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Gebelik ve Toksoplazmoz: Rutin tarama yapılmalı mı?

Year 2019, Volume: 4 Issue: 2, 74 - 78, 30.08.2019
https://doi.org/10.22391/fppc.396866

Abstract

Gebelik, etkenlerin transplasental yolla fetüse
ulaşıp, hastalık yapabilme potansiyelleri nedeniyle enfeksiyon hastalıkları
için özel bir dönemdir. Enfeksiyon etkenlerinin anneden bebeğe geçerek hastalık
oluşturmalarının önlenmesi, gebelik sırasında tanınmaları ve uygun şekilde
tedavi edilmelerine bağlıdır.  Bu amaçla,
gebelik sırasında çeşitli enfeksiyon hastalıklar için tarama yapılmakta, fetüs
ve yenidoğanda olabilecek hastalık ve olumsuz etkiler önlenmeye çalışılmaktadır.
Gebelerde T. gondii taraması konusunda dünyada farklı görüş ve uygulamalar
vardır. Bu derlemede, gebelikte T. gondii enfeksiyonunun dünyada ve Türkiye’de
seroprevalansı, fetüs üzerine etkileri, korunma yolları,  tarama konusundaki görüş ve önerilerin literatür
eşliğinde gözden geçirilmesi, birinci basamak hekimleri için klinik
uygulamalarda yol gösterici olması amaçlanmıştır. 

