[Severe fetopathy--toxoplasma despite serologic screening. A case report]

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Fetal Medicine

Context:

• Prenatal toxoplasmosis is a significant concern due to its potential for fetal harm.
• Early diagnosis and treatment are crucial for successful outcomes.
• Standard serologic screening is the primary method for detecting new infections.

Purpose:

• To present a case of prenatal toxoplasmosis diagnosed late in pregnancy despite initial negative screening.
• To discuss the challenges posed by false-negative initial serologic tests.
• To underscore the importance of continued vigilance in prenatal screening.

Summary:

• A 22-year-old gravida-II presented with seroconversion indicating a new toxoplasmosis infection late in the second trimester.
• Ultrasound revealed severe fetal abnormalities including hydrocephalus, hepatomegaly, and ascites.
• Congenital toxoplasmosis was confirmed post-delivery, with labor induced at 33 weeks gestation.

Impact:

• This case illustrates the limitations of primary serologic screening for toxoplasmosis in pregnancy.
• It highlights the potential for missed diagnoses and severe fetal consequences.
• Emphasizes the need for considering alternative diagnostic strategies or repeat screening in high-risk pregnancies.