Toxoplasmosis in Pregnancy

  • Chinmayee RathaEmail author
Review Article


Toxoplasmosis is a rare but important infection in pregnant women which can potentially cause serious fetal adverse effects. Methods of screening, diagnosing and treating toxoplasmosis in pregnancy have been evaluated for over four decades now but still, there is a lack of robust evidence in these areas to guide care plans. Yet with the advent of newer techniques in imaging and laboratory diagnosis, reasonable protocols can be formulated to optimally mange cases with toxoplasmosis in pregnancy. It is becoming increasingly evident that antenatal treatment definitely helps in reducing fetal and hence neonatal morbidity from this infection. Timely identification and adequate therapy to prevent vertical transmission or even treat infected fetuses seem to be a practical approach. Most importantly, health education and public awareness will help reduce the infection rates in pregnant women.


Toxoplasmosis Pregnancy Fetal infection Congenital toxoplasmosis Antenatal infection Prenatal diagnosis 



  1. 1.
    Sensini A. Toxoplasma gondii infection in pregnancy: opportunities and pitfalls of serological diagnosis. Clin Microbiol Infect. 2006;12(6):504–12.CrossRefGoogle Scholar
  2. 2.
    Cook AJ, Gilbert RE, Buffolano W, et al. Sources of § infection in pregnant women: European multicentre case-control study. European research network on congenital toxoplasmosis. BMJ. 2000;321:142.CrossRefGoogle Scholar
  3. 3.
    Remington JSMR, Wilson CB, Desmonts G. Toxoplasmosis. In: Remington JSKJ, editor. Infectious diseases of the fetus and newborn infant. 7th ed. Philadelphia: Saunders/Elsevier; 2011.Google Scholar
  4. 4.
    Petersen E, Edvinsson B, Lundgren B, Benfield T, Evengard B. Diagnosis of pulmonary infection with Toxoplasma gondii in immunocompromised HIV-positive patients by real-time PCR. Eur J Clin Microbiol Infect Dis. 2006;25:401–4.CrossRefGoogle Scholar
  5. 5.
    Burnett AJ, Shortt SG, Isaac-Renton J, King A, Werker D, Bowie WR. Multiple cases of acquired toxoplasmosis retinitis presenting in an outbreak. Ophthalmology. 1998;105:1032–103.CrossRefGoogle Scholar
  6. 6.
    Gilbert R, Gras L. European Multicentre study on congenital toxoplasmosis. Effect of timing and type of treatment on the risk of mother to child transmission of Toxoplasma gondii. BJOG. 2003;110:112.CrossRefGoogle Scholar
  7. 7.
    Gilbert RE. Congenital toxoplasmosis: scientific background, clinical management and control. In: Petersen E, Amboise-Thomas P, editors. Epidemiology of infection in pregnant women. 1st ed. Paris: Springer; 2000.Google Scholar
  8. 8.
    Singh S, Munawwar A, Rao S, et al. Serologic prevalence of Toxoplasma gondii in Indian women of child bearing age and effects of social and environmental factors. PLoS Negl Trop Dis. 2014;8:e2737.CrossRefGoogle Scholar
  9. 9.
    Gras L, Gilbert RE, Wallon M, Peyron F, Cortina-Borja M. Duration of the IgM response in women acquiring Toxoplasma gondii during pregnancy: implications for clinical practice and cross-sectional incidence studies. Epidemiol Infect. 2004;132:541–8.CrossRefGoogle Scholar
  10. 10.
    Bessieres MH, Roques C, Berrebi A, Barre V, Cazaux M, Seguela JP. IgA antibody response during acquired and congenital toxoplasmosis. J Clin Pathol. 1992;45:605–8.CrossRefGoogle Scholar
  11. 11.
