Why is there toxoplasmosis
Toxoplasmosis during pregnancy is only dangerous for the unborn child if pregnant women are within the last six weeks before or during pregnancy infect with Toxoplasma gondii for the first time. In most cases, toxoplasmosis proceeds without symptoms during pregnancy. However, the parasites can spread to the unborn child and cause serious complications and deformities:
- Miscarriage is possible - especially if you become infected in the first trimester of pregnancy.
- Inflammation of the retina and choroid in the baby's eye (it sometimes takes months or years to show it)
- Water head (hydrocephalus)
- Calcifications of the cerebral vessels
- enlarged liver and spleen
If you contracted toxoplasmosis for the first time during pregnancy, the risk of infection for your unborn baby depends on various factors, for example:
- Timing of infection during pregnancy
- Infectious dose
- Dangerousness of the pathogen
- Immune competence of the expectant mother
The longer the pregnancy, the higher the risk that expectant mothers will transmit toxoplasmosis to the child via the placenta. In the first trimester of pregnancy, the transmission rate is around 15 percent, in the last third around 60 percent. On the other hand, the severity of the clinical picture decreases as the pregnancy increases.
Toxoplasmosis in Pregnancy: Frequency
The problem is that antibodies against toxoplasma can only be detected in 26 to 54 percent of Central European women of childbearing age. In other words, the majority of them have not yet come into contact with the dangerous pathogens. If you were infected with toxoplasmosis before you became pregnant, your baby is protected from infection by your antibodies and immunity - so there is usually no danger to your child. Doctors can use a toxoplasmosis test to determine whether or not you have antibodies to the toxoplasma. According to the Institute for Risk Assessment (BfR), around 15 infections with Toxoplasma acquired in the womb are reported every year. They are also called congenital infections because the infection occurs in the womb or at birth. However, doctors assume a high number of unreported cases.
Toxoplasmosis in pregnancy: treatment
Doctors treat an initial infection with toxoplasmosis during pregnancy with antibiotics (drugs against bacteria), antiparasitics (drugs against parasites), or a combination of both. The following active ingredients are available:
- Spiramycin (Antibiotic) for pregnant women up to the 16th week of pregnancy
- Pyrimethamine (Anti-parasitic) plus Sulfadiazine (Antibiotic): from the 16th week of pregnancy for at least four weeks; simultaneous treatment with Folinic acid (not folic acid!) so as not to impair the effectiveness of the treatment. If there is evidence of an infection or damage to the embryo in the ultrasound, doctors continue treatment with these three active substances until the end of the pregnancy. Regular blood and urine tests as well as monitoring of liver function are important. In addition, doctors more often determine the level of drugs in the blood.
However, doctors are controversial about the effectiveness of toxoplasmosis therapy for the first infection during pregnancy. A recent study found evidence that treatment with pyrimethamine and sulfadiazine performed better than treatment with spiramycin within the first few weeks after infection. This applied to the transmission rate of the pathogens via the placenta and the brain damage in newborns.
Toxoplasmosis: Treatment of Newborns
Doctors also treat a newborn child with toxoplasmosis with the combination of pyrimethamine, sulfadiazine, and folinic acid. The duration of therapy in newborns with symptoms depends on the severity of toxoplasmosis in the child and can be up to twelve months. Doctors continuously determine the level of medication in the blood. Doctors consider treatment for three to six months for infected babies with no symptoms, for whom the infection can only be detected via laboratory values.
Toxoplasmosis in Pregnancy - Tips to Protect
Pregnant women and women who want to have children should definitely prevent an initial infection during pregnancy! It is essential to find out from your doctor by means of a toxoplasmosis test whether you have ever had contact with the toxoplasm and whether you have immunity - in this case antibodies against the pathogen can be detected in the blood. Have your antibody status determined before or as early as possible in pregnancy. If you are not immune, get regular toxoplasmosis screening during pregnancy. But: The toxoplasmosis test is only a service of the statutory health insurance companies if there is justified suspicion. Screening for toxoplasmosis does not (yet) exist in Germany.
If you had no contact with Toxoplasma gondii before your pregnancy, you do not have any antibodies against the pathogen. Special protective measures are advisable, especially when dealing with cats in your household and outdoors, as well as with their diet. They apply particularly to pregnant women, but also to all other people!
- Do not consume raw, insufficiently heated / frozen sausage and meat products (e.g. minced meat, carpaccio, sausage or tea sausage, salami, raw ham)
- Heat meat sufficiently and fry it well. Cooking, frying or pasteurizing kill toxoplasma. At a temperature of over 67 ° C, permanent stages of the pathogens that encapsulate in cysts die off within one to two minutes. Important: You have to achieve the high temperature evenly throughout the product - brief heating in the microwave is not suitable for this!
- Freezing food also kills toxoplasma, but it is not enough as the sole measure because some strains survive freezing. Freeze meat for at least eight hours at –20 ° C to kill the toxoplasma.
- Wash, peel, or boil fruits and vegetables well before eating them.
- Keep earthy foods like potatoes or carrots separate from other foods to avoid possible parasite transmission.
- Wash your hands both before eating and after preparing raw meat. Then clean all the kitchen utensils you have used.
- Do not drink water from lakes, streams, or other water sources when engaging in outdoor activities.
- Avoid feeding your cat raw meat that may contain Toxoplasma gondii. Better to use canned or dry food.
- Pregnant women should have other people in the household clean the litter box. They should clean the manure box daily with hot water and dispose of the litter.
- If you have visited sand playgrounds - wash your hands thoroughly afterwards.
- Wear gloves when gardening, fieldwork, or other earthworks. Then wash your hands again well.
- Do not pet cats that are roaming free outside.
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