Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Ginekologia Polska
MENU
Shortcuts Submit an article Author Guidelines Ahead Of Print Reviewers 2023

open access

Vol 89, No 7 (2018)
Research paper
Published online: 2018-07-31
View PDF Download PDF file
Get Citation

Preventing congenital toxoplasmosis — implementation of clinical practice guidelines

Maria Biskupska1, Adam Kujawa2, Jacek Wysocki3
DOI: 10.5603/GP.a2018.0066
·
Pubmed: 30091449
·
Ginekol Pol 2018;89(7):388-392.
Affiliations
  1. Poznan University of Medical Sciences, Department of Preventive Medicine, Święcickiego 6, 60-781Poznań, Poland
  2. Specialist Hospital for Mother and Child, Nowowiejskiego 56/58, 60-734 Poznań, Poland, Poznan, Poland
  3. Poznan University of Medical Sciences, Department of Preventive Medicine 1,Specialist Hospital for Mother and Child 2, Święcickiego 6 , 60-781 Poznań 1, Nowowiejskiego 56/58, 60-734 Poznań 2, Poznań, Poland

open access

Vol 89, No 7 (2018)
ORIGINAL PAPERS Obstetrics
Published online: 2018-07-31

Abstract

 Objectives: The aim of the study was to evaluate obstetric care of pregnant women with regard to prevention of congenital toxoplasmosis. Additionally, we attempted to determine the frequency of markers for past infection with Toxoplasma gondii in order to characterize the current significance of preventive measures in the Polish population.

Material and methods: The analysis of the medical records — pregnancy charts of women who presented for delivery — was performed. Patient age, place of residence, and toxoplasmosis test (or lack of it) were evaluated. Also, further diagnostic management, depending on the serologic result, was investigated.

Results: Out of 670 pregnant women, 628 (93.73%) underwent at least one toxoplasmosis diagnostic test. Out of those, 502 (73%) had a negative result (IgG –, IgM –), and 2 (0.32%) had a positive result (IgG +, IgM +), while history of infection with Toxoplasma gondii was confirmed (IgG +, IgM –) in 124 (19.75%) cases. Repeat testing was required in 183 (29.14%) out of the 628 women.

Conclusions: A high rate of women in whom IgG antibodies were not detected in the first test and a low rate of women who required repeat testing later in pregnancy are noteworthy. Regardless of the healthcare policy, parents should receive reliable information about the nature of the disease and possibilities of prevention, while medical professionals ought to have easy access to research data about the epidemiologic status and recommendations.

Abstract

 Objectives: The aim of the study was to evaluate obstetric care of pregnant women with regard to prevention of congenital toxoplasmosis. Additionally, we attempted to determine the frequency of markers for past infection with Toxoplasma gondii in order to characterize the current significance of preventive measures in the Polish population.

Material and methods: The analysis of the medical records — pregnancy charts of women who presented for delivery — was performed. Patient age, place of residence, and toxoplasmosis test (or lack of it) were evaluated. Also, further diagnostic management, depending on the serologic result, was investigated.

Results: Out of 670 pregnant women, 628 (93.73%) underwent at least one toxoplasmosis diagnostic test. Out of those, 502 (73%) had a negative result (IgG –, IgM –), and 2 (0.32%) had a positive result (IgG +, IgM +), while history of infection with Toxoplasma gondii was confirmed (IgG +, IgM –) in 124 (19.75%) cases. Repeat testing was required in 183 (29.14%) out of the 628 women.

Conclusions: A high rate of women in whom IgG antibodies were not detected in the first test and a low rate of women who required repeat testing later in pregnancy are noteworthy. Regardless of the healthcare policy, parents should receive reliable information about the nature of the disease and possibilities of prevention, while medical professionals ought to have easy access to research data about the epidemiologic status and recommendations.

Full Text:

View PDF Download PDF file
Get Citation

Keywords

obstetric care, prophylaxis, seroprevalence

About this article
Title

Preventing congenital toxoplasmosis — implementation of clinical practice guidelines

Journal

Ginekologia Polska

Issue

Vol 89, No 7 (2018)

Article type

Research paper

Pages

388-392

Published online

2018-07-31

Page views

2585

Article views/downloads

1760

DOI

10.5603/GP.a2018.0066

Pubmed

30091449

Bibliographic record

Ginekol Pol 2018;89(7):388-392.