References

  • 1. Montoya JG. Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. J İnfect Dis. 2002;185(Supplement_1):P73-82. ‎ https://doi.org/10.1086/338827
  • 2. Hegab SM, Al-Mutawa SA. Immunopathogenesis of toxoplasmosis. Clin and Exp Med. 2003;3(2):84-105. ‎ https://doi.org/10.1007/s10238-003-0011-2
  • 3. Saricaoglu EM, Memikoglu KO. [Pregnancy and Toxoplasmosis]. (in Turkish). Journal of Ankara University Faculty Medicine. 2018; 71:17-22. http://dergiler.ankara.edu.tr/dergiler/36/2263/23548.pdf
  • 4. ‎Zeteroglu S. Toksoplazmosis. In: Intrauterine infections; Parasitic Infections, Cicek N, Akyurek C, Celik C, Haberal A (editors). Gynecology and Obstetrics Textbook, 2th ed, chp 64. Gunes Publishing, Istanbul, 2006;P720-72.‎
  • 5. Yazar S, Yaman O, Sahin I. [Evaluation of the Results of IgG Avidity Testing of Toxoplasma gondii in Pregnant Women] (in Turkish) Turkiye Parazitol Derg 2005; 29(4):221-3. http://parazitoloji.dergisi.org/pdf/pdf_TPD_1.pdf
  • 6. ‎Tanriverdi EÇ, Kadioglu BG, Alay H, Ozkurt Z. Retrospective Evaluation of Anti-Toxoplasma gondii Antibody Among First Trimester ‎Pregnant Women Admitted to Nenehatun Maternity Hospital between 2013-2017 in Erzurum. Turkiye Parazitol Derg, 2018; 42(2):‎‎101-5. http://cms.galenos.com.tr/Uploads/Article_21627/TPD-42-101-En.pdf
  • 7. ‎Montaya JG, Remington JS. Toxoplasma gondii. Fifth edition. New York, Churchill Livingstone. 2001;p30.‎
  • 8. ‎Torgerson PR, Mastroiacovo P. The global burden of congenital toxoplasmosis: a systematic review. Bulletin of the World Health ‎Organization. 2013; 91:501-8. https://www.who.int/bulletin/volumes/91/7/12-111732.pdf
  • 9. ‎Hill D, Dubey JP. Toxoplasma gondii: transmission, diagnosis and prevention. Clin Microbiol İnfect, 2002. 8(10):634-40. ‎ https://doi.org/10.1046/j.1469-0691.2002.00485.x
  • 10. ‎Liu Q, Wei F, Gao S, Jiang L, Lian H, Yuan B, et al. Toxoplasma gondii infection in pregnant women in China. Trans R Soc Trop Med ‎Hyg. 2009; 103(2):162-6. https://doi.org/10.1016/j.trstmh.2008.07.008
  • 11. ‎Sakikawa M, Noda S, Hanaoka M, Nakayama H, Hojo S, Kakinoki S, et al. Anti-Toxoplasma antibody prevalence, primary infection ‎rate, and risk factors in a study of toxoplasmosis in 4,466 pregnant women in Japan. Clin. Vaccine Immunol. 2012. 19(3):365-7. ‎ https://www.ncbi.nlm.nih.gov/pubmed/22205659
  • 12. Khurana S, Bagga R, Aggarwal A, Lyngdoh V, Diddi K, Malla N. Serological screening for antenatal toxoplasma infection in India. J ‎Med Microbiol. 2010. 28(2):143-6. https://doi.org/10.4103/0255-0857.62492 13. ‎Bakacak M, Bostanci MS, Kostu B, Ercan O, Serin S, Avci F. [Seroprevalance of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women] (in Turkish). Dicle Med J, 2014; 41(2):326-31. https://doi.org/10.5798/diclemedj.0921.2014.02.0425
  • 14. ‎Tekay F, Ozbek E. [The Seroprevalence of Toxoplasma gondii in Women from Sanliurfa, a Province with a High Raw Meatball Consumption] (in Turkish). Turkiye Parazitol Derg. ‎‎2007;31(3):176-9. http://www.parazitoloji.dergisi.org/pdf/pdf_TPD_266.pdf
  • 15. ‎Madazli R. Toxoplasma Infection. İstanbul; İstanbul Medical Publishing; 2017; p310. http://tmftp.org/webkontrol/uploads/files/GebelikteTaramaveOngoru.pdf
  • 16. ‎Montoya JG, Toxoplasma gondii. Wilson WR, Sande MA ed. Dundar IH translation ed. [Infectious diseases, diagnosis, and treatment]. 1st ed. ‎Istanbul: Nobel Medical Publishing, 2004; 807–16.‎
  • 17. Di Mario S, Basevi V, Gagliotti C, Spettoli D, Gori G, D'Amico R, et al. Prenatal education for congenital toxoplasmosis. Cochrane ‎Database of Systematic Reviews. 2013;(2): CD006171. https://doi.org/10.1002/14651858.CD006171.pub3
  • 18. Remington JS, Klein JO, Alpert JJ. Current concepts of infections of the fetus and newborn infant. In Infectious diseases of the fetus and newborn infant. WB Saunders ed. 2001. P9.
