Pons J C, Sigrand C, Grangeot-Keros L, Frydman R, Thulliez P
Service de Gynécologie-Obstétrique 1, Hôpital Cochin-Port Royal, Paris.
Presse Med. 1995 Jan 21;24(3):179-82.
It has been established that maternal immunity developing before conception protects the fetus from congenital toxoplasmosis. We observed a case of congenital toxoplasmosis consecutive to a maternal toxoplasma infection that had preceded pregnancy. A woman with normal immune system developed toxoplasmosis 2 months before conceiving. No treatment was given to this prepregnancy seroconverted patient. At 25 weeks of amenorrhoea, the ultrasound examination showed a fetal cerebral ventricular dilatation. Amniocentesis and cordocentesis showed fetal toxoplasmosis infection. Fetopathologic examination confirmed the diagnosis of cerebral toxoplasmosis. The pathophysiology of maternal-fetal toxoplasma transmission and the role played by maternal immunodeficiency are discussed. This exceptional case-report showed the difficulties of the management in patients with 3-month pre-pregnancy toxoplasmosis and its practical implications.
已经证实，受孕前产生的母体免疫可保护胎儿免受先天性弓形虫病的侵害。我们观察到一例先天性弓形虫病病例，其母体弓形虫感染发生在怀孕之前。一名免疫系统正常的女性在受孕前2个月感染了弓形虫。对这名孕前血清转化的患者未进行治疗。停经25周时，超声检查显示胎儿脑室扩张。羊膜穿刺术和脐带穿刺术显示胎儿感染了弓形虫。胎儿病理检查证实了脑弓形虫病的诊断。本文讨论了母婴弓形虫传播的病理生理学以及母体免疫缺陷所起的作用。这个特殊的病例报告显示了孕前3个月感染弓形虫病患者的管理困难及其实际影响。
