Toxoplasmosis in pregnancy is still an open subject

To assess the consequences of a systematic screening for toxoplasma infection in pregnant women in a potentially high risk population.

We have investigated all consecutive women with likely toxoplasma seroconversion in a referral center setting. Data were obtained from 68 women for whom an acute infection during pregnancy was considered likely or definite. They were all treated with antibiotics in the first instance and offered, if in the first or second trimester, amniocentesis for detection of vertical transmission (PCR and IFAT). Third trimester seroconversions and positive cases after amniocentesis were offered more aggressive antibiotic treatment.

Five fetuses/neonates (7%) were found to be infected. Four of them were diagnosed prenatally at amniocentesis, two women decided for termination of pregnancy, two were treated and gave birth to seronegative, normally developing children. One case was found postnatally, after a third trimester conversion; this developed into hydrocephalus with neurologic impairment.

Prenatal screening and antibiotic treatment of mothers infected with toxoplasmosis showed good feasibility in our infection-susceptible population. However, there were some weak points; for example, the high number of invasive procedures and the questionable prevention of mother to child transmission in the second to third trimester.