Medical and Surgical Complications in Pregnancy
Pregnant women in 1st trimester is given spiramycin that she did not take complete treatment and baby is born with hydrocephalus. From which infection she was suffering? (AIIMS May 2009)
When a mother is infected with T. gondii during gestation, the parasite may be disseminated hematogenously to the placenta.
1. Infection may be transmitted to the fetus transplacentally or during vaginal delivery.
2. If the Infection is acquired in the first trimester the risk of infection to the fetus is approximately14-17%, and toxoplasmosis in the infant is usually severe.
3. If the mother is infected in the third trimester and it goes untreated, the risk of fetal infection is approximately 59-65%, and involvement is mild or inapparent at birth.
4. These different rates of transmission are most likely related to placental blood flow, the virulence and amount of T. gondii acquired, and the immunologic ability of the mother to restrict parasitemia.
5. Congenital toxoplasmosis
a. Approximately 67% of patients have no signs or symptoms of infection.
b. Chorioretinitis occurs in about 15% of patients.
c. Intracranial calcifications develop in about 10%.
d. Cerebrospinal fluid pleocytosis and elevated protein values are present in 20% of patients.
e. Infected newborns have anemia, thrombocytopenia, and jaundice at birth.
f. Microcephaly is reported.
g. Affected survivors may have mental retardation, seizures, visual defects, spasticity, or other severe neurologic sequelae.
6. Ocular toxoplasmosis
a. Patients develop chorioretinitis
b. They have a yellowish, white, elevated cotton patch with indistinct margins.
c. The lesions may occur in small clusters.