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Fetal toxoplasmosis: outcome of pregnancy and infant follow-up after in utero treatment.

Abstract
Eight-nine cases of fetal Toxoplasma infection are reported in women treated with spiramycin during pregnancy. Thirty-four pregnancy terminations were performed (2.7% of the total number of acquired Toxoplasma infections during pregnancy). Fifty-two pregnancies were allowed to proceed (43 being additionally treated with pyrimethamine and sulfonamides), leading to the birth of 54 live infants. After a mean follow-up period of 19 months, 41 infants had evidence of subclinical Toxoplasma infection, 12 had a benign form, and one had severe congenital toxoplasmosis (this infant did not receive the additional treatment during pregnancy). Efficacy of the additional treatment with pyrimethamine and sulfonamides was demonstrated by a significant reduction of severe congenital toxoplasmosis and the relative decrease of the ratio of benign to subclinical forms. We recommended that spiramycin treatment be started as soon as possible once the diagnosis of maternal Toxoplasma infection during pregnancy is proved or strongly suspected, because a prolonged time interval between onset of infection and start of treatment seems to be associated with the presence of severe fetal lesions at the time of prenatal diagnosis.
AuthorsP Hohlfeld, F Daffos, P Thulliez, C Aufrant, J Couvreur, J MacAleese, D Descombey, F Forestier
JournalThe Journal of pediatrics (J Pediatr) Vol. 115 Issue 5 Pt 1 Pg. 765-9 (Nov 1989) ISSN: 0022-3476 [Print] United States
PMID2681638 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Sulfonamides
  • Spiramycin
  • Pyrimethamine
Topics
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications, Infectious (drug therapy)
  • Pregnancy Outcome
  • Prenatal Diagnosis
  • Prognosis
  • Pyrimethamine (therapeutic use)
  • Spiramycin (therapeutic use)
  • Sulfonamides (therapeutic use)
  • Toxoplasmosis (drug therapy)
  • Toxoplasmosis, Congenital (diagnosis, drug therapy, etiology)
  • Ultrasonography

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