The disease is provoked by protozoa called Toxoplasma. These are microscopic organisms (protozoa), so it is impossible to determine the moment of infection.
The situation is quite different when a woman is infected long before the fertilization of the egg. During the initial infection, immunity develops. The protective functions of the body make it possible to protect the child in the future if the protozoa are again in the body during pregnancy. For this reason, a woman is being screened for TORCH infections, which include toxoplasmosis.
Worst-case scenario: the death of a child in the womb. When a pregnant woman is infected in the first and second trimesters, there is a risk of spontaneous abortion. As the term increases, the likelihood of preterm birth increases.
In addition, the child shows serious deviations:
Epilepsy often develops later mental development delayed. AT different time the level of severity of defects and abnormalities in the development of organs is different. So, from 1 to 8 weeks, the penetration of protozoa into the body leads to hydrocephalus, anophthalmia, anencephaly. The size of certain organs increase (liver, spleen). During this period, the disease often provokes spontaneous abortion, fetal death.
From 1 to 8 weeks: at this time, the disease often provokes spontaneous abortion, fetal death
A number of organs (eyes, brain, liver) develop with deviations. They can be detected from 8 to 18 weeks. Defeat internal organs occurs at 18-24 weeks. Infection in the third trimester does not cause serious consequences for the fetus inside the womb, and after birth, the crumbs may not have any signs of infection. However, in adulthood, the consequences of toxoplasmosis still become noticeable: deafness, epilepsy, mental retardation.
When infected in the 1st trimester, the fetus may develop malformations that are not compatible with life.
Severe infection and high sensitivity of the woman's body provoke the appearance of more serious symptoms:
Clinical manifestations:
Based on the symptoms, the patient is sent for examination. Recommended tests:
The first type of study (indirect immunofluorescence reaction) can be carried out as early as a week after the penetration of protozoa. Later, the figures will only increase. RSK (stands for complement fixation reaction) gives positive results, but this usually happens 2 weeks after infection. However, if such an analysis is carried out later than 4 months. after infection, the study will be ineffective, since toxoplasmosis will become chronic by that time, which complicates the task of diagnosis.
In addition, sometimes there is a need for other diagnostic methods:
Useful video: Toxoplasmosis during pregnancy - how to avoid the consequences
The most effective drugs based on pyrimethamine and sulfa drugs
Drugs are also involved, the action of which is based on blocking protein synthesis in microorganisms. These include macrolides. If the examination did not confirm the presence of protozoa, the course of treatment is not prescribed.
In the first trimester, doctors usually recommend an abortion, as Toxoplasma parasitism provokes serious disorders in the organs of the fetus. It is recommended to take spiramycin. After the first trimester, drugs based on pyrimethamine and sulfonamides are added.
Toxoplasma is able to cross the placenta of a pregnant woman. They affect the course of pregnancy itself and cause developmental pathology in the fetus. Serological screening of a pregnant woman for toxoplasmosis and administration of antimicrobial therapy are common methods of preventing toxoplasmosis in pregnant women.
Rice. 2. Scheme of the spread of infection. Wild and domestic cats are the main hosts of toxoplasmosis. Warm-blooded animals (including humans) and birds are intermediate.
Rice. 3. Home and wild cats- the main source of distribution of toxoplasma.
Lymph nodes increase significantly in size.
Toxoplasmosis in pregnant women can occur in the form of carriage, have a latent (hidden) course, have an acute or subacute course, acquire a chronic course with periodic exacerbations. The disease most often proceeds benignly.
The asymptomatic course of the disease can only be determined by determining the level of antibodies or the determination in the enzyme-linked immunosorbent assay (ELISA) of IgM immunoglobulins.
The acute form of the disease is always difficult. Incubation period(reproduction period of Toxoplasma) is on average a few weeks. General weakness, malaise, muscle pain, chills and subfebrile temperature bodies are the main symptoms of toxoplasmosis during pregnancy during this period.
The acute form of toxoplasmosis lasts from several days to several months. Subsequently, a secondary latent form of the disease is formed or the disease acquires a chronic course.
