domestic cats can become infected (for example, by eating grass, near which the "bad" cat has arranged a toilet).

Only cats infected with toxoplasmosis within the past three weeks are contagious. But it is worth remembering that a cat can be infectious for some time with each new infection. Nevertheless, in defense of cats, I would like to say that infection rarely occurs directly from a sick animal. The main source is still uncooked meat and street dust. When cat feces enter the external environment, the pathogen remains active for up to two years.

Diagnosis of toxoplasmosis

When planning a pregnancy, it is important for a doctor not only to determine the presence of an infection in the body, but also to determine whether it is fresh or old. For this, immunoglobulins of class M and G (IgM and IgG) are determined in the blood.

If IgM is detected, but IgG is not, this is the most unfavorable situation, since it indicates that the infection has occurred recently.

If both IgM and IgG are present, then the infection occurred within a year (in this case, it is recommended to repeat the study after 3 weeks. An increase in IgG indicates an acute process).

The most common situation is IgG, no IgM. This suggests that sometime in the past there was contact with an infection, at present it does not pose a danger, since you have immunity.

If immunoglobulins are not found at all, then you do not have immunity to toxoplasmosis, and all precautions should be taken so as not to become infected with them during pregnancy.

To diagnose toxoplasmosis, blood PCR is sometimes prescribed. Diagnostics by PCR method is quite accurate, but its disadvantage is that it does not indicate the age of infection.

In order to accurately determine whether the fetus is infected (when a primary infection is detected in the mother), it is recommended to study the amniotic fluid by amniocentesis (pierce with a thin needle through the anterior abdominal wall). However, it should be remembered that Toxoplasma enters the amniotic fluid a month after the mother is infected, therefore, the fetus can be diagnosed only after this period.

According to ultrasound, an enlarged liver and spleen, expansion of the ventricles of the brain, and intracranial calcifications can be determined in an infected fetus. The placenta can be thickened, and calcifications can also be determined in it.

In some cases, the doctor, even after learning that a cat has been living in your house for many years, may not send you for analysis. The fact is that in 90% of cases, cat owners have immunity to toxoplasmosis (the longer a cat lives, the more likely it is to be immune). Therefore, if the doctor, on the contrary, begins to insist that you part with a cat that has been living in your house for 5 years and is a member of the family, then it will be easier to part with the doctor.

Treatment of toxoplasmosis during pregnancy

Treatment is carried out only with primary infection!

Drugs that affect Toxoplasma can only be used after 12 weeks of pregnancy (some only after 16 weeks), since they themselves can have a harmful effect on the fetus. Usually, the pathogen is not completely destroyed; treatment is aimed mainly at reducing its activity.

Newborns with infection of the mother and her subsequent treatment must be examined even in the absence of clinical manifestations.

Prevention of toxoplasmosis in pregnant women

Prevention of toxoplasmosis is most important during pregnancy, and for those women who have never met with toxoplasma before and do not have immunity to it.

• Wear gloves when working in the garden to keep the dirt off your skin. There may be microcracks on the skin, and toxoplasma in the ground. Wash vegetables and fruits thoroughly.
• It is also better to cut raw meat with gloves, at least after that you need to wash your hands. Thoroughly fry or boil meat, avoid steaks with blood during pregnancy.
• If you have a kitty, entrust the cleaning of her toilet to someone else, or suddenly there are traces of old feces on the cat bath.
• Do not kiss your beloved pet, as in case of acute infection of a cat, Toxoplasma can be excreted from it with saliva and nasal discharge.
• Cat feces can be tested to determine if it is infected with toxoplasmosis. If your kitty turns out to be so clean that she has never encountered toxoplasmosis, then it is necessary to protect her from the disease in the future (at least for the period of your pregnancy): do not feed raw meat, do not let her communicate with relatives and do not let her go outside.

