Toksoplazmoz Enfeksiyonu Olan Gebeliklerin Araştırılması

Öz

Amaç: Bu çalışmada Şanlıurfa'da üçüncü basamak bir hastanede takip edilen toksoplazma gondii enfeksiyonu olan gebelerin perinatal sonuçları, serolojik özellikleri ve doğum öncesi bakım algoritmasının etkinliğinin retrospektif olarak değerlendirilmesi amaçlanmıştır.
Materyal ve metod: Ocak 2020 ile Ocak 2025 tarihleri arasında toksoplazma IgG/IgM testi pozitif çıkan ve doğum yapan 64 gebenin tıbbi kayıtları retrospektif olarak incelendi. Hastaların yönetiminde normal doğum öncesi takip ve tedavi prosedürü izlendi. Doğum öncesi tedavi yöntemleri, ultrason bulguları, amniyosentez ve PCR sonuçları, bebeklerin klinik ve laboratuvar verileri, demografik bilgiler ve serolojik test sonuçları da incelendi. İstatistiksel analizde tanımlayıcı istatistikler kullanıldı.
Bulgular:  Çalışmaya dahil edilen 64 gebe kadının ortalama yaşı 26,70 ± 4,56 yıldı. 58 olgunun %90,6'sında yüksek IgG aviditesi vardı. Düşük avidite nedeniyle altı olguda spiramisin tedavisine başlandı. Üç hastaya amniyosentez yapıldı ve her üç hastanın PCR sonucu pozitifti. İki olguda gebelik sonlandırıldı. Konjenital toksoplazmozlu bir bebekte hepatosplenomegali ve hipotoni gözlendi. Bebeklerin çoğunda konjenital enfeksiyon belirtisi yoktu ve toksoplazma IgM/IgG negatifti.
Sonuç: IgG aviditesinin yüksek sıklığı, enfeksiyonun genellikle gebelikten önce kapıldığını göstermektedir. Mevcut doğum öncesi tanı ve tedavi protokolü ile konjenital bulaşmanın etkili bir şekilde önlendiği bulunmuştur. Erken tedavi ve dikkatli takibin, düşük aviditeli hastaların küçük bir yüzdesinde bile olumlu perinatal sonuçlarla ilişkilidir.

Anahtar Kelimeler

• Toxoplasma gondii
• Konjenital Toksoplazmoz
• Gebelik
• Prenatal Tani
• Spiramisin

Investigation of Pregnancies with Toxoplasmosis Infection

Öz

Background: This study sought to retrospectively assess the perinatal outcomes, serological features, and efficacy of the prenatal care algorithm of pregnant women with toxoplasma gondii infection who were monitored at a tertiary-level hospital in Şanlıurfa.
Materials and Methods: A retrospective review was made of the medical records of 64 pregnant women who tested positive for toxoplasma IgG/IgM and gave birth between January 2020 and January 2025. The normal prenatal follow-up and treatment procedure was followed in the management of the patients. Prenatal treatment methods, ultrasound findings, amniocentesis and PCR results, clinical and laboratory data of the infants, demographic information, and serological test results were also examined. Descriptive statistics were used in the statistical analysis.
Results: The 64 pregnant women included in the study had an average age of 26.70 ± 4.56 years. In 58 cases, 90.6% had high IgG avidity. Low avidity led to the initiation of spiramycin treatment in six cases. Three patients underwent amniocentesis, and PCR results were positive in all three cases. Two cases resulted in pregnancy termination. Hepatosplenomegaly and hypotonia were observed in one infant with congenital toxoplasmosis. Most of the infants showed no symptoms of congenital infection and were toxoplasma IgM/IgG negative.
Conclusions: The high frequency of IgG avidity indicates that the infection was typically contracted before pregnancy. Congenital transmission was found to be effectively prevented by the present prenatal diagnosis and treatment protocol. Early treatment and careful monitoring are associated with positive perinatal outcomes, even in the small percentage of low avidity patients. 

Anahtar Kelimeler

• Toxoplasma gondii
• Congenital Toxoplasmosis
• Pregnancy
• Prenatal Diagnosis
• Spiramycin

Kaynakça

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