Rice. 4. Toxoplasma from pseudocysts or cysts are activated and penetrate into the blood, from where they enter the fetus through the placenta, affecting it at any phase of its development.
Chronic toxoplasmosis occurs with constant exacerbations and rare intervals of weakening of the symptoms of the disease, with little effectiveness of anti-infective treatment. Prolonged low-grade fever, phenomena of intoxication and asthenia, generalized enlargement of the lymph nodes are the main symptoms of toxoplasmosis during pregnancy during this period of the disease.
Clinical manifestations of the disease depend on the damage to the internal organs - central and peripheral nervous system, muscles, eyes, liver, spleen, genitals. Patients are worried about weakness, sleep is disturbed, appetite worsens. Memory loss, adynamia and psycho-emotional instability are constant symptoms of the disease.
Symptoms of toxoplasmosis during pregnancy do not have any features or differences from the known clinical picture of the disease.
The signs and symptoms of toxoplasmosis are described in detail in the article.
Serological methods: indirect immunofluorescence reaction (RNIF), enzyme immunoassay (ELISA Toxo, IgG, IgM) form the basis of laboratory diagnosis of toxoplasmosis. The dynamics of the level of antibodies of the IgG and IgM class is a marker of the effectiveness of the therapy.
The presence of antibodies of the IgM class, a significantly increasing dynamics of the titer of immunoglobulins, their high level confirm the diagnosis of toxoplasmosis. The reliability of diagnosis is confirmed by the data of monitoring the level of antibodies in dynamics.
An increase in the level of antibodies of all classes is noted at 2-3 weeks from the moment of infection. The correct interpretation of the data obtained is the responsibility of the doctor.
The following factors indicate infection during pregnancy:
Patients with toxoplasmosis do not pose a danger to others, which allows them not to be isolated for the duration of treatment, but to be treated at home or in a general somatic hospital.
Treatment of toxoplasmosis in pregnant women is carried out from the second trimester of pregnancy. Rovamycin and Fansidar drugs of choice for the treatment of this disease. It is advisable to carry out two full courses of antimicrobial therapy with a break of 1-1.5 months. good effect gives the simultaneous use of immunomodulators ( Galovit, Polyoxidonium). A decrease in the level of antibodies of the IgM class indicates a positive trend in the treatment process
Selection of the drug, its dose and determination of the duration of treatment is carried out only by a doctor. Detection of toxoplasmosis in early pregnancy and treatment adequate treatment prevent fetal infection.
Toxoplasmosis during pregnancy is confirmed by an infectious disease doctor. AT Russian Federation women of childbearing age are infected with toxoplasma in 20 - 30% of cases.
Women not infected with toxoplasma make up 70-80%. They are at risk for congenital toxoplasmosis.
Continuous serological monitoring during pregnancy is the basis for the prevention of toxoplasmosis.
Rice. 6. In the photo, the fetus is at the 8th week of pregnancy. Toxoplasma infection in the 1st trimester of pregnancy is complicated by severe developmental anomalies and intrauterine death fetus. The risk of infection of the fetus during this period is 17%.
Rice. 7. In the photo, the fetus is at 12 weeks of gestation. Toxoplasma infection of the fetus at 12-18 weeks of gestation is complicated by severe damage to the central nervous system (hydrocephalus), organs of vision and liver. The risk of infection of the fetus during this period is 25%.
Rice. 8. In the photo, the fetus is at 18 weeks of gestation. Toxoplasma infection of the fetus at 18-24 weeks of gestation is complicated by the pathology of many internal organs. At birth, newborns have jaundice, anemia, an enlarged liver and spleen, and thrombocytopenia. The risk of infection of the fetus during this period is 65%.
Rice. 9. In the photo, the fetus is at 28 weeks of gestation. Fetal infection with Toxoplasma later dates(28 - 40 weeks) is complicated by deafness and damage to the organs of vision, which appear several years after birth. The risk of infection of the fetus during this period is 80%.
Congenital toxoplasmosis is 1-8 patients per 1000 live births.
Infection of pregnant women in the early stages or shortly before pregnancy is dangerous due to the possibility of damage by toxoplasma gestational sac, which leads to miscarriage, stillbirth, the birth of children with malformations, hepatosplenomegaly, etc.
