According to some experts, on average, 80% of the world's population has toxoplasmosis, but its prevalence varies significantly in different regions. So, in France there are 84% of carriers, in some Latin American countries - almost 95%, and in Russia only about 20% of the population. But such a “favorable” indicator does not mean that Russian women need not worry. According to medical reports, toxoplasmosis during pregnancy in our country is diagnosed in 25% of women.
In most cases, it does not make itself felt, so pregnant women do not suspect that they are infected. But even "silent" toxoplasmosis poses a deadly threat to the fetus, because the microorganisms that cause it easily seep through the placenta.
The population has misconceptions about where toxoplasmosis comes from. This leads to the fact that pregnant women try to protect themselves from the unlikely culprit of the infection, not attaching importance to the real source of the threat. In the articleoffers comprehensive information about toxoplasmosis during pregnancy, reveals its causes, symptoms, diagnosis and treatment methods.
Characteristic of the microbe
There are several dozen types of microorganisms that parasitize in humans. Mostly it's bacteria. There are not so many protists among pathogenic microbes, but those that exist can cause severe, sometimes fatal diseases. These are the protists of Toxoplasma gondii (the common abbreviation is T. gondii). Their main owner is cats. Humans, birds and all other mammals are only an intermediate link in the life cycle of parasites.
In the body of cats, their sexual reproduction occurs, and in the human body - asexual. T. gondii invades cells, where they form parasitic vacuoles containing so-called bradyzoids. They, like a copier, multiply their own kind. When there are too many of them, the cell breaks. Vacuoles create cysts that can develop in the liver, lungs, kidneys, brain, heart and skeletal muscles, and human eyes.
Because T. gondii operates inside the cell, the immune system does not "see" them. It begins to work only against those microbes that have just left the ruptured cell and have not yet invaded the new one. Antibiotics act selectively on them.
It is for these reasons that it is difficult to completely get rid of toxoplasmosis.
In the body of cats, T. gondii cysts develop in the stomach and intestines. In the process of sexual reproduction, they form oocysts, which are secretedout with feces.
Cats are other routes of infection
From the above, it is logical to assume that it is possible to catch toxoplasmosis during pregnancy from a cat. However, in reality, the percentage of infection in this way is negligible. Therefore, you do not need to drive cute tailed pets out of the house if you find yourself in an “interesting position”. In defense of these animals, one can also say that they become infected with Toxoplasma only if they have eaten raw infected meat or caught a sick mouse. In extreme cases, even before pregnancy, you can conduct laboratory diagnostics for your cat to make sure that he is not a carrier of dangerous microbes, and if he is, then treat him.
Specialists believe that the presence of an infected cat in the house before the owner's pregnancy is not so bad, because thanks to this, the woman develops antibodies to parasites that no longer pose a threat to the unborn child. A cat can only be dangerous if it gets into the house of an already pregnant woman (for example, it was bought) and infects her.
A good way to avoid getting infected from a pet is to maintain personal hygiene, that is, always wash your hands after doing anything with the animal.
The most likely cause of toxoplasmosis during pregnancy is eating raw contaminated meat. It can be pork, beef, lamb, venison, poultry.
Threat is also the work with such meat (its cutting and otheroperation) if the woman does not wash her hands thoroughly afterwards.
The classic way to become infected with fecal parasites is to eat unwashed fruits and vegetables, and to work in the field.
It is impossible to catch T. gondii from an infected person through any household and sexual contacts. It is possible to adopt dangerous protists from him only through a blood transfusion or organ transplant.
Symptoms
Note that only 10% of women infected with T. gondii experience signs of developing the disease. In the remaining 90%, it goes unnoticed. Symptoms of toxoplasmosis during pregnancy appear in women with low immunity.
The incubation period after infection lasts from one to three weeks. During this time, a woman may already forget that she ate incompletely cooked meat or an unwashed vegetable. Therefore, it is often impossible to determine the source of the infection.
The disease can occur in acute and chronic forms.
In acute symptoms of toxoplasmosis during pregnancy are:
- Heat temperature.
- Bruised, pain all over the body.
- Headache.
- Enlarged spleen and liver.
- Vomiting.
- Paralysis
For many patients, the symptoms of toxoplasmosis during pregnancy can give the impression that the woman has a cold.
She has:
- Subfebrile temperature.
- Headache.
- Pharyngitis.
- Inflammation of the lymph nodes.
- Conjunctivitis.
ScientificToxoplasma has been proven to influence the behavior of its victim. In pregnant women and other people, this can manifest itself in such changes in the usual state:
- Distracted attention.
- Slow reactions.
