Keywords
Maternal Serum Screening Tests
Toxoplasmosis, Congenital
Infant, Newborn
How to Cite
Abstract
Toxoplasma screening during pregnancy is not recommended in Spain and currently only half of hospitals perform it. However, prenatal treatment in pregnant women (spiramycin to prevent mother-to-child transmission and pyrimethamine-sulfadiazine if already established) reduces cases of symptomatic congenital toxoplasmosis and longterm sequelae. The treatment of choice in children with confirmed infection is the combination of pyrimethamine, sulfadiazine and folinic acid for one year. Treatment reduces but does not eliminate the risk of sequelae (especially chorioretinitis), so follow-up should be carried out until adulthood.
Maternal cytomegalovirus screening is also not recommended in our country, although should be performed in the first trimester of pregnancy, as sequelae are limited to maternal infection acquired in the first trimester of pregnancy. In cases of maternal primary infection in the first trimester, oral valaciclovir should be administered as early as possible and until the amniocentesis, to reduce vertical transmission. Newborns with symptomatic disease should be treated with valganciclovir for 6 months.
Children with congenital cytomegalovirus and confirmed transmission in the first trimester or unknown timing of transmission should be followed up to at least 6 years of age to ensure specialized management. For those with documented maternal primary infection in the second and third trimesters of pregnancy this follow-up may not be necessary.
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