Ultrasound features of fetal toxoplasmosis : diagnostic and prognostic contributions in prenatal management

Background: Congenital toxoplasmosis (CT) is a parasitic infection that can cause severe fetal damage, particularly when maternal infection occurs early in pregnancy. Although biological methods remain the cornerstone of prenatal diagnosis, ultrasound plays a key role in detecting suggestive lesions and guiding antenatal care decisions. Methods: This retrospective and descriptive study included 10 pregnant women diagnosed with confirmed Toxoplasma gondii seroconversion between 2018 and 2022 at the Department of Gynecology and Obstetrics of Ibn El Jazzar Hospital, Kairouan. Data were collected in collaboration with the Neonatology Unit and included clinical, biological, and ultrasound findings, as well as neonatal outcomes. Results: Among the 10 cases, amniocentesis was performed in 6 patients, yielding 3 positive and 3 negative PCR results for Toxoplasma DNA. Ultrasound surveillance revealed no major fetal lesions except one case of mild ventriculomegaly in a newborn with multiple congenital anomalies not attributed to toxoplasmosis. All infected infants received in utero and postnatal treatment and demonstrated normal psychomotor development over one year of follow-up. Conclusion: Ultrasound remains an essential tool in the prenatal surveillance of maternal toxoplasma seroconversion, contributing both to the detection of potential fetal damage and to the avoidance of unnecessary terminations of pregnancy. When integrated with serological and molecular diagnostics, it strengthens clinical decision-making and supports effective, conservative management.