Toxoplasmosis during Pregnancy

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KEY POINTS

• Toxoplasmosis is an infection that babies can get from their mothers before birth. 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. If you have this infection during pregnancy, it can hurt the baby.
• 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.
• To help prevent this infection while you are pregnant, eat only well-cooked meat, avoid handling cats, and avoid contact with cat litter.

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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?

A tiny parasite called Toxoplasma gondii causes the disease. 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 or more 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. The placenta is tissue inside the uterus attached to the baby by the umbilical cord. It carries oxygen and food from your blood to the baby’s blood and can pass the Toxoplasma parasite to your baby.

What are the symptoms?

Sometimes there are no symptoms. If you have symptoms, they are usually mild and start about 10 days after exposure to the parasite. Symptoms may include:

• Rash
• Fever
• Weakness
• Swollen glands
• Night sweats
• Muscle pain

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

• Fever
• Rash
• Swollen glands
• Enlarged liver and spleen
• Yellowing of the skin and eyes (jaundice)
• Eye infection

Lifelong symptoms or problems may include:

• Hearing loss
• Problems with learning, growth, and behavior
• Extra fluid that puts pressure on the brain
• A brain that is too small or too large
• Seizures

Toxoplasmosis may cause miscarriage or stillbirth.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You will have blood tests to see if you are infected or if you are immune to the disease from an earlier infection.

If you are infected while you are pregnant, tests to see if your baby is infected may include:

• Amniocentesis, which is a test of fluid around the baby
• Ultrasound, which uses sound waves to show pictures of the baby

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

• A physical exam, including looking for infection in the eyes
• Blood test
• X-rays of the head
• Tests of fluid from the brain or spine

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 supplement of folic acid may be included in your treatment because some medicines used to treat toxoplasmosis can keep you from getting enough of this vitamin from your diet. Folic acid is needed during pregnancy for normal development of the baby’s spine.

A baby who is found to be infected after birth can also be treated with these medicines. Treatment of babies who have been infected can help prevent or reduce problems caused by the infection. However, some babies may still have lasting problems.

How can I take care of myself?

Take your medicines exactly as prescribed.

Follow your healthcare provider's instructions. Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent toxoplasmosis?

To help prevent this infection 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 day.
• Wear gloves when you garden. Wash your hands thoroughly after working in the yard or with soil.

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