With an asymptomatic infection in a pregnant woman during the period of immune suppression, reactivation of toxoplasmosis may occur. Toxoplasma from pseudocysts and cysts are activated and penetrate into the blood, from where they enter the body of the fetus through the placenta, affecting it at any phase of its development.
Infection of the fetus in late pregnancy leads to the birth of children whose symptoms of toxoplasmosis in the form of deafness and damage to the organs of vision appear several years after birth.
Congenital toxoplasmosis occurs either in the form acute illness, or can immediately take a latent or chronic course.
The acute form of congenital toxoplasmosis is severe. Intoxication, fever, skin rash (exanthema), damage to many internal organs, eyes, central nervous system and enlarged lymph nodes are the main clinical manifestations diseases. The disease often acquires a progressive course. The child dies in the first weeks of life.
In some cases, the severity of the process gradually subsides and the disease becomes chronic. During this period, the disease is manifested by signs of damage to the central nervous system - a lag mental development, paresis, paralysis, epileptiform seizures, chorioretinitis.
Rice. 10. Rash in a newborn with toxoplasmosis (exanthema of newborns).
Rice. 11. Congenital toxoplasmosis. The sizes of the enlarged liver and spleen are marked with a felt-tip pen.
Rice. 12. Enlargement of the liver in congenital toxoplasmosis is often accompanied by jaundice.
Rice. 13. Hydrocephalus is a malformation of the nervous system in toxoplasmosis.
For every woman, pregnancy is a unique event in life. During this period, you should especially carefully monitor personal health, as the disease can disrupt full development fetus. Unfortunately, it is not always possible to fully protect yourself from the harmful effects of environmental factors. Toxoplasmosis during pregnancy is no exception. Upon hearing such a diagnosis, women panic and begin to worry excessively. However, is the diagnosis really as scary as it seems at first glance? This article will help you sort out this difficult issue.
It is important to note that fresh feces are not dangerous! Toxoplasmosis requires exposure to external environment for a while. Given this nuance, if a woman cleans the cat litter immediately, then she is absolutely not afraid of the disease. During cleaning, the tray must be thoroughly washed with soap so that larvae from past feces do not develop.
Important! If a woman had toxoplasmosis before pregnancy, then she developed immunity to this disease. Re-infection is not possible. However, if the disease has a primary form, then the patient does not have immunity to Toxoplasma qondii.
What threatens toxoplasmosis unborn baby? The disease leads to serious consequences for the fetus. In the early stages, spontaneous abortion may occur. In the third trimester may develop premature birth, fetal fading or the birth of an infected child. As a rule, toxoplasmosis develops in 20% of newborn babies if the infection was detected in the mother.
At the first symptoms, it is important to immediately consult a doctor. On the initial stage the disease is perfectly treatable without harm to the unborn baby. However, neglected infection leads to the manifestation of severe symptoms for a woman and poses a serious danger to the fetus.
Toxoplasma qondii can be determined using a special study - serological analysis. To do this, a woman must simply donate blood for analysis. How to take - the attending physician will tell. However, the doctor is faced with the task of further determining when the infection occurred. The answer to this question will be given by an immunoglobulin study (G, M). It is the primary ailment that carries a serious danger, since re-infection does not harm the woman and the child. An analysis for toxoplasmosis during pregnancy may have the following laboratory parameters (decoding):
Important! When planning a pregnancy, experts recommend taking a test for antibodies to toxoplasmosis. This procedure will protect the woman and the unborn child from serious consequences.
Drug therapy at the beginning of pregnancy is strictly prohibited. The drugs are made up of chemical substances, 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 the organs and systems of the child are formed, so the likelihood of pathological complications is less.
Important! If a woman has a serious form of toxoplasmosis, then a written consent is taken from her before starting therapy. In him future mother undertakes not to make claims against the medical staff if the child has complications on the background of medications.
Medical treatment always includes antibiotics. Usually the doctor recommends such drugs:
At the first signs of infection, a woman should consult 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.
