Prenatal diagnosis of congenital toxoplasmosis with a polymerase-chain-reaction test on amniotic fluid

Details

Serval ID
serval:BIB_66791A21D6B1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prenatal diagnosis of congenital toxoplasmosis with a polymerase-chain-reaction test on amniotic fluid
Journal
New England Journal of Medicine
Author(s)
Hohlfeld  P., Daffos  F., Costa  J. M., Thulliez  P., Forestier  F., Vidaud  M.
ISSN
0028-4793 (Print)
Publication state
Published
Issued date
09/1994
Volume
331
Number
11
Pages
695-9
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Sep 15
Abstract
BACKGROUND. Congenital infection with Toxoplasma gondii can produce serious sequelae. However, there is little consensus about screening during pregnancy, and the tests used to establish a prenatal diagnosis of toxoplasmosis are complex and slow. We evaluated a simpler approach that is based on a polymerase-chain-reaction (PCR) test. METHODS. Prenatal diagnostic tests, including ultrasonography, amniocentesis, and fetal-blood sampling, were performed in 2632 women with T. gondii infection acquired during pregnancy. In 339 consecutive women, a competitive PCR test for T. gondii was performed on amniotic fluid, and its results were compared with those of conventional diagnostic tests. The PCR test targets the B1 gene of T. gondii, uses an internal control, and can be completed in a day. Positive tests were confirmed by serologic testing of newborns or by autopsy in terminated pregnancies. RESULTS. Overall, the risk of fetal infection was 7.4 percent, but it increased sharply with gestational age. Congenital infection was demonstrated in 34 of 339 fetuses by conventional methods, and the PCR test was positive in all 34. In three other fetuses, only the PCR test gave positive results, and follow-up testing confirmed the presence of congenital toxoplasmosis. The PCR test gave one false negative result but no false positive results. The PCR test performed better than conventional parasitologic methods (sensitivity, 97.4 vs. 89.5 percent; negative predictive value, 99.7 vs. 98.7 percent). CONCLUSIONS. For the prenatal diagnosis of congenital T. gondii infection, an approach based on a PCR test performed on amniotic fluid is rapid, safe, and accurate.
Keywords
Amniotic Fluid/parasitology Animals Base Sequence DNA Primers DNA, Protozoan/isolation & purification False Negative Reactions Female Fetal Diseases/*diagnosis/parasitology Humans Infant, Newborn Molecular Sequence Data *Polymerase Chain Reaction Pregnancy Pregnancy Outcome *Prenatal Diagnosis Prospective Studies Toxoplasma/genetics/isolation & purification Toxoplasmosis, Congenital/*diagnosis/parasitology
Pubmed
Web of science
Create date
25/01/2008 11:12
Last modification date
20/08/2019 14:22
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