Mother-to-Child Transmission of Toxoplasmosis: Risk Estimates for Clinical Counselling

Dunn, David; Wallon, Martine; Peyron, François; Petersen, Eskild; Peckham, Catherine; Gilbert, Ruth

doi:10.1097/00006254-200001000-00004

Cited by 143 publications

(229 citation statements)

References 0 publications

Supporting

Mentioning

172

Contrasting

Unclassified

Order By: Relevance

“…The maternal-fetal transmission rate found in this study was 9.3%, higher than 7.4% obtained by Hohlfeld et al 12 and lower than 38.7% and 29% from Foulon et al 8 and Dunn et al 6 , respectively. However, we could not determine the transmission rate according to the period of maternal seroconversion, which can vary widely.…”

Section: Discussioncontrasting

confidence: 69%

Prenatal toxoplasmosis diagnosis from amniotic fluid by PCR

Vidigal

Santos

Castro

et al. 2002

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

Toxoplasmosis is one of the most common infections all over the world. Most cases are asymptomatic, except in immunosuppressed individuals and fetuses, which can be seriously damaged. Prenatal diagnosis should be made as soon as possible since treatment of the mother can minimize fetal sequelae. Our aim in this study was to test the polymerase chain reaction technique (PCR) in 86 samples of amniotic fluid from women who seroconverted during pregnancy. DNA was amplified using external primers and, in a second step, internal primers, in a nested PCR system. Samples were also inoculated into mice and the newborn were evaluated by T. gondii serology, skull x-ray, transfontanel ultrasound, fundoscopic examination, lumbar puncture and clinical examination. PCR was positive in seven cases and negative in 79. Among PCR-positive cases, two were negative by inoculation into mice and by clinical evaluation; among PCR-negative ones, three had clinical evidence of toxoplasmosis and one was positive after inoculation into mice. PCR showed values of sensitivity = 62.5% and specificity = 97.4%; the values of inoculation into mice where 42.9% and 100%, respectively. Although PCR should not be used alone for prenatal diagnosis of congenital toxoplasmosis, it is a promising method and deserves more studies to improve its efficacy. Key-words: Congenital toxoplasmosis. PCR. Amniotic fluid.Resumo A toxoplasmose é infecção freqüente em todo o mundo, mas na maioria dos casos não traz repercussões importantes para o paciente, exceto indivíduos imunodeprimidos e fetos, os quais podem apresentar graves seqüelas. O diagnóstico precoce durante a gravidez é altamente desejável, já que o tratamento da gestante reduz a freqüência e gravidade da infecção fetal. Neste estudo aplicou-se a técnica de PCR em 86 amostras de líquido amniótico de gestantes que apresentaram soroconversão durante a gravidez. O DNA foi amplificado usando-se iniciadores externos e internos, num sistema de nested PCR. As amostras foram também inoculadas em camundongos e os recém-nascidos acompanhados clinicamente através de sorologia, RX de crânio, ultrassom transfontanela, exame de fundo de olho e punção lombar. Pela PCR, sete casos foram positivos e 79 negativos. Entre os positivos, dois não se confirmaram pela inoculação em camundongo nem pela avaliação clínica da criança; dos negativos, três apresentaram clínica de toxoplasmose congênita, e em um deles o exame de inoculação em camundongo foi positivo. A sensibilidade e especificidade da PCR foram 62,5% e 97,4%, respectivamente; a inoculação em camundongos mostrou 42,9% de sensibilidade e 100% de especificidade. Embora a PCR não deva ser usada como único teste diagnóstico da toxoplasmose congênita, trata-se de método promissor e merece mais estudos para aumentar sua eficácia. Palavras-chaves: Toxoplasmose congênita. PCR. Líquido amniótico.

show abstract

Section: Discussioncontrasting

confidence: 69%

Prenatal toxoplasmosis diagnosis from amniotic fluid by PCR

Vidigal

Santos

Castro

et al. 2002

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

show abstract

“…Nevertheless, it is just the opposite (Figure 2). 2 The FcRn is present in the syncytiotrophoblast and fetal endothelial cells, and binds IgG of the four subclasses with high affinity. 82,94 It mediates IgG transcytosis and immune complexes during pregnancy.…”

Section: Igs and Fcrs Polymorphismsmentioning

confidence: 99%

“…The transmission frequency increases to near 80% by the end of pregnancy, but the proportion of ill newborns is low. 2 The changes in endocrine phenomena occurring during pregnancy, as well as the size and maturity of the placenta and of the embryonic/fetal immune response certainly affect the ability to be protected from invasion or to fight infection. [3][4][5] The size of the inoculum is also relevant for congenital infection risk and disease severity.…”

Section: Introductionmentioning

confidence: 99%

Congenital toxoplasmosis: candidate host immune genes relevant for vertical transmission and pathogenesis

et al. 2010

View full text Add to dashboard Cite

“…Although newborns affected by congenital infection may seem normal upon first examination, serious sequelae, such as neurological impairment and blindness, can develop a few years later (Mombro et al 1995, Dunn et al 1999, Safadi et al 2003, Remington et al 2005.…”

mentioning

confidence: 99%