Treating Toxoplasmosis in Pregnancy

All about the infectious disease: Toxoplasmosis in pregnancy can be dangerous for the unborn baby in the womb and after birth.

Every second person gets infected with toxoplasmosis in the course of his life. It can go asymptomatic. It becomes dangerous, however, when the immune system is weakened or pregnancy is present.

What is toxoplasmosis and how does it spread?

This infectious disease is caused by parasites. The main host for the so-called Toxoplasma gondii is cats. Their faeces carry the parasite into the environment in the form of oocysts: soil and sand can be contaminated.

Toxoplasmas survive in the earth for years regardless of weather conditions. In the next step, farm animals or humans can ingest the pathogen through the remains of cat faeces. This happens through infected food (e.g. unwashed fruit or vegetables) or during gardening. For the animal disease toxoplasmosis, humans only act as intermediate hosts. Often the course of the disease is asymptomatic and therefore hardly noticed. However, flu-like symptoms with fever can also occur.

Toxoplasmosis in pregnant women and people with weakened immune systems

An initial infection with the parasite can have serious consequences, for example a special type of pneumonia can occur in weakened patients. This is accompanied by fever, cough and shortness of breath as symptoms.

In addition, a reactivation of the initial infection can occur. Then the brain is affected (cerebral toxoplasmosis). An inflammation of the affected brain region then leads to corresponding failures. Paralysis, cramps or impaired vision are symptoms of toxoplasmosis infection. Untreated, the parasite spreads further and can affect many organs.

Dangerous for the unborn child

Toxoplasmosis in pregnancy is dangerous: in pregnant women, the parasite can pass to the baby via the placenta. According to the Robert Koch Institute (rki), the probability of transmission increases with the duration of the pregnancy, but the severity of the disease in the child decreases. The transmission rate increases from around 15 percent in the first trimester to around 60 percent in the last trimester.

Miscarriage and subsequent damage caused by toxoplasmosis during pregnancy

About 1500 children are born with consequential damages per year. An early toxoplasmosis infection during pregnancy, if left untreated, can severely damage the unborn child or even lead to a miscarriage. The consequences can be blindness, the so-called hydrocephalus or other malformations. Babies that become infected in the womb from the second trimester of pregnancy onwards can be born without symptoms, but then only become ill years later through a so-called congenital toxoplasmosis. Delays in development or seizures then occur. But blindness or damage to the central nervous system can also occur. Children with congenital toxoplasmosis can also be mentally retarded. It is therefore important to prevent toxoplasmosis during pregnancy and to treat it quickly in case of infection.

Diagnosis of the infectious disease

The safest way of diagnosis is a test for antibodies. This involves taking blood and testing it for toxoplasmosis antibodies. If the mother is immune, so is the embryo. In pregnant women, this test is repeated regularly during pregnancy. This is important because one can become infected with toxoplasmosis unknowingly at any time. However, the test is voluntary and we are not always paid by every health insurance company. In addition, ultrasound examinations and umbilical cord puncture can provide information about toxoplasmosis during pregnancy and the consequences of this. In any case, early detection and treatment of an initial infection in pregnant women is important.

Treatment with pyrimethamine and sulfadiazine

Therapy is only necessary if there are complaints or risks for risk groups (pregnant women and immunocompromised persons). Antibiotics are then used. The active substances are called pyrimethamine and sulfadiazine, they kill the parasites and thus prevent them from spreading. Pregnant women also receive folic acid to strengthen the unborn child’s bone marrow. If a baby is born with a toxoplasmosis infection, it will also be given antibiotics to prevent late complications.

Prevention of toxoplasmosis in pregnancy

It is important to treat food that may be contaminated with the pathogen safely before consumption!

Also note:

• Fruit, vegetables and salad should be thoroughly cleaned before consumption
• Meat and sausage should not be eaten raw, not even pink (cook thoroughly!),
• Tartar, salami, bloody steaks, sausage and carpaccio should be avoided,
• Only handle raw meat with gloves and thoroughly clean all kitchen equipment that has come into contact with it,
• Avoid contact with free running cats and do not clean litter trays / remove excrement,
• Wear gloves when working in the garden
• Always wash your hands thoroughly.

Avoiding the use of raw milk products can also prevent this.