Prospective evaluation of pregnant women suspected of acute toxoplasmosis attended in a reference antenatal clinic in a university teaching hospital in Southern Brazil

Abstract

Resumo: O estudo foi realizado com mulheres grávidas com IgM e IgG anti-T específicos. O reagente de gondii de janeiro de 2009 a agosto de 2018 participou de um hospital universitário de ensino. Dos 520 pacientes suspeitos, 218 foram acompanhados com IgM e IgG anti-T. reagentes gondii. Estes, 83 (38,0%) com baixa avidez de IgG; 39 (18%) soroconversão no segundo ou terceiro trimestre; 19 (8,7%) sem teste de avidez; 69 (31,6%) com alta avidez após 16 semanas de gestação incluíram cinco com coriorretinite recorrente (2,2%) e três (1,3%) HIV positivo. Para complementar algum diagnóstico, 27/41 (66%) a IgA sorológica foi reagente; Foram detectadas 2/63 (3,2%) amostras de sangue periférico e 1/57 (1,8%) amostras de líquido amniótico no DNA de T. gondii. Houve oito casos de morte fetal, um caso de hepatomegalia neonatal e outro com DNA de T. gondii no sangue periférico. 139 partos de bebês neste hospital, no entanto, 38% de perda de seguimento dessas crianças. A prevalência de toxoplasmose congênita foi de 1,5 casos / 1000 nascidos vivos nesta área de estudo, com casos tardiamente investigados. O tratamento pré-natal pode ter ajudado a reduzir o risco de transmissão infantil

Abstract: The study was performed with pregnant women with specific IgM and IgG anti-T. gondii reagent from January 2009 to August 2018 attended in a university teaching hospital. From 520 patients suspected, 218 were followed up with IgM and IgG anti-T. gondii reagents. These, 83 (38.0%) with low IgG avidity; 39 (18%) seroconversion in the second or third trimester; 19 (8.7%) without avidity test; 69 (31.6%) with high avidity after 16 weeks of gestation included five with recurrent chorioretinitis (2.2%), and three (1.3%) HIV positive. To complementary some diagnosis, 27/41 (66%) the serological IgA was reagent; 2/63 (3.2%) peripheral blood samples and 1/57 (1.8%) amniotic fluid samples were detected T. gondii DNA. There were eight cases of fetal death, one case of hepatomegaly neonatal and other with T. gondii DNA in the peripheral blood. 139 babies deliveries in this hospital, however, 38% loss of follow-up of these children. The prevalence of congenital toxoplasmosis was 1.5 cases/1000 live births in this study area, with cases belatedly investigated. The antenatal treatment may have helped to reduce the risk of child transmission