Patient information from BMJ

Toxoplasmosis in pregnancy: what treatments work?

Last published:Feb 01, 2022

Toxoplasmosis is a common infection that can be passed on by cats. It doesn't usually make people ill. But it can harm your baby if you get it when you're pregnant.

We’ve looked at the best and most up-to-date research to produce this information. You can use it to talk to your doctor and decide which treatments are right for you and your baby.

What treatments work?

Toxoplasmosis is caused by a parasite. Parasites live inside the bodies of other living things. The toxoplasmosis parasite lives mainly in cats, although it can also infect other animals and people.

When cats are infected, the parasite comes out in their stools, and into litter boxes or soil, where it can infect you if you come in contact with it.

You can also be infected if you eat undercooked meat or drink water that contains the parasite.

Once you're infected, the toxoplasmosis parasite lives in your body, but it doesn’t usually cause problems. Your immune system protects you by keeping it in check.

And if you've had toxoplasmosis several months or more before becoming pregnant, your unborn baby will be protected, too.

But if you get toxoplasmosis while you are pregnant, or just before, it can cause serious health problems for your unborn baby.

If you do get toxoplasmosis in pregnancy, medicines may help prevent harm to your baby.

If tests suggest that you've recently been infected but your baby is not infected, your doctor may offer you an antibiotic.

This treatment is designed to reduce the chance of you passing the infection to your unborn baby.

If tests suggest that your baby has been infected, you will be offered treatment to prevent or reduce problems for your baby. You’ll probably see a specialist doctor.

Treatment for toxoplasmosis includes antibiotics. The antibiotics you need will depend on how far along your pregnancy is.

You will also need to take a type of medicine called an antiparasitic. As its name suggests, it kills parasites.

And you will also need to take a supplement called calcium folinate, which works in a similar way to folic acid. You will need to take this because the antiparasitic medicine interferes with your body's ability to absorb folic acid, a vitamin that is essential for the healthy development of your baby.

You will probably take these drugs for the rest of your pregnancy. Once your baby is born, he or she might need medicine for the first year of life, to make sure the infection is cleared.

Things you can do to avoid getting toxoplasmosis

If you're pregnant or thinking about becoming pregnant, it's important to take steps to avoid getting toxoplasmosis. Here are some precautions.

• If you have a cat, try to avoid changing its litter yourself. Have another family member do it. If you have to do it, use gloves and then wash your hands thoroughly.

  The litter box should be changed daily. It takes several days for your cat's stools to become infectious. Ideally keep your cat inside, or have someone else look after it while you're pregnant.

  Don't feed your cat raw or undercooked meat. Don't handle stray cats.

• Avoid eating undercooked meat. Cook meat to safe temperatures, using a thermometer to make sure.

• Peel or wash fruits and vegetables before eating, and wash your hands and all utensils, chopping boards, plates, and surfaces that have been in contact with raw meat, or unwashed fruits and vegetables.

• Wear gloves when you’re gardening or handling soil or sand. Afterwards, wash your hands thoroughly.

For more background information on toxoplasmosis see our leaflet Toxoplasmosis in pregnancy: what is it?