Toxoplasmosis is considered the most terrible disease for expectant mothers, as it can lead to severe malformations of the child. If toxoplasmosis is detected during pregnancy in the early stages, it is usually recommended to have an abortion, and in the later stages, drugs that are dangerous for the fetus are prescribed to the woman. But is toxoplasmosis really that terrible for a pregnant woman and an unborn baby? Is it possible to protect yourself from the disease and what to do if the diagnosis has already been made? You will find answers to these questions in our article.
Many will be surprised and ask how it happened that a harmless pet living in almost every second family became a potential carrier of a serious disease? The fact is that sexual reproduction of Toxoplasma can occur only in the cells that line the cat's intestines. Toxoplasma eggs (oocytes) are shed in cat feces and end up in the ground, where they can be swallowed by livestock and other animals.
In the vast majority of cases, toxoplasmosis in pregnant women is asymptomatic. It is possible to determine the disease only after passing tests for the presence of infection. Sometimes non-specific symptoms may appear, including:
Often, the symptoms of toxoplasmosis in pregnant women are mistaken for signs of a cold, so a woman may not even be aware that she has encountered such a dangerous problem.
The chronic form of toxoplasmosis is characterized by a general infectious syndrome, which is sometimes accompanied by signs of damage to the nervous system, internal organs, eyes or genitals. In especially severe cases, the disease is accompanied by pain in the muscles and joints, a spotted rash, and fever.
It must be said right away that women who have had toxoplasmosis long before the conception of a child may not worry about anything - immunity has formed to the disease. If future mom had not previously encountered this disease and became infected during pregnancy, it is worth sounding the alarm.
Toxoplasmosis in pregnant women primarily attacks the fetus and leads to gross violations of its development. But here, too, there are some nuances - the severity of the consequences depends on the gestation period. So, if Toxoplasma enters the mother's body in the first trimester, the probability of infection of the fetus is 15-20%, in the second - 30%, and in the third - over 60%.
However, the “older” the baby, the more likely it is that he will be born into the world without any visible pathologies. In this case, there is a latent (latent) toxoplasmosis: the consequences of the infection can make themselves felt months or even years later.
How to decipher the results of the analysis for toxoplasmosis during pregnancy? Let's consider each of the possible options:
Toxoplasmosis is not an absolute indication for abortion. If IgM antibodies are found in the woman's blood, further testing will be required. If Toxoplasma or their antigens are present in amniotic fluid, the probability of damage to the fetus is quite high. Ultrasound will help to give an adequate assessment of the situation.
It is worth noting that the treatment of toxoplasmosis in pregnant women can only be started from 12-16 weeks. Due to the fact that antibiotics are used to treat the disease, doctors recommend that all sick women have an abortion if the gestation period is less than 24 weeks.
However, it is still not clear whether it makes sense to treat toxoplasmosis during childbearing. There is no evidence that this can somehow improve the prognosis, but antibiotics will definitely not be of benefit. The only one positive moment in this situation - complete confidence that the next baby is not threatened by toxoplasmosis due to the immunity acquired by the mother.
If a woman does not have one hundred percent confidence that she will be able to protect herself from contact with a cat during pregnancy, first you need to take an immunoglobulin test. If antibodies to Toxoplasma are found in the blood, there is nothing to worry about. In the event that there is no immunity, the cat will have to do the analysis. With a sick or previously ill pet, you will have to part for a while. A healthy animal should not be allowed outside and fed raw meat. A pregnant woman should be checked for toxoplasmosis every 2-3 months. 4.7 out of 5 (14 votes)
Pregnancy is a special period when you need to be more attentive to your body, protect it from diseases, because it is known that they can adversely affect the child. However, it is impossible to completely hide from diseases. Toxoplasmosis during pregnancy is no exception. Many mothers, having heard such a diagnosis from a doctor, immediately panic. But don't worry ahead of time. First of all, it is worth finding out what this disease is and why it is dangerous.
You can also get toxoplasmosis if you wash your hands badly after communicating with sick animals and contact with cat feces.
Many pregnant women have no symptoms of toxoplasmosis. You can learn about the disease only after passing tests for the presence of infection. Laboratory indicators will confirm toxoplasmosis during pregnancy.
