Before pregnancy, few women learn about toxoplasmosis, and the overwhelming number of men do not meet with this name until the end of life.
This is due to several factors, one of which is an asymptomatic course of the disease.
However, if for a healthy person with a normal immune system, the disease is not dangerous, then toxoplasmosis during pregnancy is fraught with serious complications, even death.
Toxoplasmosis - what is it?
Toxoplasmosis refers to the types of TORCH-infections (capable of infecting the fetus in the womb). The disease is caused by a representative of the simplest type - Toxoplasma (Toxoplasma gondii). For the first time the parasite was discovered in 1908 in hot countries in the rodent Gondi. To this day, the main source of human infection with toxoplasmosis is domestic animal feces (most often cats).
Parasite spores (cysts) are characterized by viability outside the host. Toxoplasma retains its viability for a long time, continuing intracellular reproduction inside the small intestine of the host, forming oocysts that leave the intestine with feces. If the host’s immune system does not cope with the parasites, then toxoplasmosis spreads through the blood to all organs of the body.
People most often become infected by eating raw meat and insufficiently thermally processed vegetables, berries, or greens with which an infected animal came in contact.
How does toxoplasmosis
After an oocysts or cysts enter the human body, the human immune system begins to fight toxoplasmosis, producing antibodies in the blood serum, specific proteins of immunoglobulins. They just "grasp" and destroy the parasite, remaining in the human body forever. Now, even if it enters the body, Toxoplasma cannot harm a person. Toxoplasmosis is similar to chickenpox - having re-ill one day, it will not work again.
The course of the disease is usually asymptomatic.. Only the flu-like symptoms in the acute stage of toxoplasmosis, when the parasite has just entered the body and the immune system “launched” its forces, can put on guard. Symptoms include fever, swollen lymph nodes, headache and muscle pain, and general weakness. They usually take place at the same time as when infected with influenza, and the person learns that he had had toxoplasmosis, after a long time, according to the results of a serological study.
Who is dangerous for toxoplasmosis
But this applies to people with reliable immune protection. When the immune system is weakened, especially in the postoperative period, or in case of immunodeficiency, toxoplasmosis spreads through the lymph and blood to all organs and tissues, it can cause deadly diseases. Most often, toxoplasma in such patients affects the brain, causing encephalitis. This disease is manifested by loss of consciousness, cramps and severe headache. It is difficult to treat and does not pass without a trace.
Toxoplasmosis in pregnancy, when a woman is already infected "in position", is able to hit the fetus by passing through the blood vessels through the placenta. Since the fetus does not yet have its own immunity, Toxoplasma directly affects its brain.
As a result of toxoplasmosis during pregnancy it is possible:
• the onset of hydrocephalus, chorioretinitis;
• intracranial calcification;
• damage to the eyeballs;
• spontaneous abortion;
• fetal death.
If the child is affected by toxoplasmosis intrauterinely, then after birth he usually suffers from congenital malformations, usually problems with brain activity.
Toxoplasmosis in pregnancy: causes
If a woman becomes infected with toxoplasmosis at least a year before the onset of pregnancy, her immune system has already developed antibodies to the disease and the parasites will not be afraid of the fetus. But toxoplasmosis in pregnancy during the initial infection is very dangerous for the fetus, and in some cases - fatal.
In the world, much more than half of women from adolescence already have antibodies to toxoplasmosis, and not more than one percent become infected with them during pregnancy. Moreover, even if the pregnant woman “caught” Toxoplasma, the child will not necessarily be infected. Huge maturity is important, on which parasites got into the body of the future mother.
Toxoplasmosis in early pregnancy
At this time, the probability of infecting the fetus with toxoplasmosis is minimal, usually if the pregnant woman has problems with immunity. But if, nevertheless, parasites penetrated the placenta, then the probability of serious damage to the systems and organs of the fetus is very high.
Toxoplasmosis during pregnancy in the last trimester
The highest chance of infecting a child with toxoplasmosis occurs in the last three months of pregnancy, when the placenta is full of blood vessels, which constantly receive a large amount of blood. It is precisely the rate of exchange of fluids that determines the increased risk of infection - mother did not have time to develop immunity, and the parasites have already “carried away” to the unborn child.
However, the later the fetus becomes infected with toxoplasmosis in the womb, the lower the risk of severe damage from the infection - almost all vital organs are almost formed, and the parasites do not have time to multiply to harm them all.
There are two reasons for infection with toxoplasmosis during pregnancy:
1. Most pregnant women become infected with toxoplasmosis. when dealing with cats. They are the most active peddler of toxoplasma in large quantities through feces. If the cat is indoor and will regularly be with a pregnant woman, it makes sense to check it with the help of laboratory tests for infection. With other cats it is better to avoid intercourse during pregnancy.
2. Infected surfaces and soil - The second most likely source of toxoplasmosis during pregnancy. In the garden or garden you need to work in gloves, as well as to clean trays of domestic cats.