- Increased talkativeness.
- Anxiety, doubts about every (even the most harmless) reason.
Testing for toxoplasmosis during pregnancy
If a disease is suspected, the attending physician in the antenatal clinic collects an anamnesis, and also finds out under what circumstances infection could occur. However, the most important is the serological analysis, in which blood is taken for toxoplasmosis during pregnancy. This first trimester study is done on all women, whether they have symptoms or not. For this, blood is taken from a vein. In her serum, the level of LgM and LgG antibodies specific to Toxoplasma is determined. The results should tell if the woman has been infected, and if so, for how long. If the infection has occurred recently, it is very important to determine whether this happened before or after conception.
In case of doubtful result, additional testing is carried out.
When testing for toxoplasmosis during pregnancy, the indicators may be as follows:
- LgM and LgG are negative. This means that there is no infection, but it may occur, as the immune system is weakened.
- LgM (-), LgG (+) - there is no infection that threatens the fetus, and the protective functions work well. This may mean that the infection of a womanhappened a long time ago (perhaps in her childhood), so the body has already developed immunity. To confirm this, a PCR test is prescribed and for avidity.
- LgM (+), LgG (-) - there is a primary infection, there is no immunity. This result of the analysis is the most alarming, since the fetus is in danger. The woman is scheduled for a second test in 2 weeks, as well as PCR and ELISA tests.
- LgM (+), LgG (+) - perhaps there is a disease of toxoplasmosis. To confirm this, tests for avidity and PCR are prescribed.
Other diagnostic methods
Testing for toxoplasmosis during pregnancy also includes an ultrasound. It is carried out to find out what condition the fetus is in. This does not mean that an ultrasound will necessarily show anomalies in the structure of the body or the like. Such a diagnosis helps to find out whether there is intrauterine growth retardation or not. If significant deviations are found, termination of pregnancy is recommended.
If a woman is confirmed to be infected with T. gondii, an amniocentesis is performed to determine if the fetus is infected or not. This analysis involves the puncture of amniotic fluid. Its reliability is 90-95%. For the fluid taken by puncture for this test, PCR is performed. Such a study can be performed for a period of more than 18 weeks.
They also do a general blood test to determine the he alth of the mother.
Ancillary test is a skin test. It is carried out when 3-4 weeks have passed since the alleged infection. Signs of the presence of toxoplasma in the body are swelling and redness of the papules, as well as inflammation of the lymph nodes.
It should be noted that only primary infection with mother's toxoplasma will be dangerous for the baby. If she was a carrier of microbes before pregnancy, then her body has already developed immunity against these parasites. The consequences of the infection for the child are closely related to how long it happened.
If in the first trimester, when the embryo is laying all its organs, toxoplasmosis is detected during pregnancy, the consequences for the fetus are serious, since there is a high probability of congenital anomalies. Very often miscarriages or fetal fading occur during this period.
Infection in the next 3 months can lead to abnormal development in only 5% of cases. If the mother fell ill in the second trimester, the baby may have vision problems, up to blindness, hydrocephalus, abnormalities in the activity of the brain, in the functioning of the kidneys, liver, heart, spleen, and digestive tract. A woman who falls ill during this period may go into premature labor.
If in the last three months toxoplasmosis has occurred during pregnancy, the consequences for the fetus are the most favorable, since by this time all body systems have already been formed. In this case, the baby will be born without visible anomalies, but he cannot avoid congenital toxoplasmosis. He may experience skin rashes like urticaria, diseases of internal organs, and poor eyesight. All these problems can be solved with the right treatment.
Treatment
If a non-pregnant woman is infected with T. gondii and has no serioussymptoms, such as high fever, vomiting, inflammation of the internal organs, retinal lesions, then treatment is not carried out, since toxoplasmosis resolves on its own, leaving behind strong immunity.
If you are diagnosed with toxoplasmosis during pregnancy, what should you do? This is the first question women ask after a positive serological test. There are several options for the development of events:
1. T. gondii was not found in the amniotic fluid. In this case, Spiramycin is prescribed. It is able to accumulate in the placenta, thereby preventing infection of the baby.
2. T. gondii was found in the amniotic fluid. Treatment of toxoplasmosis during pregnancy in the second trimeter is carried out using the drugs "Sulfadiazine" and "Pyrimethamine". As a preventive measure for a child with bone marrow, folic acid is prescribed at the same time.
Treatment in the first trimester of pregnancy is at the discretion of the doctor and according to indications (the woman has an acute or latent form of toxoplasmosis). Most often, at this time, doctors advise to terminate the pregnancy.
