Book of Medical Disorders in Pregnancy - Tintash

Fig13.4: shows CMV infection rash on
the Retina of the eye
Clinical features: There may be no
symptoms but several clinical syndromes
reported includes, acute generalized
lymphadenopathy with or without fever.
Sometimes the condition mimics infectious
mononucleosis, or acute typhus
pneumonitis and myocarditis.
Eagle
Cat Bear
Children
Dog
Man Woman
Fig13.5: Shows roots of transmission
for toxoplasmosis infection
Congenital toxoplasmosis: When a
nonimmune pregnant woman is infected,
the parasite can pass through the
placenta and infect the foetus. The
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earlier the infection occurs in the course
of pregnancy, the more severe is the fetal
disease. Maternal infection during the
first trimester usually does not involve
the foetus; since the placenta is not
sufficiently mature to develop foci of
infection. However abortion may still
occur.
Maternal infection during the second
trimester has been associated with severe
congenital toxoplasmosis at birth,
stillbirth, and prematurity. When the
maternal disease is acquired during the
third trimester, pregnancy approaches
term but the newborn is invariably
damaged. The infection of the infant
may not be apparent at birth, and remain
latent for many years. Mild cases of
congenital toxoplasmosis show a few
retinal lesions at birth, and additional
evidence of the disease may develop
during the first year of life.
In severe cases there are signs of
generalized infection, i.e. fever, diffuse
lymphadenopathy, hepatosplenomegaly,
jaundice, and a maculopapular rash. The
condition may be compared with
erythroblastosis foetalis and
hemorrhagic disease of the newborn.
Appropriate serological tests must be
carried out to differentiate this
complication.
In very severe cases involvement of the
central nevoussystem and the eyes can
occur. Chorioretinitis, cerebral
calcifications, psychomotor retardation,
convulsions, microphthalmos,
hydrocephalus and microcephaly, have
all been reported. The central nervous
system and ocular lesions usually occur
together. Epilepsy and mental retardation
have been regarded by some
authorities as the most common evid-