    Villarda O, Cimon B, L’Ollivier C, et al. Serological diagnosis of Toxoplasma gondii infection: recommendations from the French National Reference Center for Toxoplasmosis. Diagn Microbiol Infect Dis. 2016;84(1):22–33.CrossRefGoogle Scholar
  12. 12.
    Liesenfeld O, Montoya JG, Kinney S, Press C, Remington JS. Effect of testing for IgG avidity in the diagnosis of Toxoplasma gondii infection in pregnant women: experience in a US reference laboratory. J Infect Dis. 2001;183:1248–53.CrossRefGoogle Scholar
  13. 13.
    Maldonado YA, Read JS. Diagnosis, treatment, and prevention of congenital toxoplasmosis in the United States. Pediatrics. 2017;139(2):e20163860. CrossRefPubMedGoogle Scholar
  14. 14.
    Paquet C, Yudin MH. Society of obstetricians and gynaecologists of Canada. Toxoplasmosis in pregnancy: prevention, screening, and treatment. J Obstet Gynaecol Can. 2013;35:78.CrossRefGoogle Scholar
  15. 15.
    Cornu C, Bissery A, Malbos C, et al. Factors affecting the adherence to an antenatal screening programme: an experience with toxoplasmosis screening in France. Eurosurveillance. 2009;14:21.PubMedGoogle Scholar
  16. 16.
    Hohlfeld P, MacAleese J, Capella-Pavlovski M, et al. Fetal toxoplasmosis: ultrasonographic signs. Ultrasound Obstet Gynecol. 1991;1:241.CrossRefGoogle Scholar
  17. 17.
    Malinger G, Werner H, Rodriguez Leonel JC, et al. Prenatal brain imaging in congenital toxoplasmosis. Prenat Diagn. 2011;31:881.PubMedGoogle Scholar
  18. 18.
    de Oliveira Azevedo CT, do Brasil PE, Guida L, Lopes Moreira ME. Performance of polymerase chain reaction analysis of the amniotic fluid of pregnant women for diagnosis of congenital toxoplasmosis: a systematic review and meta-analysis. PLoS ONE. 2016;11:e0149938.CrossRefGoogle Scholar
  19. 19.
    Findal G, Helbig A, Haugen G, Jenum PA, Stray-Pedersen B. Management of suspected primary Toxoplasma gondii infection in pregnant women in Norway: twenty years of experience of amniocentesis in a low-prevalence population. BMC Pregnancy Childbirth. 2017;17(1):127.CrossRefGoogle Scholar
  20. 20.
    Lebech M, Joynson DH, Seitz HM, Thulliez P, Gilbert RE, Dutton GN, Ovlisen B, Petersen E. Classification system and case definitions of Toxoplasma gondii infection in immunocompetent pregnant women and their congenitally infected offspring. European research network on congenital toxoplasmosis. Eur J Clin Microbiol Infect Dis. 1996;15(10):799–805.CrossRefGoogle Scholar
  21. 21.
    SYROCOT (Systematic Review on Congenital Toxoplasmosis) study group, Thiébaut R, Leproust S, Chêne G, Gilbert R. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients’ data. Lancet. 2007;369(9556):115–22.CrossRefGoogle Scholar
  22. 22.
    Mandelbrot L, Kieffer F, Sitta R, et al. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial. Am J Obstet Gynecol. 2018;219(386):e1.Google Scholar
  23. 23.
    Cortina-Borja M, Tan HK, Wallon M, et al. Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: an observational prospective cohort study. PLoS Med. 2010;7:e1000351. Scholar
  24. 24.
    Kaye A. Toxoplasmosis: diagnosis, treatment, and prevention in congenitally exposed infants. J Pediatr Health Care. 2011;25(06):355–64.CrossRefGoogle Scholar
  25. 25.
    Di Mario S, Basevi V, Gagliotti C, et al. Prenatal education for congenital toxoplasmosis. Cochrane Database Syst Rev. 2013;CD006171.Google Scholar

Copyright information

© Society of Fetal Medicine 2019

Authors and Affiliations

  1. 1.Resolution Fetal Medicine CentreNavodaya HospitalsSecunderabadIndia
  2. 2.Yashoda HospitalsHyderabadIndia

Personalised recommendations