| Neonatal screening for congenital toxoplasmosis in a cohort of 165 women infected during pregnancy and influence of in utero treatment on the results of neonatal tests. | |
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MedLine Citation:
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PMID: 11134824 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of this study was to determine the performances of methods used for the neonatal diagnosis of congenital toxoplasmosis. We included 165 pregnant women infected during pregnancy over a 10-year period. Fifty-seven cases of congenital toxoplasmosis were demonstrated (34.5%). Neonatal diagnosis gave positive results in 50 cases (88%). Parasites were isolated from placenta or cord blood in 61% of the infected newborns, more frequently from placenta (60%) than from cord blood (43%). This method was the only criterion of infection in 18% of these infected infants. The detection of specific IgM and IgA antibodies performed on 42 sera of infected infants allowed the diagnosis of congenital infection in 34 cases (81%). IgA antibodies were more frequently detected (60%) than specific IgM (50%). Neonatal and prenatal screening were carried out for 143 pregnant women. This combination diagnosed 39 of 40 infected infants (98%). Prenatal diagnosis identified 30 of 40 cases (75%). Nine cases were diagnosed through neonatal screening and one case with the postnatal follow-up. When prenatal diagnosis was positive, pyrimethamine and sulfadoxine were administered to the mothers (25 cases) in addition to spiramycin. Toxoplasma gondii was less frequently isolated in the placenta and the cord blood of these women (32% and 19%, respectively) than in women treated by spiramycin alone (83% and 63%) proving the antiparasitic action of these drugs. In conclusion, neonatal screening combining parasite detection in placenta and immunological methods on cord blood is essential particularly when prenatal diagnosis is negative. Therefore, when this diagnosis is positive, a treatment with pyrimethamine and sulfamide can be started in the first month of life. |
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Authors:
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M H Bessières; A Berrebi; M Rolland; M C Bloom; C Roques; S Cassaing; C Courjault; J P Séguéla |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of obstetrics, gynecology, and reproductive biology Volume: 94 ISSN: 0301-2115 ISO Abbreviation: Eur. J. Obstet. Gynecol. Reprod. Biol. Publication Date: 2001 Jan |
Date Detail:
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Created Date: 2001-01-26 Completed Date: 2001-03-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0375672 Medline TA: Eur J Obstet Gynecol Reprod Biol Country: Ireland |
Other Details:
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Languages: eng Pagination: 37-45 Citation Subset: IM |
Affiliation:
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Department of Parasitology, CHU, Rangueil 1 Avenue du Professeur Jean Poulhès, 31403 Cedex 4, Toulouse, France. bessieres.m@chu-toulouse.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Antibodies, Protozoan / blood Antiprotozoal Agents / administration & dosage, therapeutic use Cohort Studies Female Fetal Blood / parasitology Fetal Diseases / diagnosis, drug therapy* Humans Immunoglobulin A / blood Immunoglobulin M / blood Infant, Newborn Neonatal Screening* Placenta / parasitology Pregnancy Pregnancy Complications, Infectious / parasitology* Prenatal Diagnosis* Pyrimethamine / administration & dosage, therapeutic use Spiramycin / administration & dosage, therapeutic use Sulfadoxine / administration & dosage, therapeutic use Toxoplasma / immunology, isolation & purification Toxoplasmosis, Congenital / diagnosis*, drug therapy* |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Protozoan; 0/Antiprotozoal Agents; 0/Immunoglobulin A; 0/Immunoglobulin M; 2447-57-6/Sulfadoxine; 58-14-0/Pyrimethamine; 8025-81-8/Spiramycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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