Introduction
Pregnancy health is a critical parameter that can have direct reflections on the baby’s health within the womb. Ailment or infections in the maternal body, particularly during the gestational period, expose the baby to various health risks, which can be in the form of inborn disability, disease, or infection. Therefore it is imperative to remain healthy and disease-free throughout pregnancy. Prenatal and perinatal care of expectant women holds a key role in managing such undesirable health complications. The severity and impact on the baby are determined by the nature of the disease condition and the potency of the pathogen concerned with the disease.
What Is Toxoplasmosis?
Toxoplasmosis is a specific ailment triggered by Toxoplasma gondii, which is an animal parasite that is capable of infecting the human body. These parasites multiply in the cat’s gut and get access to the human body mostly through their excreta. Meats contaminated with Toxoplasma gondii, when consumed undercooked, can also bring parasites to the human body. The immune system often suppresses the parasitic infection by itself, even without precipitating any manifestations.
What Is the Significance of Toxoplasmosis Infection in Expectant Women?
In healthy individuals, toxoplasmosis infection is handled by the immune system without necessitating an obvious therapeutic regimen. However, certain categories of populations are more susceptible to elicit complications from toxoplasmosis infection. Individuals with remarkably compromised immune functions and expectant women are the two distinct categories in which toxoplasmosis can bring about health risks.
These parasites can infect the baby in the womb after acquiring access to an expectant woman. It breaches the placental barrier and gains access to the baby in the womb. Maternal toxoplasmosis infection, typically in the initial weeks of pregnancy, can threaten the pregnancy itself and may result in miscarriage (pregnancy loss). The deleterious effects of maternal toxoplasmosis are often subjected to the pregnancy stage at which the expectant women acquire the infection.
Once the parasites access and invade the baby in the womb, it results in congenital toxoplasmosis in the unborn baby. The infection may trigger premature delivery of the baby in the womb, much before the intended delivery date. Babies born prematurely lack the normal growth and development that a full-term newborn is supposed to possess. The parasites also impair the eye and ear functions, precipitating troubled vision and hearing. It also brings about neurological and skin issues. Impaired intellectual and cognitive skills and altered dimensions of the baby’s head are often reported in babies who are born with congenital toxoplasmosis.
What Are the Perinatal Management Strategies for Toxoplasmosis?
-
Perinatal management begins with the diagnosis of toxoplasmosis in expectant women. Suppose the expectant woman had a prior encounter with toxoplasmosis infection less than three months before conception. In that case, the developing baby can still acquire the infection as the parasite can persist in inactive form for a significant period. Therefore, proper medical history and screening of expectant women is imperative in exposing the risk of toxoplasmosis infection for the baby in the womb.
-
Once toxoplasmosis is detected in an expectant mother, the treatment strategy is designed in such a way as to check the parasitic transmission to the baby in the womb. For infected expectant women with uninfected babies, a macrolide antibiotic, Spiramycin is the recommended antibiotic medicine of choice. 0.03 ounces of Spiramycin eight hourly is the authorized dosage that effectively checks parasitic invasion through the placenta, thus offering necessary shielding for the baby in the womb. Amniotic fluid analysis, through techniques like polymerase chain reaction (PCR), aids in detecting the presence of parasites in the amniotic fluid, which confirms the invasion of the parasite into the baby’s body.
-
If the amniotic fluid analysis reveals toxoplasmosis infection in the baby, then Spiramycin is not found to be fruitful when administered alone. In such cases, the drug choice will be modified and altered. Sulfadiazine and Pyrimethamine combinations are the hallmark medicine advised when the baby’s toxoplasmosis infection status is confirmed. It is strictly instructed not to employ these medicines unless the fetal (baby in the womb) infection is unequivocally confirmed with a reliable diagnostic test. Often, the infected expectant women may remain free of obvious manifestations, which leave the condition undetected and may end up in transmission to the unborn baby.
-
The treatment and surveillance need to be continued even after the baby is delivered. There are reports of health complications that are elicited in the later course of life of babies who are born with toxoplasmosis infection acquired from the maternal body. As congenital toxoplasmosis can precipitate vision impairment, such children need to be periodically evaluated to assess and track deterioration of eyesight. Strict adherence to the follow-up visits aids in tracking the long-term consequences of congenital toxoplasmosis.
-
Certain babies with congenital toxoplasmosis might not bring about immediate manifestations following birth and may even remain free of manifestation for several years. Therefore, it is imperative to follow the routine check-ups advised by the concerned doctors. In addition to Sulfadiazine and Pyrimethamine, newborns who are diagnosed with congenital toxoplasmosis are also advised Leucovorin. The therapy needs to be continued throughout the first year of life. Babies with obvious visual impairment are advised with corticosteroids. The early initiation of the therapeutic intervention curbs the progression and mitigates the severity of impairment. The treatment modalities for babies are determined by considering the associated manifestations and impairments. Babies diagnosed with hydrocephalus (gathering of fluid inside the brain spaces), as a consequence of congenital toxoplasmosis, need specific treatment modalities to relieve the abnormal fluid gathering.
-
In addition to the treatment interventions, maternal counseling is also an important aspect concerning perinatal management of toxoplasmosis. The expectant women should be made aware of the risks associated with the infection and the necessary precautionary measures that should be undertaken to keep themselves safe and healthy. Expectant women detected with toxoplasmosis should also be counseled about the possible impacts on the fetus that the toxoplasmosis could bring in.
Conclusion
Toxoplasmosis, though not a potential threat, can bring deleterious impacts when it develops in susceptible individuals like those with compromised immune status and expectant women. Prompt perinatal management safeguards the health of the growing baby in the womb. Maternal toxoplasmosis can influence the pregnancy outcome and is capable of giving rise to even stillbirth, where the baby will be born lifeless. Maternal toxoplasmosis makes the baby vulnerable to acquiring congenital toxoplasmosis, which is associated with various health impairments and disabilities. Timely diagnosis of maternal toxoplasmosis is essential to exercise timely intervention. Perinatal management strategies effectively check the complications and improve pregnancy outcomes.
