Maternal-fetal transmission

<p> In this review, we discuss how to counsel pregnant women and their spouses about maternal-fetal transmission of Toxoplasma gondii （T. gondii）, cytomegalovirus（CMV）, and Treponema pallidum （T. pallidum）.</p><p>1. Congenital toxoplasmosis:</p><p> Because congenital toxoplasmosis is caused only by maternal primary T. gondii infection during pregnancy, it is important to estimate when maternal primary infection was established. Pregnant women with suspicion of primary T. gondii infection can receive prophylaxis of fetal infection with spiramycin. T. gondii-DNA PCR analysis of amniotic fluid is available for prenatal diagnosis of fetal infection. Diagnosis of congenital T. gondii infection in newborns is difficult in some cases.</p><p>2. Congenital CMV infection（cCMV）:</p><p> Because cCMV can be caused not only by maternal primary CMV infection but also by nonprimary infection during pregnancy, maternal serological CMV screening can overlook cCMV from nonprimary infection. CMV-DNA PCR analysis of amniotic fluid is available for prenatal diagnosis of cCMV. There is no evidence-based fetal therapy for symptomatic cCMV, while neonatal therapy with valganciclovir will be available with health insurance coverage in Japan.</p><p>3. Congenital syphilis:</p><p> The number of women who had syphilis during pregnancy has increased. Because congenital syphilis can be prevented by maternal treatment with penicillin, maternal universal screening for syphilis is important. Treatment by intramuscular injection of benzathine penicillin for syphilis is now available in Japan.</p>