  • 19. ‎Bahar IH, Karaman M, Kirdar S, Yilmaz O, Celiloglu M, Mutlu D. [The Importance and Validity of anti-Toxoplasma gondii IgG, IgM, IgA Antibodies and IgG Avidity Tests in the Diagnosis of Toxoplasmosis Infection during Pregnancy] (in Turkish). Turkiye Parazitol Derg. 2005;29(2):76-9. ‎ http://parazitoloji.dergisi.org/pdf/pdf_TPD_103.pdf
  • 20. SYROCOT (Systematic Review on Congenital Toxoplasmosis) study group. Effectiveness of prenatal treatment for congenital ‎toxoplasmosis: a meta-analysis of individual patients' data. Lancet. 2007; 369 : 115-22. https://doi.org/10.1016/S0140-6736(07)60072-5
  • 21. ‎Paquet C, Yudin MH, Allen VM, Bouchard C, Boucher M, Caddy S. et al. Toxoplasmosis in pregnancy: prevention, screening, and ‎treatment. J Obstet Gynaecol Can. 2013;35(1):78-9. https://doi.org/10.1016/S1701-2163(15)31053-7
  • 22. Liesenfeld O, Montoya JG, Kinney S, Press C, Remington JS. Effect of testing for IgG avidity in the diagnosis of Toxoplasma gondii ‎infection in pregnant women: experience in a US reference laboratory. J Infect Dis. 2001;183(8):1248-53. https://doi.org/10.1086/319672
  • 23. Liesenfeld O, Press C, Montoya JG, Gill R, Isaac-Renton JL, Hedman K, et al. False-positive results in immunoglobulin M (IgM) ‎toxoplasma antibody tests and importance of confirmatory testing: the Platelia Toxo IgM test. J Clin Microbiol. 1997;35(1):174-8. ‎ https://jcm.asm.org/content/jcm/35/1/174.full.pdf
  • 24. American College of Obstetricians and Gynecologists. Practice bulletin no. 151: Cytomegalovirus, parvovirus B19, varicella zoster, and ‎toxoplasmosis in pregnancy. Obstet Gynecol. 2015;125(6):1510-25. https://doi.org/10.1097/01.AOG.0000466430.19823.53
  • 25. Goldstein EJC, Montoya JG, Remington JS. Management of Toxoplasma gondii infection during pregnancy. Clin Inf Dis. ‎‎2008;47(4):554-66. https://doi.org/10.1086/590149
  • 26. McLeod R, Kieffer F, Sautter M, Hosten T, Pelloux H. Why prevent, diagnose and treat congenital toxoplasmosis? Mem. Inst. ‎Oswaldo Cruz. 2009;104(2):320-44. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735102/
  • 27. Bénard A, Salmi R. European Toxo Prevention Study Group (EUROTOXO).Survey of European programmes for the epidemiological ‎surveillance of congenital toxoplasmosis. Euro Surveill. 2008;10;13(15). pii:18834. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740836/
  • 28. Society of Obstetricians and Gynaecologists of Canada (SOGC) (2013b) Clinical Practice Guideline. Toxoplasmosis in Pregnancy: ‎Prevention, Screening, and Treatment. J Obstet Gynaecol Can 2013;35(1 eSuppl A):S1–S7. https://www.sogc.org/guidelines/toxoplasmosis-in-pregnancy-prevention-screening-and-treatment/
  • 29. Mittendorf R, Pryde P, Herschel M, Williams MA. Is routine antenatal toxoplasmosis screening justified in the United States? Statistical ‎considerations in the application of medical screening tests. Clin Obstet Gynecol. 1999;42(1):163-73. https://www.ncbi.nlm.nih.gov/pubmed/10073309
  • 30. Saadatnia G, Golkar M. A review on human toxoplasmosis. Scandinavian j İnfect Dis. 2012;44(11):805-14. https://doi.org/10.3109/00365548.2012.693197
  • 31. Hokelek M, Uyar Y, Gunaydin M, Cetin M. [Investigation of Toxoplasma Antibodies Seroprevalence in Samsun Region] (in Turkish). J Exp Clin ‎Med. 2010;17(1):50-55. http://www.parazitoloji.dergisi.org/pdf/pdf_TPD_447.pdf
  • 32. Royal College of Obstetricians Gynecologists. http://www.rcog.org.uk/womens-health/clinical-guidance/infection-and-pregnancy-study-group-statement
  • 33. Centers for Disease Control and Prevention. Preventing congenital toxoplasmosis. Recommendations and reports. MMVR. 2000;49. ‎ https://www.cdc.gov/mmwr/preview/mmwrhtml/rr4902a5.htm
  • 34. Turkish Ministry of Health, Institution of Public Health, Women and Reproductive Health Department. [Obstetric Care and Management Guideline].(in Turkish) 2018. Ankara. https://sbu.saglik.gov.tr/Ekutuphane/kitaplar/dogumonubakim.pdf
  • 35. Müngen E. Toxoplasmosis screening in pregnancy. Perinatal Journal. 2010;18(3):69-71. http://www.perinataldergi.com/Files/Archive/tr-TR/Articles/PD-1111.pdf

