This article was originally published in my sina blog, get sina recommended blog post: reposted here, I hope more friends have help http://blog.sina.com.cn/s/blog_537eff8c0100qq7m.html很多孕前检查的年轻人经常会问到一个问题, we are ready to have a baby, is it no longer possible to have a cat? How can we handle the relationship between the baby and the cat? Zhang Yu, Department of Gynecology, Peking Union Medical College Hospital With the popularization of health knowledge, many people know that if they get infected with Toxoplasma gondii during pregnancy, they will give birth to silly children or strange babies. The following are possible scenarios for pregnant women infected with Toxoplasma gondii: Toxoplasma gondii infection during pregnancy can lead to intrauterine fetal death and spontaneous abortion. If the child survives and the pregnancy continues, Toxoplasma gondii may invade the fetus’ central nervous system and cause hydrocephalus, microcephaly, cerebral calcification, hepatosplenomegaly, ascites, intrauterine growth restriction, and other problems. After birth, babies face convulsions, cerebral palsy, visual and hearing impairment, mental retardation, etc., with a mortality rate of 72%. Listen, how frightening, if so generalized look, once infected with Toxoplasma gondii, is simply the end of the world, do not rush to send away the cat, even if you love again, you can not leave the root of the trouble around. The pathogenic microorganism of Toxoplasma gondii is mainly Toxoplasma gondii, and the route of infection is mainly through the ingestion of food contaminated with feline body fluids or feces, and the majority of Toxoplasma infections are through food intake, the so-called “worms from the mouth. Eating raw or undercooked meat, especially raw beef in modern times, is an important route of infection for urban populations. Workers who slaughter or transport raw meat or offal are also at risk if they eat without cleaning their hands after contact. Then there are families with cats, which can be infected through contact with cat feces. In fact, only cats infected with Toxoplasma gondii for the first time will transmit the eggs within the first two weeks of infection. Furthermore, the egg sacs in cat feces do not become infectious until they have “incubated” for one day. So, the odds of a mother-to-be having a cat that happens to be dangerous should be low. Furthermore, the only confirmed end-hosts are felines. Although dogs are intermediate hosts for Toxoplasma gondii, their feces and excrement are not contagious and contact with dogs alone will not result in Toxoplasmosis infection. The incidence of toxoplasmosis during pregnancy in foreign countries is about 0.2% to 1%, and the rate of toxoplasmosis infection in China is reported to be 4.9% to 8.4%. Pregnant women with Toxoplasma gondii infection generally have no obvious symptoms, and require medical history, such as cat ownership, exposure to its dirt, or raw meat, or unhygienic kitchen utensils (raw and cooked), to trace the source. Serological tests for Toxoplasma gondii antibodies (TOXO IgG and IgM) have some reference value, but a pregnant woman should not be blindly induced to give up the fetus because of a positive result from a blood test. Doctors will advise suspected patients to undergo further tests after 20 weeks of gestation, such as amniocentesis, percutaneous puncture for cord blood and ultrasound to make a comprehensive judgment. Toxoplasmosis in pregnancy, if treated aggressively, can reduce the incidence of congenital toxoplasmosis while reducing severe fetal damage. Early intrauterine treatment is far more effective than waiting until the child is born, and can significantly reduce the incidence of CNS sequelae, mental retardation, and retinopathy. Europe is mainly treated with spiramycin, while WHO and the United States treat with sulfadiazine and ethidiazine after 12 weeks of gestation. A 70% reduction in the rate of congenital Toxoplasma infection has been reported. Some European countries require routine screening of pregnant women for Toxoplasma gondii antibodies by performing a serum antibody test early in pregnancy, and if the test is negative (i.e., no infection has occurred), the pregnant woman is told to pay attention to prevention of infection and to review regularly; once acute infection is detected, the pregnant woman is treated with spiramycin, and amniocentesis and ultrasonography are performed on the fetus. If the fetus is proved to be infected, the mother is treated with sulfanilamide plus pyrimethamine. If the fetus is found to be significantly ill, the parents may consider terminating the pregnancy. However, it is still debated whether this approach is worthwhile. Because of the small chance of both maternal infection and fetal infection during pregnancy, British and American studies have concluded that this screening is not worth