Keywords

obstetric care
prophylaxis
seroprevalence

Authors

Maria Biskupska
Adam Kujawa
Jacek Wysocki

References (33)
  1. Tenter AM, Heckeroth AR, Weiss LM. Toxoplasma gondii: from animals to humans. Int J Parasitol. 2000; 30(12-13): 1217–1258.
    PubMed
  2. Jones JL, Kruszon-Moran D, Wilson M, et al. Toxoplasma gondii infection in the United States: seroprevalence and risk factors. Am J Epidemiol. 2001; 154(4): 357–365.
    PubMed
  3. Pappas G, Roussos N, Falagas ME. Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis. Int J Parasitol. 2009; 39(12): 1385–1394.
    CrossRefPubMed
  4. Hill D, Dubey JP. Toxoplasma gondii: transmission, diagnosis and prevention. Clin Microbiol Infect. 2002; 8(10): 634–640.
    PubMed
  5. Rorman E, Zamir CS, Rilkis I, et al. Congenital toxoplasmosis--prenatal aspects of Toxoplasma gondii infection. Reprod Toxicol. 2006; 21(4): 458–472.
    CrossRefPubMed
  6. Chen KT, Eskild A, Bresnahan M, et al. Previous maternal infection with Toxoplasma gondii and the risk of fetal death. Am J Obstet Gynecol. 2005; 193(2): 443–449.
    CrossRefPubMed
  7. Sugden K, Moffitt TE, Pinto L, et al. Is Toxoplasma Gondii Infection Related to Brain and Behavior Impairments in Humans? Evidence from a Population-Representative Birth Cohort. PLoS One. 2016; 11(2): e0148435.
    CrossRefPubMed
  8. Milewska-Bobula B, Lipka B, Gołąb E, et al. Recommended management of Toxoplasma gondii infection in pregnant women and their children. Przegl Epidemiol. 2015; 69(2): 291–8, 403.
    PubMed
  9. Lopez A, Dietz VJ, Wilson M, et al. Preventing congenital toxoplasmosis. MMWR Recomm Rep. 2000; 49(RR-2): 59–68.
    PubMed
  10. Radoń-Pokracka M, Piasecki M, Lachowska A, et al. Assessment of the implementation of the infectious diseases screening programmes among pregnant women in the Lesser Poland region and comparison with similar programmes conducted in other European Union countries. Ginekol Pol. 2017; 88(3): 151–155.
    CrossRefPubMed
  11. Nowakowska D, Stray-Pedersen B, Spiewak E, et al. Prevalence and estimated incidence of Toxoplasma infection among pregnant women in Poland: a decreasing trend in the younger population. Clin Microbiol Infect. 2006; 12(9): 913–917.
    CrossRefPubMed
  12. Lewicka M, Dziedziczak-Buczyńska M, Mawlichanów K, et al. Estimation of the toxoplasmosis prevalence in pregnant women in the urban-rural Giżycko county in reference to the nationwide population. Hygeia Public Health. 2013; 48(3): 320–326.
  13. Pawłowsk SZ. Toxoplasmosis in Poznan region, Poland 1990-2000. Przegl Epidemiol. 2002; 56: 409–417.
  14. Berghold C, Herzog SA, Jakse H, et al. Prevalence and incidence of toxoplasmosis: a retrospective analysis of mother-child examinations, Styria, Austria, 1995 to 2012. Euro Surveill. 2016; 21(33).
    CrossRefPubMed
  15. Czarkowski MP, Cielebąk E, Staszewska-Jakubik E, et al. Infectious diseases and poisoning in Poland in 2016. National Institute of Public Health – National Institute of Hygiene – Department of Epidemiology. Chief Sanitary Inspectorate – Department for Communicable Disease and Infection Prevention and Control. Warszawa 2017. http://wwwold.pzh.gov.pl/oldpage/epimeld (2017-12-24).
  16. Czarkowski MP, Cielebąk E, Staszewska-Jakubik E, et al. Infectious diseases and poisoning in Poland in 2014. National Institute of Public Health – National Institute of Hygiene – Department of Epidemiology. Chief Sanitary Inspectorate – Department for Communicable Disease and Infection Prevention and Control. Warszawa 2015. http://wwwold.pzh.gov.pl/oldpage/epimeld (2017-12-24).
  17. Czarkowski MP, Cielebąk E, Kondej B, et al. Infectious diseases and poisoning in Poland in 2012. National Institute of Public Health – National Institute of Hygiene – Department of Epidemiology. Chief Sanitary Inspectorate – Department for Communicable Disease and Infection Prevention and Control. Warszawa 2013. http://wwwold.pzh.gov. pl/oldpage/epimeld (2017-12-24).