According to statistics, every third inhabitant of our country is infected with toxoplasmosis. Often, carriers of the disease do not even know about their condition, since the infection may not manifest itself in any way - the person does not have any pronounced symptoms. Due to the uncomplicated and often asymptomatic transfer of this disease, insufficient attention is paid to diagnosis and treatment methods. While in some cases, the infection can lead to fatal consequences and serious complications. What does it mean if toxoplasmosis is found in the blood? The rate and deviations of indicators, how immunoglobulins of the IgG and IgM groups contribute to the diagnosis of infection, as well as how to cope and prevent the disease, is described in this article.

The body's response to toxoplasmosis infection

Like any other infection, the human body reacts to infection with toxoplasmosis by activating immune defenses. Namely - the production of special antibodies, immunoglobulins of the protein of the IgG and IgM groups.

It is worth considering in more detail the functions and properties performed by immunoglobulins of the IgG group in the body when infected with a disease such as toxoplasmosis. IgG norm is an ambiguous concept. The presence of immunoglobulins of this group may indicate both the acute phase of the disease and a long process. How do antibodies fight disease? They perform a number of functions that protect the body and adversely affect the viability of the causative agent of the disease, namely:

An interesting and important fact is that it is the immunoglobulin of the IgG group that makes up 80% of all immunoglobulins in the body. In addition, in chronic forms of infections and autoimmune diseases, the percentage of IgG immunoglobulins increases.

Deciphering the parameters of immunoglobulin IgG

Usually, a study is not done to quantify immunoglobulins when tested for toxoplasmosis. The rate in the blood is an indicator of the detection or absence of immunoglobulins. Most often, in the analysis results, such designations as "positive" or "negative" are noted. But in some cases, according to the indications, the doctor may prescribe a special quantitative analysis. It is rather difficult to give specific norms of IgG immunoglobulin indices, since each laboratory has its own criteria. Such differences are due to the use of different chemicals during the analysis of toxoplasmosis in the blood. The rate varies markedly from laboratory to laboratory. As an example, the following rates of indicators can be cited:

1. How to decipher the results of the test for toxoplasmosis? IgG norm is values ​​below 700 mg / dl. A positive test result for measuring the amount of immunoglobulins of the IgG group is 700-1600 mg / dl or 7-16 g / l. Indicators below the specified limits are considered negative results.
2. Using other units of measurement, such norms of IgG immunoglobulins are indicated: above 12 U / ml is considered a positive result, below 9 U / ml - negative, indicators between these norms are doubtful and require additional research.

Regardless of how the indicators are labeled has the same meaning. Test positive for toxoplasmosis in your blood? The norm is the presence of IgG antibodies and the absence of IgM. The presence of IgG immunoglobulins in the test material indicates that the body has met with the causative agent of toxoplasmosis. This means that a person is reliably protected from secondary infection. But at the same time, such results may indicate a primary recent infection. To confirm or refute this assumption, it is necessary to analyze the indicators of immunoglobulins of the IgM group, which appear in the body only during the acute phase of the disease. Accordingly, the presence of such antibodies indicates a primary infection and a serious danger to the fetus. In such a situation, the doctor diagnoses toxoplasmosis. The norm in the blood is the absence of antibodies of the IgM group. Such indicators indicate long-standing infection and the absence of any danger to the body.

If the results of the analysis indicate the absence of IgG immunoglobulins in the body, special measures should be taken to prevent infection during pregnancy, since such results indicate the absence of protective antibodies against toxoplasmosis.

Methods for the diagnosis of toxoplasmosis

There are the following types of toxoplasmosis diagnostics:

ELISA diagnostic method for toxoplasmosis

More often than others it is used to determine toxoplasmosis. It is this method that allows you to determine the duration of infection, to establish the acute phase of the disease. It is possible to highlight such indicators due to the detection of IgM immunoglobulins. If the form says: "toxoplasmosis: normal in the blood", the result means that there is no acute phase of the disease.

The decoding is standard and has no peculiarities when analyzing during pregnancy. Let's take a closer look at what the results mean: "acute phase of the disease" and "toxoplasmosis: the norm in the blood." The table below clearly demonstrates the indicators and their designation. Namely:

Indicators of the analysis for toxoplasmosis by the ELISA method

Immunoglobulin IgM	Immunoglobulin IgG	Characteristics of indicators
-	-	Special attention should be paid to preventive measures. These results indicate a lack of protective antibodies in the human body.
-	+	The result indicates a long-standing infection that does not pose a danger to the body. In addition, a person is protected from re-infection with toxoplasmosis.
+	-	This variant of the indicators is the most unfavorable. It indicates a primary infection that occurred less than 5 days ago.
+	+	It is also a negative result, as it speaks of infection no later than a month ago.

