Infections in pregnancy

Protozoal infections

Toxoplasmosis

Transplacental

The infection is acquired by ingestion of the parasite found in cat feces that contaminate unwashed vegetables or fruit, or by consumption of infected undercooked sheep or pork meat. 10 to 50% of aged women reproductive disease can contract infection, which is usually asymptomatic.

If this occurs during pregnancy, the risk of "vertical" transmission is high in the third trimester and minimal in the first. Clinical suspicion of a "Toxoplasma infection occurs when clinical symptoms occur in the mother (rare), or when abortion occurs in the first trimester, or when microcephaly and cerebral calcifications appear ultrasonographically during life in utero. , if the infection is contracted in the second and third trimester, since the Toxoplasma determines, even if not always, these alterations on the fetus.

In Italy it is estimated that 2-3 newborns out of 1000 are affected by congenital toxoplasmosis, 15% of whom have severe lesions at the time of birth (visual changes, cerebral calcifications, mental retardation, deafness). Screening, which is based on ultrasound and serological tests, is therefore strictly recommended. The diagnosis of maternal infection is based on laboratory data, ie the specific IgM and IgG dosage. In subjects at risk, it is also possible to identify the infection. by searching for the DNA of the parasite in the amniotic fluid by PCR (not found before 20-21 weeks). In case of maternal infection during pregnancy, it is advisable to immediately start pharmacological treatment with antiparasitics and antibiotics.
Furthermore, during pregnancy, it is necessary to avoid raw meat, sausages and raw eggs, wash fruit and vegetables carefully, avoid contact with cats, avoid gardening work.

Malaria

Transplacental

Malarial infection, caused by a parasite called Plasmodium falciparum, can cause miscarriages or premature birth.

Main investigations to be performed in pregnancy

Immediately after pregnancy is ascertained, the following tests should be performed: VDRL And TPHA (for syphilis), Toxotest (for Toxoplasma), Rubeotest (rubella), HbsAg (hepatitis B), Anti-HCV (hepatitis C), Anti-HIV1-2 (HIV test). The Toxotest and Rubeotest, if negative, must be repeated monthly for the entire duration of the pregnancy. An ultrasound scan will also be performed immediately, which must then be repeated at intervals of about 3 weeks one from the other. Beta-hemolytic streptococcus.