Symptoms of the disease depend on its forms. There are several types:
At sharp toxoplasmosis are observed the following signs: an increase in axillary lymph nodes, a feeling of weakness, an increase in body temperature up to 38.0-39.0 degrees, muscle pain.
For cerebral toxoplasmosis is characterized by headaches, heat, loss of sensation in some areas of the body, paralysis, coma.
At congenital toxoplasmosis during pregnancy, the symptoms will be as follows: deafness, jaundice, rash, large or small size head of a newborn baby, delayed psychomotor development.
Main symptoms eye toxoplasmosis: blurred vision, eye pain, blindness.
Common toxoplasmosis occurs without damage to the brain and eyes. Its manifestations are different, as they are caused by inflammation of the heart muscle, lungs, etc. Inflamed organs may stop working.
Chronic toxoplasmosis during pregnancy manifested by irritability, memory loss, neurotic reactions, nausea, bloating, constipation. The most important symptoms are specific myositis and myocarditis.
Toxoplasmosis during pregnancy is absolutely harmless for women who have suffered this disease long before conception. It develops immunity.
If a woman has not had toxoplasmosis before, then it will be very dangerous for her and the child. The risk of infection of the fetus with each month of pregnancy becomes higher. For example, in the first trimester, the risk of infection of the baby is 15%, in the second - 30%, in the third - more than 60%.
The severity of the disease does not increase with time, but rather decreases. If a woman becomes infected with toxoplasmosis during pregnancy in the first trimester, then the likelihood that the fetus will die is very high. There is almost always a miscarriage. Even if a child is born, he may have serious damage to the brain, spleen, liver, and eyes.
In order to determine whether a pregnant woman is infected with toxoplasmosis or not, they carry out serological analysis blood. The doctor is faced with a difficult task - not only to detect an infection in the body, but also to determine whether it is old or fresh. To find out medical worker determines the presence of class G and M immunoglobulins (IgM, IgG).
Norm toxoplasmosis during pregnancy - the presence of a stable IgG indicator and the absence of IgM antibodies. If there are only class M immunoglobulins in the blood, this means that the infection has occurred quite recently. This situation is extremely unfavorable for a woman in a position. If the period is short, then a miscarriage is possible. If this does not happen, then doctors recommend termination of pregnancy, as the baby will serious problems with health. At a later date, treatment is carried out.
If the analysis for toxoplasmosis during pregnancy reveals immunoglobulins of both classes, then this indicates that the woman has been infected for a long time, and the infection has been in the body for about a year. In this case, a re-examination after a few weeks is recommended.
During the examination, immunoglobulins may not be detected at all. A pregnant woman will need to follow all precautions throughout the entire period, because she had not previously suffered from toxoplasmosis, and she has no immunity to this disease.
Often, when analyzing, the doctor states the presence of class G immunoglobulins and the absence of class M immunoglobulins. This indicates that the infection was previously in the body, but immunity has now been developed to it. Antibodies to toxoplasmosis during pregnancy remain in the body for long years(about 10 years). Thus, a meeting with an infection does not threaten absolutely nothing.
Treatment of toxoplasmosis in pregnant women is mandatory. The doctor, having diagnosed this disease, determines the scheme and duration of the forthcoming treatment.
It is worth noting that toxoplasmosis can be treated from 12-16 weeks. However, doctors recommend to sick women to terminate the pregnancy if its term is less than 24 weeks. This is due to the fact that for the treatment of the disease are used antibiotics. At an early stage harmful effects drugs on the fetus cannot be avoided.
Most often, doctors prescribe to their patients a drug that is highly effective. Rovamycin significantly reduces the risk of transmission to the child. In addition, this antibiotic is well tolerated by most women.
All drugs for toxoplasmosis and pregnancy are taken only on prescription. You do not need to self-medicate.
Pregnant women who have never had toxoplasmosis can avoid contracting this terrible infection. To do this, you just need to carefully observe the rules of hygiene.
Compliance with all these preventive measures will allow a pregnant woman without immunity to protect herself and her unborn baby from infection.