Prenatal infections

Cytomegalovirus is the commonest form of intrauterine infection to cause LD. The mother is usually symptom-free. The child has microcephaly, necrotizing haem-orrhaging encephalitis, and intracerebral calcification, and may die in early life.

Toxoplasmosis is a protozoal infection that causes LD, choroidoretinitis, and miliary intracranial calcification. Maternal infection can be detected by serologi-cal testing in pregnancy.

Rubella, if contracted by a woman during the first trimester of pregnancy, can cause LD, deafness, cataract and cardiac lesions in the child. Such cases are preventable by vaccination of girls who have not developed natural immunity to rubella in childhood.

Congenital syphilis, now rare, causes LD, deafness, keratitis, and malformed teeth, and general paralysis of the insane (GPI) develops in adolescence. Serological tests may be negative. It can be prevented by screening pregnant women and giving antisyphilitic treatment if required.

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