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Pregnancy complications

  • Pregnancy complications may need special medical care.
  • Common complications include diabetes and anemia.
  • Go to all your prenatal care checkups, even if you feel fine.
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Toxoplasmosis

Toxoplasmosis is an infection. It’s caused by a parasite called Toxoplasma gondii. The parasite is so tiny you can’t see it.

More than 60 million people in the United States may have the parasite. Very few people have symptoms because a healthy immune system usually keeps the parasite from causing infection. But toxoplasmosis can cause big health problems for your baby during pregnancy.

How do you get infected with toxoplasmosis?
You can come in contact with the parasite that causes the infection through:

  • Eating raw or undercooked meat
  • Eating unwashed fruits and vegetables
  • Touching cat poop
  • Touching kitchen utensils and cutting boards used to prepare raw or undercooked meat and fruits and vegetables
  • Touching dirt or sand

What are the signs and symptoms of toxoplasmosis?
You may not know if you have the infection. Lots of times there are no symptoms. For some people, it feels like the flu. Symptoms can include:

  • Achy muscles
  • Headache
  • Fatigue (tiredness)
  • Fever
  • Discomfort
  • Swollen glands

These symptoms can last for a month or longer. If you think you have toxoplasmosis, talk to your health care provider. Your provider can give you a blood test to find out if you have the infection. Even though blood tests are a regular part of prenatal care, you don’t’ usually get testing for toxoplasmosis. So be sure to talk to your provider if you think you have the infection.

Can toxoplasmosis cause problems before pregnancy?
If you have toxoplasmosis within 6 months of getting pregnant, you may be able to pass it to your baby during pregnancy. Talk to your health care provider about being tested.

Can toxoplasmosis cause problems during pregnancy?
Yes. Pregnancy complications caused by toxoplasmosis include:

  • Preterm birth – Birth before 37 weeks of pregnancy
  • Stillbirth – The death a baby in the womb before birth but after 20 weeks of pregnancy

If you get toxoplasmosis during pregnancy, you have a 3 in 10 chance (30 percent) of passing the infection to your baby. The later in your pregnancy you get infected, the more likely it is that your baby gets infected. But the earlier in pregnancy you get infected, the more serious the baby’s problems may be after birth. For example, he could have damage of the brain and eyes. Some infected babies may die.

If you have toxoplasmosis during pregnancy, your health care provider may suggest a test called amniocentesis (also called amnio) to see if your baby is infected. Amnio is a test that takes some amniotic fluid from around your baby in the uterus. You can get this test at 15 to 20 weeks of pregnancy.

The fluid can be tested to see if your baby has toxoplasmosis. It also can be tested for other problems with the baby, like birth defects or genetic problems. Birth defects are problems with a baby’s body that are present at birth. Genetic conditions may be passed from parents to children through genes and include certain diseases and birth defects.

Can toxoplasmosis during pregnancy harm your baby?
Most babies born with toxoplasmosis have no symptoms. But about 1 in 10 babies (10 percent) with the infection are born with problems, including:

  • Eye infections
  • Enlarged liver and spleen
  • Jaundice (yellowing of the skin and the whites of the eyes)
  • Pneumonia

Without treatment, 8 or 9 out of 10 newborns (85 percent) may develop problems later in life, even if they show no symptoms earlier. These problems include:

  • Intellectual disabilities
  • Vision problems
  • Cerebral palsy (a group of disorders that can cause problems with brain development that can affect a person’s balance, posture and ability to move)
  • Seizures
  • Hearing loss

Each year, between 400 and 4,000 babies in the United States are born with toxoplasmosis. If you think you had toxoplasmosis during pregnancy, be sure your baby is tested. Your baby can have a blood test to check for this infection.

How is toxoplasmosis treated during pregnancy?
Getting treatment with certain antibiotics helps reduce the chance of your baby getting toxoplasmosis. Antibiotics are medicines that kill some types of organisms that cause infections. This treatment also helps reduce the seriousness of any symptoms your baby may have.

If you’re infected before 18 weeks of pregnancy, your provider may give you an antibiotic called spiramycin. This medicine helps reduce the chance of your baby getting the infection.

If you’re infected after 18 weeks of pregnancy, your provider may give you different antibiotics called pyrimethamine and sulfadiazine. These medicines are recommended for use after 18 weeks of pregnancy. This is because if you take them before 18 weeks of pregnancy, they may cause birth defects in your baby.

How is toxoplasmosis treated in your baby after birth?
If your baby shows symptoms of toxoplasmosis, she gets treated with the antibiotics pyrimethamine and sulfadiazine. She continues these antibiotic treatments through her first birthday, sometimes even longer.

How can you prevent toxoplasmosis?
Here’s how to protect yourself from toxoplasmosis:

  • Don’t eat raw or undercooked meat, especially lamb or pork. Cooked meat should not look pink, and the juices should be clear.
  • Wash your hands with soap and water after handling fruits, vegetables or raw meat.
  • Don’t touch your eyes, nose or mouth when handling raw meat.
  • Clean cutting boards, work surfaces and utensils with hot, soapy water after using them with fruits, vegetables or raw meat.
  • Peel or thoroughly wash all raw fruits and vegetables before eating.
  • Use work gloves when you’re gardening. Wash your hands afterwards.
  • Don’t let your cat go outside your home where it may come in contact with the parasite.
  • Ask someone else to clean your cat’s litter box. If you have to do it yourself, wear gloves. Wash your hands thoroughly when you’re done emptying the litter.
  • Stay away from children’s sandboxes. Cats like to use them as litter boxes.

Last updated February 2012

See also: Eating healthy during pregnancy

When to call your provider

  • If you have heavy bleeding or bleeding for more than 24 hours
  • If you have fever, chills or severe headaches
  • If you have vision problems, like blurriness
  • If you have quick weight gain or your legs and face swell

Most common questions

What is mononucleosis?

Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.

You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:

  • Achy muscles
  • Belly pain
  • Fatigue (feeling tired all the time)
  • Fever
  • Sore throat
  • Swollen glands in your neck

If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.

There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.

Can Rh factor affect my baby?

The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.

If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.

If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.

I had a miscarriage. How long should I wait to try again?

Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.

Are gallstones common during pregnancy?

Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.

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