It has been established that the placenta passes pathogens in the first trimester in 15% of cases, in the second - in 30% of cases, and in the third - in 60%.
The well-known pediatrician Komarovsky says that if T. gondii was found in the amniotic fluid during pregnancy, with any treatment of the mother, the child has no chance of being born completely he althy. The difference will only be in the degree of damage to his organs.
Family Planning
Toxoplasmosis, which infected more than half of the populationplanet, does not cause any problems to people with good immunity. It is dangerous only for certain categories of citizens, including pregnant women. According to many doctors, the treatment of toxoplasmosis does not give a 100% guarantee of the birth of a he althy baby, so preventive measures are extremely important for this disease.
Knowing the dangers of toxoplasmosis during pregnancy, it is highly desirable to plan the birth of a child, and not let things take their course. Women who are going to become mothers should be tested for toxoplasmosis.
If the result shows that they have LgG antibodies in their blood plasma, then they already have immunity against T. gondii. Therefore, no cats are afraid of their baby.
If LgM antibodies were found as a result of the test, and the analysis showed that they appeared in the plasma recently, this is also a good indicator. It means that a woman needs to postpone pregnancy for about nine months (or better, a year). During this time, she will develop a stable immunity that will protect her baby.
If the test answer is negative, this indicates that the woman will have to be on the alert for the entire period of pregnancy and in every possible way protect herself from infection.
Prevention
Besides getting tested for toxoplasmosis, there are other things you can do to protect yourself from T. gondii infection. They are as follows:
- Keep hygiene, which means washing your hands thoroughly. This should be especially done after field and garden work and after cutting raw meat.
- Exclude from the diet meat dishes if their ingredients include thermally unprocessed meat. This also includes the ban on tasting raw minced meat for s alt and other spices.
- Be sure to wash vegetables and fruits before eating.
- Do not drink raw water from open sources, including wells located in the courtyard of the house.
- Examine domestic cats for toxoplasmosis. Eliminate raw meat from their diet.
Chronic toxoplasmosis
Some doctors believe that it is not bad at all if a woman in childhood or adolescence has been ill with acquired toxoplasmosis, since her body has developed a stable immunity against this disease for the rest of her life. This immunity will protect her baby during pregnancy and a whole year after birth.
However, in many who encounter tocoplasma, microorganisms do not disappear from the body, but in the form of cysts they settle in the tissues of various organs. They do not bring anxiety as long as their owner has strong immunity. If it decreases, they "wake up". For this reason, there is an exacerbation of toxoplasmosis. During pregnancy, this phenomenon is not uncommon, since the very “interesting position” of a woman already affects the weakening of the protective functions of the body. In addition, recurrence of chronic toxoplasmosis can be caused by:
- Stress, anxiety.
- Past illnesses (any, even a mild cold).
- Meager, vitamin-poor nutrition.
- Increased fatigue due to a busy work schedule.
Symptomsexacerbations of chronic toxoplasmosis during pregnancy depend on the organ in which toxoplasma is activated. Possible signs:
- Fever (subfebrile values).
- Inflammation of the lymph nodes.
- Dizziness, weakness.
- Mental disorders (anxiety, obsessive fears, irritability).
- Insomnia, tiredness in the morning with a good night's sleep.
- Deterioration of memory, concentration.
- Impaired vision (sharp deterioration).
- Decreased appetite, dull abdominal pain, nausea, difficulty with defecation, flatulence (if the microbe is activated in the digestive tract).
- Inflammation of the pancreas, kidneys.
- Endocrine disorders.
- Muscle pain.
- Myocarditis.
The expediency of treating pregnant women with exacerbated toxoplasmosis is decided by the attending physician based on additional tests.
Women's opinions
Now you can find a lot of information about the dangers of T. gondii microbes for the fetus and newborn baby. However, reviews of toxoplasmosis during pregnancy of women giving birth are full of optimism. Cat lovers are not going to part with them for the period of their “interesting position”, but they advise not to give raw meat to pets and check them for toxoplasma. It is also recommended to entrust the cleaning of the cat's pot to one of the family members.
Reviews contain reports of women who had no contact with cats and did not eat raw meat, but became ill with toxoplasmosis after eating a salad of raw vegetables stored in a warehouse wherethere were mice.
Women are advised not to be afraid of infection, be sure to take tests before pregnancy, and if immunity to toxoplasma is not found, be very careful in choosing dishes and in close contact with animals.
If there is immunity, women who have given birth to babies are advised to eat well, get enough rest, not be nervous and protect yourself from any diseases that can reduce immunity or somehow affect the he alth of the unborn child.