Toxoplasmosis: the norm in the blood during pregnancy

Infection at a later date leads to premature birth, stillbirth, the appearance of a child with serious developmental pathologies, such as:

• retinal inflammation, blindness;
• deafness;
• enlargement of the spleen and liver;
• violation of the development of internal organs;
• jaundice;
• damage to the central nervous system (convulsions, paralysis, hydrocephalus, oligophrenia, epilepsy, encephalitis);
• pneumonia;
• disruption of the heart;
• external deformities: cleft lips and palate, pathologies of limb development, hernia, hermaphroditism, strabismus, cataracts and more.

Many of the above congenital abnormalities lead to infant mortality within the first few weeks of life or to profound disability. There are cases of the birth of a child without, at first glance, pathologies expressed. But during the first year of life, symptoms of acute toxoplasmosis appear.

Given the high level of danger of infection for an unborn baby, doctors during the planning period, conception, and throughout pregnancy prescribe women a comprehensive analysis for TORCH infection, which includes a study for toxoplasmosis. The test rate during pregnancy is no different from the generally accepted indicators.

Timely treatment significantly increases the chances of having a healthy baby. In this case, the benefits of the drugs used outweigh the possible harm they cause.

Indications for the treatment of toxoplasmosis

The test form shows the result "toxoplasmosis: blood norm" - treatment in this case is not required. In most cases, the human immune system is able to cope with the pathogenic microorganism on its own. Treatment is prescribed only for various immunity disorders in the following cases:

• with acute toxoplasmosis in order to prevent serious complications in AIDS patients and pregnant women;
• in the chronic form of the disease during an exacerbation in order to form a normal immune response;
• treatment can be prescribed for chronic toxoplasmosis in the case of the development of chorioretinitis, infertility, miscarriage.

Treatment of toxoplasmosis in immunocompromised people without pregnancy

People with weakened immunity may be prescribed different drugs, depending on the symptoms and history:

For pregnant women, therapy with the above drugs is prohibited.

Treatment of toxoplasmosis in pregnant women

If the analysis has confirmed the presence of an acute phase of infection, one of two types of therapy can be used:

1. The appointment of "Rovamycin" is possible in different courses: 1.5 million units twice a day for 6 weeks; 3 million units twice a day for 4 weeks or 3 million units three times a day for 10 days. Such treatment is prescribed for a period not earlier than 16 weeks of pregnancy.
2. A complex consisting of "Pyrimethamine" and "Sulfodaxine". The dosage and duration of the course is indicated by the doctor. Treatment can be prescribed after 20 weeks of pregnancy.
3. In case of eye inflammation, treatment with Prednisolone is necessary.
4. Also in uncomplicated cases, use "Spiramycin".

Prevention methods

If you are planning a baby, and the test results showed the absence of antibodies to toxoplasmosis, there is no other way to protect the unborn baby from the disease, except for preventive measures. Based on knowledge about the methods of infection, the following preventive measures can be identified:

• minimize contact with animals throughout the entire period of pregnancy;
• do not eat raw and poorly fried meat, unwashed vegetables;
• work with soil only in;
• remember to wash your hands thoroughly and often.

Based on the information provided in the article, we can conclude that toxoplasmosis is an extremely dangerous disease for the expectant mother and her baby. But modern medicine is able to timely detect specific antibodies that protect the body from infection. In this case, it is necessary not only to pass it on time, but also to correctly interpret the results of the analysis for toxoplasmosis. The norm in pregnant women is no different from the generally established indicators. So, the presence or absence of IgG immunoglobulins may indicate directly opposite clinical pictures. Therefore, trust the specialist - strictly follow all his recommendations, do not decipher the results yourself. In this case, the probability of a successful birth of a healthy child is very high. Be healthy!