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• W1997538244 abstract "La toxoplasmose constitue l’étiologie la plus fréquente des uvéites postérieures dans le monde. Le problème de la toxoplasmose au cours de la grossesse pose en réalité deux questions : celle de la toxoplasmose congénitale, due à une primo-infection de la femme enceinte et celle de la présence d’une rétinochoroïdite toxoplasmique active chez une femme enceinte. L’ingestion de viande mal cuite ou crue est responsable d’un tiers à deux tiers des contaminations chez les femmes enceintes. La séroprévalence en Europe de la toxoplasmose est élevée, jusqu’à 54 % dans les pays européens du Sud. Les mesures hygiénodiététiques de prévention primaire sont proposées aux femmes enceintes immunocompétentes séronégatives pour la toxoplasmose. Les atteintes oculaires sont représentées par la rétinochoroïdite et différentes lésions associées. Le service d’ophtalmologie et de parasitologie du CHU de la Croix-Rousse (hospices civils de Lyon) suit actuellement la plus grande cohorte mondiale d’enfants atteints de toxoplasmose congénitale (430 enfants vivants en 2005). Notre taux global de transmission lors d’une primo-infection est de 30 %. L’incidence notée des rétinochoroïdites est de 24 % au sein de notre cohorte prospective. Au cours du suivi, des récidives sont apparues dans 29 % des cas. La présence d’une rétinochoroïdite toxoplasmique active chez une femme enceinte pourrait peut-être exposer à un risque de transmission à cause de la possible parasitémie. Le traitement pourrait être envisagé chez toutes les femmes enceintes, à base d’azithromycine seule ou en cas de menace maculaire associée à la pyriméthamine à partir du deuxième trimestre. Toxoplasmosis is the most common etiology of posterior uveitis. Toxoplasma gondii infection during pregnancy means either primary infection and risk of congenital toxoplasmosis or acute retinochoroiditis in a pregnant woman (risk of transmission, severity of injuries, therapeutics). Ingestion or manipulation of raw or undercooked meat is responsible for most contaminations (one- to two-thirds) in pregnant women. Toxoplasmosis seroprevalence is high in Europe, up to 54 % in southern European countries. Primary prevention advice is proposed to immunocompetent pregnant women who are seronegative for toxoplasmosis. The risk of transplacental transmission congenital toxoplasmosis during pregnancy is analyzed. The ocular lesions include retinochoroiditis and a number of other lesions. The departments of ophthalmology and of parasitology of Croix-Rousse University Hospital (Hospices Civils de Lyon) is currently following one of the largest cohorts of children infected with T. gondii (430 children alive in 2005). Our overall transmission rate during primary infection was 30 %. Retinochoroiditis incidence was 24 % in our prospective cohort. During follow-up, recurrences appeared in 29 % of cases. Acute toxoplasmic retinochoroiditis in pregnancy could be a risk of transplacental transmission due to potential parasitemia. Practices in cases of suspected or proved congenital infection are discussed. The antiparasitic drugs authorized during pregnancy are azithromycin and pyrimethamine. Azithromycin can be used alone but an association with pyrimethamine during the second trimester is useful in case of macular threat." @default.
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• W1997538244 date "2010-05-01" @default.
• W1997538244 modified "2023-09-26" @default.
• W1997538244 title "Toxoplasmose et grossesse" @default.
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• W1997538244 doi "https://doi.org/10.1016/j.jfo.2010.03.002" @default.
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