Toxoplasmosis During Pregnancy

What is toxoplasmosis?

Toxoplasmosis is an infection that babies can get from their mothers before birth. If you have this infection during pregnancy, it can hurt the baby.

What is the cause?

Tiny organisms called Toxoplasma gondii cause the disease. These organisms are protozoa, not bacteria. People are most often infected by eating raw or undercooked meats, especially lamb or pork. You can also get infected from contact with insects in the soil and bowel movements of cats.

Generally, if you were infected with Toxoplasma several months before getting pregnant, you have become immune. This means that you will not have an active infection again and your unborn child is protected by your immunity. If you are infected just before or during pregnancy, the infection can pass to the baby through the placenta.

What are the symptoms?

In most cases the mother's symptoms of the disease are mild. Sometimes there are no symptoms. If symptoms appear, it is usually about 10 days after exposure to infected, poorly cooked meat or contact with an infected cat's bowel movements. Symptoms the mother may have are:

• rash
• fever
• weakness
• swollen glands
• night sweats
• muscle pain

Many infected babies do not show any symptoms at birth, but they may develop serious problems later. If a newborn has been infected with toxoplasma, some possible symptoms or problems are:

• fever
• rash
• swollen glands
• enlarged liver and spleen
• jaundice (yellowing of the skin and eyes)
• eye infection
• hearing loss
• mental retardation
• extra fluid that puts pressure on the brain
• a brain that is too small or too large
• seizures

Toxoplasmosis may cause miscarriage or stillbirth (a baby who is dead at birth).

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. You will have blood tests to see if you are infected. Blood tests can also show if you have become immune to the disease.

If you are infected while you are pregnant, the following tests may be done to see if the baby is infected:

• amniocentesis
• ultrasound scan

The baby may have the following tests after birth to check for infection:

• a physical exam, including looking for infection in the eyes
• blood test
• X-rays of the head
• lab tests of fluid from the brain or spine
• There are blood tests you can have to see if you were exposed earlier.

How is it treated?

If you get infected during pregnancy and tests suggest that your baby is infected, you may be given medicines to treat the infection. The earlier you get treatment, the less likely it is that your baby will have symptoms of the disease after birth. A baby who is found to be infected after birth can also be treated with these medicines.

The dietary supplement folic acid may also be a part of your treatment because some medicines used to treat toxoplasmosis can keep you from getting enough folic acid from your diet. Folic acid is needed for normal development of the baby’s spine.

How long will the effects last?

Most toxoplasma infections are cured within a few months after treatment.

If a baby is infected late in the pregnancy, the baby may have a mild form of the disease and may not have any symptoms. If a baby is infected early in the pregnancy, the baby is more likely to have severe permanent effects, such as:

• loss of vision or hearing
• learning disabilities or mental retardation
• seizures
• death

Treatment of babies who have been infected can help prevent or reduce these possible complications. However, some babies may still have lasting disabilities.

How can I help prevent toxoplasmosis?

To help prevent getting toxoplasmosis while you are pregnant:

• Eat only well-cooked meat. Wash your hands thoroughly with soap and water after handling raw meat.
• Avoid handling cats, especially outdoor cats. If you have contact with a cat, wash your hands thoroughly afterward.
• Avoid contact with cat litter and sand or soil that may contain cat bowel movements. Have someone else clean the litter box every 24 hours.
• Wear gloves when you garden. Wash your hands thoroughly after working in the yard or with soil.

If you have been recently infected, your healthcare provider may recommend that you wait at least 6 months before trying to get pregnant.