Hohlfeld P, Biedermann K, Extermann P, Gyr T
Département de gynécologie-obstétrique, CHUV, Lausanne.
Schweiz Med Wochenschr Suppl. 1995;65:62S-69S.
Maternal infection with Toxoplasma gondii acquired during pregnancy occurs in more than 500 women per year in Switzerland. Systematic screening at the beginning of pregnancy allows the introduction of health education programs. The screening during pregnancy is performed to diagnose primary maternal infections and to propose prenatal diagnosis and treatment. The administration of specific antibiotherapy during pregnancy (spiramycine or the association of pyrimethamine and sulfonamides) significantly reduces the risk of fetal infection. Prenatal diagnosis of congenital toxoplasmosis is possible and reliable. It avoids unnecessary termination of pregnancy when the fetus is not infected and specific therapy in case of infection (association of pyrimethamine and sulfonamides). Prenatal treatment may be proposed without prenatal diagnosis as of the 16th week of gestation. In any case, prenatal treatment seems to reduce the incidence of severe congenital toxoplasmosis.
在瑞士,每年有超过500名孕妇在孕期感染弓形虫。孕期开始时进行系统筛查有助于开展健康教育项目。孕期筛查旨在诊断孕妇原发性感染,并建议进行产前诊断和治疗。孕期使用特定的抗微生物疗法(螺旋霉素或乙胺嘧啶与磺胺类药物联合使用)可显著降低胎儿感染风险。先天性弓形虫病的产前诊断是可行且可靠的。它可避免在胎儿未感染时进行不必要的终止妊娠,并在感染时进行特异性治疗(乙胺嘧啶与磺胺类药物联合使用)。自妊娠第16周起,可不进行产前诊断而直接建议进行产前治疗。无论如何,产前治疗似乎可降低严重先天性弓形虫病的发病率。