Toxoplasmosis gestacional: desenlaces obstétricos y resultados perinatales en un hospital de referencia en Medellín, Colombia. 2015-2021. Un estudio descriptivo

Objective: To describe the perinatal outcomes of pregnant women suspected of seroconversion or confirmation of gestational toxoplasmosis and the clinical evolution of their neonates up to one month of age in a high-complexity institution, from 2015 to 2021. Materials and Methods: A retrospective descriptive study was conducted, including pregnant women who were referred to the maternal-fetal medicine service due to gestational toxoplasmosis. Positive serologies for this condition, ultrasound findings, polymerase chain reaction in amniotic fluid, and neonatal serologies were considered. Clinical variable information and serological test results were collected through medical records. Results: A total of 209 patients were included. The median gestational age at the time of serological testing at the initial care institution was 16 weeks (IQR: 10-24 weeks). Serological results were positive for Immunoglobulin G (IgG) in 191 out of 208 (91.8%) and for Immunoglobulin M (IgM) in 194 out of 209 (92.8%) patients. Among patients with positive IgG and IgM, an avidity test was conducted on 60 (28.7%), of which 15 (26.8%) showed low avidity. Polymerase chain reaction testing in amniotic fluid was performed on 76 (36.4%) pregnant women, with 15 (19.7%) having positive results for congenital toxoplasmosis diagnosis. Among these cases, nine newborns exhibited positive findings in the initial ophthalmological examination and/or transfontanelle ultrasound, confirming prenatal ultrasound findings. Detailed anatomical ultrasound was performed on 188 (90%) of the pregnant women, with alterations found in 47 (25.0%) cases. Conclusions: Serological interpretation and obstetric ultrasound allowed for the identification of a population of pregnant women with the infection, who were offered available treatment. However, there were cases of congenital toxoplasmosis that were occasionally fatal or resulted in severe neurological impairment in the studied population.