3. The least of all cases (but they are) are due to Toxoplasma infection. from meatwhich is eaten without full heat treatment.
Dangerous toxoplasmosis can be diagnosed and treated in a timely manner, carried not to be too lazy to pass tests.
Toxoplasmosis in pregnancy: diagnosis
The trouble with toxoplasmosis during pregnancy is that it is recognized in the body late enough when the parasites had time to harm. An asymptomatic course of the disease requires a blood test for the presence of antibodies to parasites for diagnosis.
A pregnant woman who has not been diagnosed with toxoplasmosis in a timely manner and has not begun treatment is at risk of fetal infection with a probability of up to 70%. But the timely detection of antibodies, the determination of their number, can tell the doctor the time elapsed since the moment of infection. Time plays a huge role, because a pregnant woman who has had toxoplasmosis, at least three months before pregnancy, has almost zero chance of getting her baby infected.
The most reliable and accurate methods of diagnosis of toxoplasmosis in pregnant women
ELISA (enzyme immunoassay) - allows you to determine the presence and level of IgM and IgG antibodies to toxoplasma in serum with the determination of the avidity of IgG. The biochemical reactions provoked in the laboratory make it possible to detect the presence of immunoglobulins in the blood to combat toxoplasma. The bottom line is that IgM is produced at the very beginning of the disease, as soon as the infection has penetrated into the body, and after two months they do not remain in the blood.
Roughly speaking, IgG comes to replace IgM. Their body begins to produce after two or three days from the moment of infection, and by the time IgM disappears, their number reaches a maximum, and does not disappear anywhere until the end of human life, forming immunity to the destroyed infection. It is the presence of IgG and the absence of IgM in a pregnant woman at the initial stages indicates a chronic form of toxoplasmosis, she will not be able to infect the child with parasites in utero. But the final interpretation of the indicators can only give a doctor for an individual visit. Sometimes, to clarify the diagnosis, the pregnant woman is sent to undergo blood and urine tests by PCR.
PCR (for polymerase chain reaction) - a very sensitive method of diagnosing an infection, based on the detection of parasite RNA and DNA in the test material. Analysis of PCR for toxoplasmosis is rarely done due to the high cost of the equipment and, accordingly, the study itself. Toxoplasmosis during pregnancy is usually detected using ELISA.
Toxoplasmosis in pregnancy: treatment (drugs and folk remedies)
A number of antibiotics and sulfonamides have a pronounced activity to toxoplasma. The treatment is effective and necessary in an acute, dangerous for health, stage in patients with a weak immune system. Doctors have developed courses of treatment with a combination of drugs, with the help of which the parasites die in the shortest possible time.
Treatment of toxoplasmosis during pregnancy is carried out using macrolide antibiotics, mainly "Rowamycin" and "Spiramycin." In tablet form or by injection. Treatment must begin as early as possible, so the risk of infection of the fetus is much less. Even if the child is infected, treatment of the pregnant woman will reduce the destructive effect of the parasites on the baby’s organs.
A newborn baby with a diagnosis of toxoplasmosis should receive treatment during the first year of life. Treatment is carried out with a combination of sulfadiazine, pyrimethamine and folic acid in certain therapeutic doses.
Toxoplasmosis, which has passed into the chronic stage, is not treated.
Folk remedies for toxoplasmosis
Doctors categorically prohibit pregnant women to attempt self-treatment of toxoplasmosis, but folk healers insist on the effectiveness of the following methods.
• Crush five cloves of garlic and pour a glass of milk. Cook over low heat for 15 minutes. Cool and drink throughout the day for five receptions at regular intervals. Treatment continued for 10 days.
• Pour a liter of water from a mixture of 30 g of grass from a three-leaf watch, 20 g of tansy and 10 g of centaury. Insist (better in a thermos) for a day. Take 100 ml of the drug 30 minutes before breakfast, 300 ml before lunch, and 200 ml 1 hour before bedtime.
• Dissolve 30 drops of propolis alcohol extract in 1/4 cup of boiled cold water. Take 30 minutes before meals three times a day, and 1 hour before bedtime. Continue treatment for 20 days.
Toxoplasmosis in pregnancy: prevention of miscarriage
Every conscious woman planning pregnancy should be tested for toxoplasmosis. In time, the disease is easily treatable, and there will be no more danger.
Even if toxoplasmosis is detected during pregnancy, do not panic: not in all cases the child becomes infected from the mother. To find out whether to terminate the pregnancy at an early period, or the risk of fetal infection is not, conduct PCR tests from amniotic fluid. If the parasites or their antigens are present, then after an ultrasound examination and an assessment of the degree of fetal damage, the doctor decides whether it is necessary to abort the pregnancy or further treatment of the pregnant woman.
The easiest way to prevent infection with toxoplasmosis during pregnancy is to avoid contact with potentially dangerous animals, follow the rules of hygiene and subject food to full heat treatment.
