During the first trimester of pregnancy with our second child, an early test of my wife’s blood indicated a potential for a Toxoplasmosis infection. I had heard of Toxoplasmosis before – we have a cat and it’s usually something the doctors will tell cat owners or an annoying family member will shout out when trying to show-off their knowledge of pregnancy facts and grill you about owning the litter box maintenance.
With our first child, I took over litter box duty and we never had any indication of issues. With our second child we had a scare.
What is Toxoplasmosis?
From all that I’ve read on various websites, Toxoplasmosis is something that can infect human beings at any point in life. It’s typically caught by exposure to feces from animals that have been infected as well, most notably, cats. However, you can also contract it from secondary exposures which is why doctors typically tell women to give up gardening during pregnancy (worried that a neighborhood cat/animal used your garden as a toilet) and to thoroughly wash fruits, vegetables, and eat only well-cooked meat (there’s a slight potential for contamination from farms).
For more information on the definition of Toxoplasmosis: http://www.cdc.gov/toxoplasmosis/
As a Dad, should I worry?
Probably not, but I sure as hell did. To clarify, I didn’t really worry until we had blood test results indicating a possible infection. Prior to the blood work, I would have never even thought of it, but if we have another child it will definitely be on my mind. I think this is partly due to the vast literature available on the web that indicates some awful things that can happen if the fetus becomes infected, but overall this is rather rare. Still, once our doctor told us about a possible infection, then my wife was sent for further blood tests and it made me worry even further.
As I mentioned, my wife’s first few blood tests showed a potential for recent infection with Toxoplasmosis. As it was explained to us, and as my memory serves me, there are two main elements in the blood that are measured when screening for Toxoplasmosis infections – antibodies IgG and IgM.
When someone is infected with Toxoplasmosis, then the IgM antibodies are produced to fight the infection. After the infection passes, then the IgG antibodies increase, as they are the memory antibodies for fighting off future infection.
During blood screening, if someone has a high level of IgG antibodies, it typically means that the person had a previous infection and now has a stockpile of IgG antibodies to fight any future infection quickly and with ease.
If someone has low IgG levels, it typically means the person has not been infected previously. During blood screening, if IgG levels are low and IGM levels increases, then it typically indicates that there is a recent infection, which if occurs during pregnancy then the infection could be passed to the fetus.
Important Lesson – If the mother is infected, it does NOT absolutely mean that the fetus will get the infection. Chances will depend on the trimester of infection – earlier trimesters the mother is less likely to pass infection, but if passed it will tend to spell worse things for the baby. The chance of passing the infection is greater in the later stages of pregnancy, but the lasting effects are not as great.
Out Test Results
My wife’s initial blood test indicated that there was a IgM level of 11.1, while IgG was less than 3.0
As a baseline, IgM of 10.0 is considered normal and anything above 10.0 will indicate heightened levels. The second blood test indicated there was a IgM level of 12.2, while the IgG was still less than 3.0. Third test showed IgM of 14, and IgG less than 3.0.
All signs lead to a recent infection, so we were worried. This all brought us to about Week 16/17 of the pregnancy, and upon our doctor’s advice – and additional down syndrome screening that came back out of range – we scheduled an amniocentesis (procedure to extract amniotic fluid via a needle through the mother’s abdomen). While the blood work will test whether or not my wife was infected with Toxoplasmosis, only an amniocentesis would reveal if the baby was infected.
More on Amniocentesis: http://www.webmd.com/baby/guide/amniocentesis
Amniocentesis, Genetic Counselling
At our hospital, patients undergoing an amniocentesis will first meet with a genetic counselor to discuss all of the results leading up to the amnio and the options available. The counselor was extremely thorough and really helped my wife and I understand why the doctor was recommending an amnio. However, she also indicated that only amniotic fluid extracted after week 18 was an accurate sample for testing Toxoplasmosis in the fetus. So, if we wanted to have an amnio for testing the Toxoplasmosis results, we would need to come back a week later.
The good news was that we no longer had a scare with Toxoplasmosis…
After 3 blood tests performed by local laboratories, a final blood test was taken 4 days prior to the amnio. This blood sample was sent to a lab in Palo Alto, California that specializes in Toxoplasmosis testing (among other things) - Palo Alto Medical Foundation. This time the test results came back with both the IgG and IgM levels low enough to be considered negative.