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Congenital toxoplasmosis and prenatal care state programs.
[congenital toxoplasmosis]
Control
programs
have
been
executed
in
an
attempt
to
reduce
vertical
transmission
and
the
severity
of
congenital
infection
in
regions
with
a
high
incidence
of
toxoplasmosis
in
pregnant
women
.
We
aimed
to
evaluate
whether
treatment
of
pregnant
women
with
spiramycin
associated
with
a
lack
of
monitoring
for
toxoplasmosis
seroconversion
affects
the
prognosis
of
patients
.
We
performed
a
prospective
cohort
study
with
246
newborns
(
NB
)
at
risk
for
congenital
toxoplasmosis
in
Goiânia
(
Brazil
)
between
October
2003
and
October
2011
.
We
analyzed
the
efficacy
of
maternal
treatment
with
spiramycin
.
A
total
of
40
.
7
%
(
66
/
162
)
of
the
neonates
were
born
seriously
infected
.
Vertical
transmission
associated
with
reactivation
during
pregnancy
occurred
in
5
.
5
%
(
9
/
162
)
of
the
NB
,
with
one
showing
severe
infection
(
systemic
)
.
The
presence
of
specific
immunoglobulins
(
fetal
IgM
and
NB
IgA
)
suggested
the
worst
prognosis
.
Treatment
of
pregnant
women
by
spiramycin
resulted
in
reduced
vertical
transmission
.
When
infected
pregnant
women
did
not
undergo
proper
treatment
,
the
risk
of
severe
infection
(
neural-optical
)
in
NB
was
significantly
increased
.
Fetal
IgM
was
associated
with
ocular
impairment
in
48
.
0
%
(
12
/
25
)
of
the
fetuses
and
neonatal
IgA-
specific
was
related
to
the
neuro-ophthalmologic
and
systemic
forms
of
the
disease
.
When
acute
toxoplasmosis
was
identified
in
the
postpartum
period
,
a
lack
of
monitoring
of
seronegative
pregnant
women
resulted
in
a
higher
risk
of
severe
congenital
infection
.
Treatment
of
pregnant
women
with
spiramycin
reduces
the
possibility
of
transmission
of
infection
to
the
fetus
.
However
,
a
lack
of
proper
treatment
is
associated
with
the
onset
of
the
neural-optical
form
of
congenital
infection
.
Primary
preventive
measures
should
be
increased
for
all
pregnant
women
during
the
prenatal
period
and
secondary
prophylaxis
through
surveillance
of
seroconversion
in
seronegative
pregnant
woman
should
be
introduced
to
reduce
the
severity
of
congenital
infection
in
the
environment
.
Diseases
Validation
Diseases presenting
"seronegative pregnant women"
symptom
congenital toxoplasmosis
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