Pregnancy and Toxoplasmosis: should screening be a routine practice?

Year 2019, Volume: 4 Issue: 2, 74 - 78, 30.08.2019
https://doi.org/10.22391/fppc.396866

Abstract

Because infectious agents can reach the fetus through
the placenta, pregnancy is regarded as a particular period for contagious
diseases. Identification of infections during pregnancy and appropriate
treatment can prevent fetal disorders. For this purpose, to avoid their harmful
effects on fetus and newborn, various infectious diseases are screened during
pregnancy. Toxoplasma gondii infection in pregnancy is transmitted through the
transplacental pathway leading to severe neurological sequelae such as fetal
abortion, stillbirth, intrauterine growth retardation, cranial calcifications,
blindness, deafness, and mental retardation. This can lead to serious social
and economic problems for the family and the infant, as well as society. To
prevent these sequelae, infections during pregnancy need to be identified and
appropriately treated. There are different opinions and practices in the world
regarding the screening of T. gondii during pregnancy follow-up. This review
aimed to assess the seroprevalence of T. gondii infection during gestation in
Turkey and the world, its effects on the fetus, ways of protection, and
suggestions about screening in the world and in Turkey in light of the
literature, so that this becomes a guide for clinical practice for physicians.

References

  • 1. Montoya JG. Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. J İnfect Dis. 2002;185(Supplement_1):P73-82. ‎ https://doi.org/10.1086/338827
  • 2. Hegab SM, Al-Mutawa SA. Immunopathogenesis of toxoplasmosis. Clin and Exp Med. 2003;3(2):84-105. ‎ https://doi.org/10.1007/s10238-003-0011-2
  • 3. Saricaoglu EM, Memikoglu KO. [Pregnancy and Toxoplasmosis]. (in Turkish). Journal of Ankara University Faculty Medicine. 2018; 71:17-22. http://dergiler.ankara.edu.tr/dergiler/36/2263/23548.pdf
  • 4. ‎Zeteroglu S. Toksoplazmosis. In: Intrauterine infections; Parasitic Infections, Cicek N, Akyurek C, Celik C, Haberal A (editors). Gynecology and Obstetrics Textbook, 2th ed, chp 64. Gunes Publishing, Istanbul, 2006;P720-72.‎
  • 5. Yazar S, Yaman O, Sahin I. [Evaluation of the Results of IgG Avidity Testing of Toxoplasma gondii in Pregnant Women] (in Turkish) Turkiye Parazitol Derg 2005; 29(4):221-3. http://parazitoloji.dergisi.org/pdf/pdf_TPD_1.pdf
  • 6. ‎Tanriverdi EÇ, Kadioglu BG, Alay H, Ozkurt Z. Retrospective Evaluation of Anti-Toxoplasma gondii Antibody Among First Trimester ‎Pregnant Women Admitted to Nenehatun Maternity Hospital between 2013-2017 in Erzurum. Turkiye Parazitol Derg, 2018; 42(2):‎‎101-5. http://cms.galenos.com.tr/Uploads/Article_21627/TPD-42-101-En.pdf
  • 7. ‎Montaya JG, Remington JS. Toxoplasma gondii. Fifth edition. New York, Churchill Livingstone. 2001;p30.‎
  • 8. ‎Torgerson PR, Mastroiacovo P. The global burden of congenital toxoplasmosis: a systematic review. Bulletin of the World Health ‎Organization. 2013; 91:501-8. https://www.who.int/bulletin/volumes/91/7/12-111732.pdf
  • 9. ‎Hill D, Dubey JP. Toxoplasma gondii: transmission, diagnosis and prevention. Clin Microbiol İnfect, 2002. 8(10):634-40. ‎ https://doi.org/10.1046/j.1469-0691.2002.00485.x
  • 10. ‎Liu Q, Wei F, Gao S, Jiang L, Lian H, Yuan B, et al. Toxoplasma gondii infection in pregnant women in China. Trans R Soc Trop Med ‎Hyg. 2009; 103(2):162-6. https://doi.org/10.1016/j.trstmh.2008.07.008
  • 11. ‎Sakikawa M, Noda S, Hanaoka M, Nakayama H, Hojo S, Kakinoki S, et al. Anti-Toxoplasma antibody prevalence, primary infection ‎rate, and risk factors in a study of toxoplasmosis in 4,466 pregnant women in Japan. Clin. Vaccine Immunol. 2012. 19(3):365-7. ‎ https://www.ncbi.nlm.nih.gov/pubmed/22205659
