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

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. This article is protected by copyright. All rights reserved.