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Congenital toxoplasmosis.
[congenital toxoplasmosis]
Congenital
toxoplasmosis
results
from
the
transplacental
transmission
of
the
parasite
Toxoplasma
gondii
after
a
maternal
infection
acquired
in
pregnancy
.
Prevalence
of
congenital
infection
ranges
from
0
.
1
to
0
.
3
per
1000
live
births
.
The
maternal
-
fetal
transmission
rate
increases
with
gestational
age
at
maternal
seroconversion
,
from
less
than
15
%
at
13
weeks
of
gestation
to
over
70
%
at
36
weeks
.
Conversely
,
the
later
the
maternal
infection
,
the
lower
the
risk
of
symptomatic
congenital
infection
(
infections
acquired
during
the
third
trimester
are
most
often
asymptomatic
at
birth
)
.
Prenatal
diagnosis
is
currently
performed
by
PCR
analysis
in
amniotic
fluid
.
Antenatal
management
and
treatment
vary
considerably
among
countries
.
In
some
European
countries
,
maternal
infections
are
detected
through
serological
screening
allowing
a
prompt
treatment
with
spiramycin
,
which
is
expected
to
reduce
the
risk
of
vertical
transmission
.
If
PCR
analysis
in
amniotic
fluid
is
positive
or
if
maternal
infection
was
acquired
in
the
third
trimester
of
pregnancy
,
a
combination
with
pyrimethamine
and
sulphonamide
is
given
until
delivery
.
Benefits
of
antenatal
treatments
remain
controversial
.
Infected
newborns
are
prescribed
pyrimethamine
and
sulphonamide
for
12
months
.
Despite
antenatal
and
postnatal
treatment
,
chorioretinitis
can
occur
at
any
age
(
prevalence
>
20
%
at
10
years
of
age
)
:
long
-term
ophthalmological
follow-up
remains
necessary
.