Question:medium
A woman in the first trimester of pregnancy has a history of previous toxoplasmosis and is IgG positive. What is the advice?
A woman in the first trimester of pregnancy has a history of previous toxoplasmosis and is IgG positive. What is the advice?
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In pregnancy, toxoplasmosis is dangerous mainly when infection is acquired during pregnancy. IgG positivity suggests past infection, but fetal risk assessment may still be needed.
Updated On: May 14, 2026
- Continue pregnancy, no risk
- Abort -- high risk
- Continue, risk exists
- Repeat IgM serology
Show Solution
The Correct Option is C
Solution and Explanation
Step 1: Understanding the Question:
This question addresses the management of Toxoplasmosis in pregnancy. The patient has a "previous" history and is currently "IgG positive."
Step 2: Detailed Explanation:
Serological Markers:
- IgG Positive: Indicates either a past infection (immunity) or a current infection.
- IgM Positive: Suggests a recent or acute infection.
Risk of Congenital Toxoplasmosis: The fetus is only at risk if the mother acquires a primary infection during pregnancy. If the mother was infected before conception and has stable IgG antibodies, she is immune, and there is virtually no risk of transmission to the fetus in the current pregnancy.
Interpreting the Scenario: The question states "previous toxoplasmosis." If this means she was known to be IgG positive before she got pregnant, the answer should technically be "no risk."
Clinical Caution (Answer C): However, if the IgG positivity is discovered for the first time during the first trimester, one cannot immediately distinguish between a past infection and a very recent one without further testing (like IgG avidity or IgM levels). The provided answer "C" suggests a cautious approach where one cannot definitively rule out a risk without further evaluation, though standard screening usually seeks to confirm old immunity to reassure the patient.
Step 3: Final Answer:
While old immunity is protective, the initial discovery of positive serology in pregnancy requires careful management to ensure the infection was not acquired recently.
This question addresses the management of Toxoplasmosis in pregnancy. The patient has a "previous" history and is currently "IgG positive."
Step 2: Detailed Explanation:
Serological Markers:
- IgG Positive: Indicates either a past infection (immunity) or a current infection.
- IgM Positive: Suggests a recent or acute infection.
Risk of Congenital Toxoplasmosis: The fetus is only at risk if the mother acquires a primary infection during pregnancy. If the mother was infected before conception and has stable IgG antibodies, she is immune, and there is virtually no risk of transmission to the fetus in the current pregnancy.
Interpreting the Scenario: The question states "previous toxoplasmosis." If this means she was known to be IgG positive before she got pregnant, the answer should technically be "no risk."
Clinical Caution (Answer C): However, if the IgG positivity is discovered for the first time during the first trimester, one cannot immediately distinguish between a past infection and a very recent one without further testing (like IgG avidity or IgM levels). The provided answer "C" suggests a cautious approach where one cannot definitively rule out a risk without further evaluation, though standard screening usually seeks to confirm old immunity to reassure the patient.
Step 3: Final Answer:
While old immunity is protective, the initial discovery of positive serology in pregnancy requires careful management to ensure the infection was not acquired recently.
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