doing routinely, given the ratio of benefits to costs and the psychological problems that may result. Whether or not screening for Toxoplasma gondii infection should be performed on pregnant women is a serious public health issue that requires a national policy based on extensive detailed research data, analysis of costs and benefits, and consideration of many factors such as socioeconomics, psychology, and ethics. At present, there is no legislation to follow in this regard in China, and many hospitals perform TORCH screening on women with early pregnancy, in fact, the incidence of real intrauterine infection is not very high, and, due to the quality of the kit itself and the test method and so on, there may be a certain percentage of false positive and false negative results, which not only wastes money, but also causes anxiety and great mental burden to patients and families, and even It may cause irreparable damage. I personally prefer to recommend women to be tested for Toxoplasma gondii before pregnancy, if there is no evidence of recent infection, and to conduct health education on prevention of Toxoplasma gondii infection by: (1) pregnant women should avoid contact with cat feces, and family members should do timely cleaning of cat feces; (2) avoid contamination of water sources, vegetables, etc. by animal, especially cat feces; (3) do not eat raw meat, or half-cooked (4) Separate raw and cooked food in the kitchen, and process raw and cooked food separately, such as using two chopping boards and two knives, etc.; (5) Make it a habit to wash hands before and after meals. In this way, this part of the most harmful infection that really occurs in early pregnancy can be prevented to a large extent. It is hoped that the domestic obstetrics community can organize large-scale multicenter clinical observation experiments to reach a scientific conclusion that will guide clinical work and give the public a relatively clear guideline. Currently, many hospitals commonly perform Toxoplasma gondii antibody tests on pregnant women. In some hospitals, the tests and treatment are not standardized, and the test is a test, and the results are indifferent and untreated. Many pregnant women will come to my clinic with an apprehensive heart, with the concerns and worries of the whole family, and even with tears in their eyes, pinching a positive test sheet for consultation. What should I do if the test is positive? Should we treat or terminate the pregnancy? Others have a positive test at one hospital and a negative test at another, so which one should I trust? It is important to know that in the United States, if a primary care unit finds a positive result, it cannot be used as a basis for confirming the diagnosis and the serum must be sent to a specialized state agency for confirmatory testing. For this reason, in 2008, Professor Dong Yue, an obstetrician at Peking University First Hospital, wrote an article entitled “Re-evaluation of perinatal screening for TORCH infection”, with the aim of calling for more than just laboratory tests and learning to look at the results professionally and scientifically, and for each pregnant woman to analyze specifically the type of microorganism infected during pregnancy, the duration of infection, and specifically whether intrauterine transmission will occur for each pregnant woman or not. It is important to give individualized professional advice and not to listen to the wind and blindly induce labor whenever it is positive. Some of the pregnant women in my clinic who have prenatal checkups may give their cats away, or temporarily foster them at a friend’s house and bring them back after the risk period. If you love your cat and can’t live without it, it’s perfectly fine to leave your cat behind, but mothers-to-be should leave the cleaning of the cat’s litter and cattery to their families, not to do it themselves. If you are living with your cat, you must pay attention to the above precautions to prevent “worms” from entering your mouth. Occasionally, we encounter families that have abandoned their cats and kittens, making them strays. I just want to say that we humans should not easily abandon another existing life while we intend to create a new unknown life. The super best-selling book series “Only the Doctor Knows” has created a new style of western medical science writing, combining knowledge with stories, and has received great response. The book won the CCTV’s “2013 China Good Book” award; the only science and health book among the 25 good books recommended to readers by the Ministry of Propaganda on World Book Day 2013; the best health book in the 2013 China Writers’ Rich List; the best book of 2013 in the China Book Power List; the best-selling book of 2013 in the Xinjing Daily; the Wenjin Book Award, the 7th Wu Dayou Award for the best work of medical popularization in Taiwan.