Ultrasound features of fetal toxoplasmosis: a contemporary multicenter survey in 88 fetuses

Camille Codaccioni (1, 2) , Olivier Picone (1, 2) , Véronique Lambert (3) , Paul Maurice (4) , Léo Pomar (3) , Norbert Winer (5) , Laurent Guibaud (6) , Rose-Anne Lavergne (7) , Anne-Hélène Saliou (8) , Dorothée Quinio (9) , Alexandra Benachi (10) , Catherine Noel (11) , Yves Ville (12, 13) , Fabrice Cuillier (14) , Christelle Pomares (15, 16) , Nicole Ferret (17) , Denis Filisetti (18) , Anne-Sophie Weingertner (19) , Valérie Vequeau-Goua (20) , Estelle Cateau (21) , Guillaume Benoist (22) , Martine Wallon (23) , Marc Dommergues (24) , Isabelle Villena (25) , Laurent Mandelbrot (1, 2)

1 Service de gynécologie et obstétrique [Colombes]
2 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
3 Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française]
4 CHU Trousseau [APHP]
5 PhAN - Physiopathologie des Adaptations Nutritionnelles
6 Laboratoire de parasitologie et de mycologie médicale [CHU Nantes]
7 Département de Radiologie [HCL, Lyon]
8 BREST - Gynéco-Obs - Service de Gynécologie-Obstétrique
9 Laboratoire de Parasitologie et Mycologiede [CHRU Brest]
10 Service de gynécologie-obstétrique, médecine de la reproduction [Béclère]
11 Service de Gynécologie-Obstétrique [CH Renée Dubos, Pontoise]
12 UPD5 - Université Paris Descartes - Paris 5
13 Service de Gynécologie Obstétrique [CHU Necker]
14 CHU La Réunion - Centre Hospitalier Universitaire de La Réunion
15 C3M - Centre méditerranéen de médecine moléculaire
16 Laboratoire de Parasitologie-Mycologie, Nice
17 CHU Nice - Centre Hospitalier Universitaire de Nice
18 Laboratoire de parasitologie et mycologie médicale [CHU Strasbourg]
19 Département de Gynécologie-Obstétrique [CHU Strasbourg]
20 Service de gynécologie, obstétrique, médecine et biologie de la reproduction [CHU Poitiers] = Department of Gynecology, Obstetrics, Reproductive Medicine and Biology [Poitiers University Hospital]
21 Laboratoire de Parasitologie-Mycologie (CHU de Poitiers)
22 UNIL - Université de Lausanne = University of Lausanne
23 HCL - Hospices Civils de Lyon
24 CHU Pitié-Salpêtrière [AP-HP]
25 ESCAPE - Epidémiosurveillance de protozooses à transmission alimentaire et vectorielle

Objective: To describe the lesions detected by prenatal ultrasound examination in congenital toxoplasmosis (CT). Methods: We retrospectively analyzed all cases of fetal infection with T. gondii with ultrasound anomalies described by fetal medicine experts in 2009-2019 in 30 French centers. Results: Eighty-eight cases of CT were included. Forty-five (51.1%) had one or more cerebral signs only, 35 (39.8%) had cerebral plus extra-cerebral signs and 8 (9.1%) had extra-cerebral signs only. The main cerebral signs were intracranial hyperechogenic nodular foci (n=60) of which 20 were isolated, ventriculomegalies (n=44) which generally increased during follow-up, and periventricular abscesses (n=12). The main extra-cerebral signs were hepatomegaly and/or splenomegaly (n=14), small for gestational age (n=14), ascites (n=14, including 2 with hydrops), and hyperechogenic bowel (n=11). Maternal infection occurred mostly in the first or second trimester (81 cases), periconceptionally in 1 and in the third trimester in 6 cases. The first ultrasound signs were detected after a median of 7 weeks [range: 1.4; 24.0] following maternal toxoplasmosis seroconversion. Conclusion: While no sign was specific of CT, there were typical associations of cerebral signs with or without extracerebral signs. Detailed ultrasound examination could improve prognostic evaluation, as well as diagnosis of CT in settings lacking serological screening.

Domaines: Sciences du Vivant [q-bio]

Camille Codaccioni, Olivier Picone, Véronique Lambert, Paul Maurice, Léo Pomar, et al.. Ultrasound features of fetal toxoplasmosis: a contemporary multicenter survey in 88 fetuses. Prenatal Diagnosis, 2020, ⟨10.1002/pd.5756⟩. ⟨inserm-02883420⟩