Spalding Sílvia Maria, Amendoeira Maria Regina R, Ribeiro Luis Carlos, Silveira Cláudio, Garcia Aparecida P, Camillo-Coura Léa
Laboratório Central do Estado, Secretaria da Saúde do Estado do Rio Grande do Sul, Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brasil.
Rev Soc Bras Med Trop. 2003 Jul-Aug;36(4):483-91. doi: 10.1590/s0037-86822003000400009. Epub 2003 Aug 13.
This study followed up 2,126 pregnant women cared for at SUS day-care clinics (Public Health Insurance System) of the northwest of the State of Rio Grande do Sul, Brazil. After serological screening we performed a follow up of all pregnant women and their babies. Serologic tests included: IgG, IgM, IgA and IgG avidity levels, mice inoculation and polymerase chain reaction (PCR) also placentas and umbilical materials were tested using immunoperoxidase as well as clinical evaluation. Of all the pregnant women screened, 74.5% were reactive to toxoplasmosis, and 3.6% presented IgM seropositivity. At ophthalmic evaluation ten women had ocular lesions and one infant presented eye lesions and brain calcification. The presence of anti-T.gondii specific IgM throughout the entire pregnancy did not characterize acute phase infection, for this, complementary tests were necessary. The importance is underscored for attendance of the newborn of mothers presenting serology compatible with this infection even in the absence of signs and symptoms of congenital toxoplasmosis.
本研究对在巴西南里奥格兰德州西北部的统一卫生系统(SUS)日间护理诊所接受护理的2126名孕妇进行了随访。血清学筛查后,我们对所有孕妇及其婴儿进行了随访。血清学检测包括:IgG、IgM、IgA和IgG亲和力水平、小鼠接种以及聚合酶链反应(PCR),胎盘和脐带材料也采用免疫过氧化物酶检测以及临床评估。在所有接受筛查的孕妇中,74.5%对弓形虫病呈反应性,3.6%呈现IgM血清阳性。眼科评估时,有10名女性有眼部病变,1名婴儿有眼部病变和脑钙化。整个孕期存在抗弓形虫特异性IgM并不代表急性期感染,为此,需要进行补充检测。强调即使母亲没有先天性弓形虫病的体征和症状,但血清学检测结果与这种感染相符时,其新生儿也需要接受检查。