Toxoplasmosis Prevention
Toxoplasmosis infections frequently have an asymptomatic course. A minority of those infected develop complaints and the most frequently occurring clinical finding is enlargement of the lymph glands. Infection leads to the production of antibodies that protect the individual from reinfection for a period of several years. About half of all pregnant women have these antibodies. For women without these antibodies, infection during pregnancy can lead to spontaneous abortion, premature birth and congenital abnormalities, including hydrocephalus, chorioretinitis and intracerebral calcifications.
The infection is caused by Toxoplasma gondii, which needs feline species for its life cycle, but can also occur in cows, sheep and pigs. Extra attention must be paid to the preparation of meals and the care of pets in order to prevent infection.
T. gondii is usually transmitted orally in one of the following two ways: directly by eating raw meat infected with cysts or indirectly by contamination of the hands or food with sporulated oocytes from cat faeces. When food is heated, the cysts and oocytes are quickly killed. Eating raw meat and meat cooked rare (steak) is advised against. All vegetables must be carefully washed. Pregnant women who work in the garden should wear gloves. Pregnant woman should avoid cleaning cat litter boxes so as to prevent contamination with infected cat faeces. There is only a danger of infection after sporulation. As sporulation of the oocytes takes at least two days, it is important to clean the cat litter box daily. As the foetus remains susceptible to this infection until the end of pregnancy, the preventive measures must be continued throughout the entire pregnancy.
Rubella Prevention
Primary rubella infection during pregnancy can lead to spontaneous abortion, stillbirth and the birth of a child with congenital abnormalities, such as hearing disorders, cardiovascular disorders, eye disorders (cataract, glaucoma) and learning disabilities. The earlier the infection takes place in pregnancy, the greater the chance of severe abnormalities and intra-uterine foetal demise. Occurrences of the infection late in pregnancy can lead to abnormalities that are only expressed years later.
Seroconversion does not occur in every individual vaccinated. All pregnant women undergo an additional test during the first pregnancy check-up to determine the rubella antibody titre. If this titre is too low, the woman is advised about the prevention of rubella infection: the pregnant woman is advised to avoid close contact with rubella patients in as far as is possible throughout the entire pregnancy. If a pregnant woman without antibodies has been in contact with rubella patients, her immune status must be checked. A positive IgM titre points to an existing or recent infection. Women with a rubella infection or a suspected rubella infection must come for a check-up outside the normal antenatal consultation times. They should also avoid contact with other pregnant women.
Use Of Medicinal Products In Pregnancy
The placenta is permeable to almost all medicinal products. The use of medicinal products can result in severe harm to the embryo and foetus. This applies to both approved and unapproved medicinal products. The fact that a medicine has been prescribed to pregnant women on a large scale for a long period of time without any abnormalities having become known, is no guarantee of that medicine’s safety. The sedative thalidomide (Softenon) was prescribed on a large scale for about four years until the considerable teratogenicity was recognised. Diethylstilbestrol (DES) was prescribed over a period of 20 years to prevent spontaneous abortion before its side-effects were recognised. The rule of thumb should be: no medication (approved or unapproved) throughout the pregnancy unless there is a strict indication.