Prevention of congenital toxoplasmosis is based on serological screening before and during pregnancy, prompt diagnosis of prenatal infection in the mother and in the fetus along with adequate farmacological therapy and early detection of congenital infection in the newborn with clinical, serological and therapeutic follow-up. Ministerial decree of 10th September 1998 and Guidelines for physiological pregnancies published by the Health Ministry in September 2011 recommend and offer free of charge serological screening for toxoplasmosis on the first prenatal check-up and, if negative, every 4-6 weeks thereafter until the end of pregnancy, in order to identify and treat as early as possible proved infections. Any diagnostic and therapeutic delay in the management of such risky pregnancy can lead to severe consequences in the newborn, specifically on the development of Central Nervous System and eyes. The outpatient clinic for Infections in Pregnancy and the Toxoplasmosis Laboratory of IRCCS Policlinico San Matteo in Pavia offer 2nd level service to pregnant women with suspected toxoplasmosis who were sent not only from Lombardy centres, but even out of Region. With this study we analyzed cases of women with suspected toxoplasmosis in pregnancy sent to our clinic in the five-year period 2010-2014 who also underwent the more sensitive diagnostic test of amniocentesis; the aim of this study is to prove the existence of a correlation between early detection of infection (and therefore early treatment with spiramycin) and negative results of PCR on amniotic fluid, considering also the timing of infection.
La prevenzione della toxoplasmosi congenita si basa sullo screening pre e in gravidanza, sulla diagnosi tempestiva dell’infezione in epoca prenatale con l’avvio di una adeguata terapia farmacologica e l’eventuale diagnosi prenatale e sulla diagnosi precoce dell’infezione congenita con follow-up clinico, sierologico e terapeutico del neonato. Il D.M. 10 settembre 1998 e le Linee Guida per la gravidanza fisiologica pubblicate dal Ministero della Salute nel settembre 2011 raccomandano e offrono gratuitamente lo screening sierologico della toxoplasmosi al primo controllo prenatale e, qualora negativo, ogni 4-6 settimane fino al termine della gravidanza, per individuare e trattare il più precocemente possibile l’avvenuta infezione in gravidanza. Un ritardo diagnostico o terapeutico nella gestione di tale gravidanza a rischio può portare a gravi conseguenze sul prodotto del concepimento, in particolare sullo sviluppo del sistema nervoso centrale e della vista. L’ambulatorio Infezioni Materno-fetali e il Laboratorio Toxoplasmosi dell’IRCCS Policlinico San Matteo di Pavia offrono prestazioni di II livello per gravide con sospetta toxoplasmosi che sono inviate non solo da centri lombardi, ma anche da fuori Regione. Con questo studio abbiamo voluto analizzare i casi di donne con sospetta toxoplasmosi in gravidanza afferenti all’ambulatorio infezioni materno-fetali nel quinquennio 2010-2014 che sono state sottoposte ad accertamenti diagnostici prenatali (amniocentesi); l’obiettivo dello studio è dimostrare l’esistenza di una correlazione tra la precocità della diagnosi d’infezione e quindi dell’inizio del trattamento con spiramicina e la negatività della PCR su liquido amniotico, tenendo in considerazione sempre l’epoca presunta di infezione.
La diagnosi prenatale nella toxoplasmosi congenita
LAMBERTENGHI, LORENZA
2015/2016
Abstract
Prevention of congenital toxoplasmosis is based on serological screening before and during pregnancy, prompt diagnosis of prenatal infection in the mother and in the fetus along with adequate farmacological therapy and early detection of congenital infection in the newborn with clinical, serological and therapeutic follow-up. Ministerial decree of 10th September 1998 and Guidelines for physiological pregnancies published by the Health Ministry in September 2011 recommend and offer free of charge serological screening for toxoplasmosis on the first prenatal check-up and, if negative, every 4-6 weeks thereafter until the end of pregnancy, in order to identify and treat as early as possible proved infections. Any diagnostic and therapeutic delay in the management of such risky pregnancy can lead to severe consequences in the newborn, specifically on the development of Central Nervous System and eyes. The outpatient clinic for Infections in Pregnancy and the Toxoplasmosis Laboratory of IRCCS Policlinico San Matteo in Pavia offer 2nd level service to pregnant women with suspected toxoplasmosis who were sent not only from Lombardy centres, but even out of Region. With this study we analyzed cases of women with suspected toxoplasmosis in pregnancy sent to our clinic in the five-year period 2010-2014 who also underwent the more sensitive diagnostic test of amniocentesis; the aim of this study is to prove the existence of a correlation between early detection of infection (and therefore early treatment with spiramycin) and negative results of PCR on amniotic fluid, considering also the timing of infection.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/24312