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Infections acquired in utero or during the birth process are a significant cause of fetal and neonatal mortality and an important contributor to early and later childhood morbidity. Advances in ultrasound, invasive prenatal procedures and molecular diagnostics have allowed in utero evaluation and given rise to more timely and accurate diagnosis in infected fetuses. Transplacental transmission of the infectious agent, even in subclinical maternal infection, may result in a severe congenital syndrome. Prenatal detection of infection is based on fetal sonographic findings and polymerase chain reaction to identify the specific agent. Nevertheless, most affected fetuses appear sonographically normal, but serial scanning may reveal evolving findings. Sonographic fetal abnormalities may be indicative of fetal infections, although they are generally not sensitive or specific. These include growth restriction, hydrops, ventriculomegaly, hydrocephaly, microcephaly, intracranial or hepatic calcifications, ascites, hepatosplenomegaly, echogenic bowel, placentomegaly, and abnormal amniotic fluid volume. When abnormalities are detected on ultrasound, a thorough fetal evaluation is recommended because of potential multiorgan involvement. The sonologist should understand the limitations of ultrasound. Patients should be counseled that ultrasound is not a sensitive test for fetal infection and that a normal fetal anatomy survey cannot reliably predict a favorable outcome.

An infection with Toxoplasma gondii during pregnancy means that the unborn baby may be infected as well. In addition to the risk that the baby may be born dead, central chorioretinitis could also occur. Pregnant women with primary infection were treated with spiramycin or a combination of pyrimethamine and sulfadiacine. A total of 153 children (1 month-1 year) were examined twice with particular attention to the macula region. Only two cases showed central retinochoroiditis. In one case the treatment was insufficient, and in the other the time between the serological examinations was too long. None of the other children showed any central pathological changes within the follow-up period. Screening methods, the appropriate treatment and the results are presented.

T-cells of the chicken tumour HPRS-1, mouse mastocytoma cells, Friend virus-transformed erythroleukaemia cells as well as normal human, mouse and chick erythrocytes were tested for their receptivity to toxoplasma infection. The studies indicate that T-cells and mastocytoma cells, which may be counted as part of the white blood cell series, have the highest invasion rate after incubation with toxoplasma. Friend-erythroleukaemia cells were less often affected; mature human, mouse and chick erythrocytes were refractory. The results suggest that cells of the white blood cell series are receptive to toxoplasma infection but that nucleated precursors of the red series may also be so, while mature erythrocytes cannot be infected. The possibility of transmission of toxoplasmosis by blood transfusion can no longer be doubted.

From 285 ejacula and 23 biopsy specimens of the testicles of men from childless marriages, no toxoplasms at all could be cultured in the mouse inoculation test. Testicles and accessory gonads of artificially infected male rabbits contained infective toxoplasms only up to the 29th day p.i. 8 artificially infected male rabbits did not transmit any agents through sexual intercourse to 13 toxoplasma-free female rabbits. One female animal became infected during the experiment. The route of infection is discussed. Experiments with ejacula of 4 artificially and freshly infected male rabbits did not lead to any Toxoplasma infection in mice, which had been inoculated with this material. From 50 testicles of sheep bound for slaughter, only in one case toxoplasms could be isolated in the mouse inoculation test. In virtue of the results in the literature and of our own experiments, the transmission of toxoplasms through sexual route does not seem to be of any vital epidemiological significance for men and animals.