  18. Czarkowski MP, Cielebąk E, Kondej B, et al. Infectious diseases and poisoning in Poland in 2010. National Institute of Public Health – National Institute of Hygiene – Department of Epidemiology. Chief Sanitary Inspectorate – Department for Communicable Disease and Infection Prevention and Control. Warszawa 2011. http://wwwold.pzh.gov.pl/oldpage/epimeld (2017-12-24).
  19. Czarkowski MP, Cielebąk E, Kondej B, et al. Infectious diseases and poisoning in Poland in 2008. National Institute of Public Health – National Institute of Hygiene – Department of Epidemiology. Chief Sanitary Inspectorate – Department for Communicable Disease and Infection Prevention and Control. Warszawa 2009. http://wwwold.pzh.gov.pl/oldpage/epimeld (2017-12-24).
  20. Sagel U, Krämer A, Mikolajczyk RT. Incidence of maternal Toxoplasma infections in pregnancy in Upper Austria, 2000-2007. BMC Infect Dis. 2011; 11: 348.
    CrossRefPubMed
  21. Logar J, Petrovec M, Novak-Antolic Z, et al. Prevention of congenital toxoplasmosis in Slovenia by serological screening of pregnant women. Scand J Infect Dis. 2002; 34(3): 201–204.
    PubMed
  22. Stajner T, Bobic B, Klun I, et al. Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis in a Setting With No Systematic Screening in Pregnancy. Medicine (Baltimore). 2016; 95(9): e2979.
    CrossRefPubMed
  23. Sagel U, Krämer A, Mikolajczyk RT. "Blind periods" in screening for toxoplasmosis in pregnancy in Austria - a debate. BMC Infect Dis. 2012; 12: 118.
    CrossRefPubMed
  24. Foulon W, Villena I, Stray-Pedersen B, et al. Treatment of toxoplasmosis during pregnancy: A multicenter study of impact on fetal transmission and children’s sequelae at age 1 year. American Journal of Obstetrics and Gynecology. 1999; 180(2): 410–415.
    CrossRef
  25. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data. The Lancet. 2007; 369(9556): 115–122.
    CrossRef
  26. Berbeka K, Dębska M. Toxoplasmosis infection during pregnancy-the poor prognosis for the fetus. Post N Med. 2016; 29(7): 452–255.
  27. Peyron F, Mc Leod R, Ajzenberg D, et al. Congenital Toxoplasmosis in France and the United States: One Parasite, Two Diverging Approaches. PLoS Negl Trop Dis. 2017; 11(2): e0005222.
    CrossRefPubMed
  28. Stillwaggon E, Carrier CS, Sautter M, et al. Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. PLoS Negl Trop Dis. 2011; 5(9): e1333.
    CrossRefPubMed
  29. Augustine SAJ. Towards Universal Screening for Toxoplasmosis: Rapid, Cost-Effective, and Simultaneous Detection of Anti-Toxoplasma IgG, IgM, and IgA Antibodies by Use of Very Small Serum Volumes. J Clin Microbiol. 2016; 54(7): 1684–1685.
    CrossRefPubMed
  30. Paul M, Petersen E, Szczapa J. Prevalence of congenital Toxoplasma gondii infection among newborns from the Poznań region of Poland: validation of a new combined enzyme immunoassay for Toxoplasma gondii-specific immunoglobulin A and immunoglobulin M antibodies. J Clin Microbiol. 2001; 39(5): 1912–1916.
    CrossRefPubMed
  31. Schaller B, Sandu N. Clinical medicine, public health and ecological health: a new basis for education and prevention? Arch Med Sci. 2011; 7(4): 541–545.
    CrossRefPubMed
  32. Robert-Gangneux F. It is not only the cat that did it: how to prevent and treat congenital toxoplasmosis. J Infect. 2014; 68 Suppl 1: S125–S133.
    CrossRefPubMed
  33. Ziemba J, Nowakowska-Głąb A, Wilczyński J, et al. Knowledge of toxoplasmosis among pregnant women, midwifes, medical students and obstetricians. Medycyna Pracy. 2010; 61(3): 271–276.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl