Each year around 2,000 children are born in Germany, who suffer from the severe effects of toxoplasmosis in pregnancy. In the unborn child, toxoplasmosis infection can lead to mental disability and vision loss.

Most adults do not even notice an acute toxoplasmosis infection, as it causes no or only mild symptoms and as such is often left untreated. It takes only a simple laboratory test to find out whether the pregnant woman has already had a toxoplasmosis infection before her pregnancy and is therefore immune or whether her baby may be at risk due to a first time infection.

Toxoplasmosis is an infection caused by a single-celled parasite called Toxoplasma gondii. The parasites multiply within the cells of the mucous lining of a cat's intestine. The eggs are excreted in the cat faeces and can infect other mammals. Humans contract toxoplasmosis from eating raw or undercooked meat containing the most resistant form of the parasites (cysts) or by coming in contact with dirt (garden soil!) contaminated with cat faeces containing infective eggs.

About 50 percent of the adult population has had a previous toxoplasmosis infection. They have developed specific antibodies and are thus immune against further infections.

Toxoplasmosis

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The foetus is checked for abnormalities with a special ultrasound device and nuchal translucency is measured. This is the accumulation of fluid around the neck of the child. The new first-trimester test is a combination of a blood test looking at two specific hormones of pregnancy: Free beta hCG and PAPP-A (pregnancy associated plasma protein A), and a scan of the nuchal transparency of the unborn baby, both in relation to the week of pregnancy. The ultrasound scan for measuring nuchal translucency (also called the NT or nuchal fold scan) is performed between 11 weeks and 13 weeks 6 days into your pregnancy, with a CLR of 45-84 mm.

Nuchal translucency measurements are not only a strong predictor for an increased risk for Down syndrome, but indicate serious, non-chromosomal defects, such as heart defects.

A computer programme then uses the measurements from the ultrasound examination and the maternal age to calculate a risk for a genetic disease with 90% accuracy. A more specific version of this test is the imaging of the foetal profile to establish whether there is a nasal bone. First results from studies showed that at week 12-14 of pregnancy, the nasal bone was absent in foetuses with Down syndrome.

Please keep in mind: Normal screening results do not guarantee that your baby is healthy. The only way to definitely exclude genetic defects are invasive procedures such as chorionic villus sampling, or amniocentesis (removal of amniotic fluid). However they pose a higher risk for your baby.

Nuchal translucency test

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The high-resolution ultrasound (also called differentiated ultrasound) is much more comprehensive than the ultrasound, normally performed in line with provided according to the maternity policy guidelines for this period. In addition to special devices, it requires extensive experience of the examiner. At our practice, Dr. Deiters has the DEGUM II qualification required for this examination.

In an ideal environment, with the position of the baby and the thickness of the maternal abdominal wall all playing an important role, a comprehensive ultrasound examination takes about 50 to 60 minutes. This includes a thorough examination and assessment of the foetus?s organs and limbs:

• Measurements of the foetus will also be taken to ensure it is growing normally
• quantity of amniotic fluid, position and appearance of the placenta
• appearance and function of all visible organs including the heart
• blood flow through the umbilical cord and uterine blood flow (to assess placental function and development)

What does DEGUM stand for?

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How well the foetus is provided with nutrients can be assessed by measuring the foetus's blood flow in arteries and veins. And it is also more accurate than other monitoring methods in assessing the unborn child?s overall state of health and the extent of any compensated oxygen deficiency.

By measuring the blood flow patterns in the uterine arteries, insufficient nutrient supply to the foetus (placental insufficiency) can already be recognized between weeks 20 and 24 of pregnancy; this way, preventive measures can be taken if the foetus is at risk. The assignment of pregnant women in risk groups of foetal growth restriction or gestosis (pregnancy-induced hypertension) or a low-risk group allows the monitoring tailored to the requirements of mother and child.

Colour Doppler ultrasound

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Two out of 100 women develop diabetes during pregnancy - with serious consequences for mother and child: urinary tract infections, hypertension and eclampsia occur disproportionately often, and more frequent complications during labour. There is also an increased incidence of foetal anomalies. In addition, pregnancy-related diabetes is a major cause of prenatal deaths. A simple blood test from week 25 of pregnancy will identify whether you are at risk.

• Fasting blood glucose test
• You drink 250ml of a glucose drink
• Blood collection after 1 hour
• Blood collection after 2 hours

This examination is not covered by your health insurance

Gestational diabetes

Group B streptococci are found in 10-15% of pregnant women, primarily in the genital area. Although these are normally harmless bacteria which inhabit the vaginal lining, pregnant women can infect their newborn at birth. This can lead to severe infections shortly after birth (?early onset?) or after 1-6 weeks (?late onset?). Early onset infection is associated with blood poisoning (sepsis), pneumonia, and meningitis, and may also lead to neurological damage and long-term effects. With late onset infection, there is a high risk of neonatal death, particularly in premature infants.

For these reasons, the German Society of Obstetrics and Gynaecology has made recommendations for the prevention of neonatal group B streptococcal infection.

Streptococcal infections

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Enhanced ultrasound examination

To monitor the foetus?s position (whether the baby's head has moved down into the pelvis), assessment of placenta, amniotic fluid and foetal head size in relation to maternal pelvis. This is also a chance to check once more for any signs of a possible illness of the foetus, which has only occurred after the last regular ultrasound and has been asymptomatic in the mother.

?Baby TV? - enhanced ultrasound

This examination is not covered by your health insurance