Prospective evalution of pregnant women with suspected acute toxoplasmosis treated in a reference prenatal care clinic at a university teaching hospital in Southern Brazil

• Published in: Revista do Instituto de Medicina Tropical de São Paulo Vol. 62; pp. 1 - 9
• Main Authors: Evangelista, Fernanda Ferreira, Mantelo, Francini Martini, Lima, Keller Karla de, Marchioro, Ariella Andrade, Beletini, Lucimara Fátima, Souza, Amanda Hinobu de, Santana, Priscila Laet, Riedo, Cristiane de Oliveira, Higa, Lourenço Tsunetomi, Guilherme, Ana Lúcia Falavigna
• Format: Journal Article
• Language: English
• Published: São Paulo Instituto de Medicina Tropical de Sao Paulo 01-01-2020; Instituto de Medicina Tropical; Instituto de Medicina Tropical de São Paulo; Universidade de São Paulo (USP)
• Subjects: Amniotic fluid; Antibodies; Architects; Congenital toxoplasmosis; Deoxyribonucleic acid; DNA; Gestational age; Infections; Original; Outpatient care facilities; Pregnancy; Prenatal care; Protozoa; Serological diagnosis; Serology; Teaching hospitals; Toxoplasma gondii; TROPICAL MEDICINE; Womens health; Brazil; Congenital toxoplasmosis; Toxoplasma gondii; Serological diagnosis; Amniotic fluid; Prenatal care
• ISSN: 1678-9946; 0036-4665; 1678-9946
• DOI: 10.1590/s1678-9946202062046

Infection by the protozoan Toxoplasma gondii during pregnancy demands greater attention from the health authorities due to the risk of placental transmission, which can have devastating consequences to the foetus and newborn. This study was conducted in a high-risk prenatal care outpatient clinic of a university teaching hospital. Pregnant women screened for specific IgM and IgG anti-T. gondii, attended from January 2009 to August 2018 were included. From 530 suspected patients, 218 were followed up and they presented positive IgM and IgG anti-T. gondii. From these patients, 83 (38.0%) had low IgG avidity, 39 (18%) seroconverted in the second or third trimester of pregnancy, 19 (8.7%) had no avidity test, 69 (31.6%) had high IgG avidity after 16 weeks of gestation, five had recurrent chorioretinitis (2.2%) and three (1.3%) were seropositive to HIV. Complementary diagnoses were made in 30/48 (62.5%) of the patients revealing the presence of specific IgA antibodies raised to T. gondii; 3/63 (4.8%) peripheral blood samples and 1/57 (1.8%) amniotic fluid sample. There were eight foetal deaths, one case of neonatal hepatomegaly and one case of T. gondii DNA detected in a peripheral blood sample. Of the 139 newborn deliveries at the teaching hospital, there was a 38% loss of follow-up. The prevalence of congenital toxoplasmosis was 1.2 cases/1,000 live births in this study area, according to the retrospective survey of cases. Prenatal treatment may have helped to reduce the risk of vertical transmission.