  • 12. Khurana S, Bagga R, Aggarwal A, Lyngdoh V, Diddi K, Malla N. Serological screening for antenatal toxoplasma infection in India. J ‎Med Microbiol. 2010. 28(2):143-6. https://doi.org/10.4103/0255-0857.62492 13. ‎Bakacak M, Bostanci MS, Kostu B, Ercan O, Serin S, Avci F. [Seroprevalance of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women] (in Turkish). Dicle Med J, 2014; 41(2):326-31. https://doi.org/10.5798/diclemedj.0921.2014.02.0425
  • 14. ‎Tekay F, Ozbek E. [The Seroprevalence of Toxoplasma gondii in Women from Sanliurfa, a Province with a High Raw Meatball Consumption] (in Turkish). Turkiye Parazitol Derg. ‎‎2007;31(3):176-9. http://www.parazitoloji.dergisi.org/pdf/pdf_TPD_266.pdf
  • 15. ‎Madazli R. Toxoplasma Infection. İstanbul; İstanbul Medical Publishing; 2017; p310. http://tmftp.org/webkontrol/uploads/files/GebelikteTaramaveOngoru.pdf
  • 16. ‎Montoya JG, Toxoplasma gondii. Wilson WR, Sande MA ed. Dundar IH translation ed. [Infectious diseases, diagnosis, and treatment]. 1st ed. ‎Istanbul: Nobel Medical Publishing, 2004; 807–16.‎
  • 17. Di Mario S, Basevi V, Gagliotti C, Spettoli D, Gori G, D'Amico R, et al. Prenatal education for congenital toxoplasmosis. Cochrane ‎Database of Systematic Reviews. 2013;(2): CD006171. https://doi.org/10.1002/14651858.CD006171.pub3
  • 18. Remington JS, Klein JO, Alpert JJ. Current concepts of infections of the fetus and newborn infant. In Infectious diseases of the fetus and newborn infant. WB Saunders ed. 2001. P9.
  • 19. ‎Bahar IH, Karaman M, Kirdar S, Yilmaz O, Celiloglu M, Mutlu D. [The Importance and Validity of anti-Toxoplasma gondii IgG, IgM, IgA Antibodies and IgG Avidity Tests in the Diagnosis of Toxoplasmosis Infection during Pregnancy] (in Turkish). Turkiye Parazitol Derg. 2005;29(2):76-9. ‎ http://parazitoloji.dergisi.org/pdf/pdf_TPD_103.pdf
  • 20. SYROCOT (Systematic Review on Congenital Toxoplasmosis) study group. Effectiveness of prenatal treatment for congenital ‎toxoplasmosis: a meta-analysis of individual patients' data. Lancet. 2007; 369 : 115-22. https://doi.org/10.1016/S0140-6736(07)60072-5
  • 21. ‎Paquet C, Yudin MH, Allen VM, Bouchard C, Boucher M, Caddy S. et al. Toxoplasmosis in pregnancy: prevention, screening, and ‎treatment. J Obstet Gynaecol Can. 2013;35(1):78-9. https://doi.org/10.1016/S1701-2163(15)31053-7
  • 22. Liesenfeld O, Montoya JG, Kinney S, Press C, Remington JS. Effect of testing for IgG avidity in the diagnosis of Toxoplasma gondii ‎infection in pregnant women: experience in a US reference laboratory. J Infect Dis. 2001;183(8):1248-53. https://doi.org/10.1086/319672
  • 23. Liesenfeld O, Press C, Montoya JG, Gill R, Isaac-Renton JL, Hedman K, et al. False-positive results in immunoglobulin M (IgM) ‎toxoplasma antibody tests and importance of confirmatory testing: the Platelia Toxo IgM test. J Clin Microbiol. 1997;35(1):174-8. ‎ https://jcm.asm.org/content/jcm/35/1/174.full.pdf
  • 24. American College of Obstetricians and Gynecologists. Practice bulletin no. 151: Cytomegalovirus, parvovirus B19, varicella zoster, and ‎toxoplasmosis in pregnancy. Obstet Gynecol. 2015;125(6):1510-25. https://doi.org/10.1097/01.AOG.0000466430.19823.53
  • 25. Goldstein EJC, Montoya JG, Remington JS. Management of Toxoplasma gondii infection during pregnancy. Clin Inf Dis. ‎‎2008;47(4):554-66. https://doi.org/10.1086/590149
  • 26. McLeod R, Kieffer F, Sautter M, Hosten T, Pelloux H. Why prevent, diagnose and treat congenital toxoplasmosis? Mem. Inst. ‎Oswaldo Cruz. 2009;104(2):320-44. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735102/
  • 27. Bénard A, Salmi R. European Toxo Prevention Study Group (EUROTOXO).Survey of European programmes for the epidemiological ‎surveillance of congenital toxoplasmosis. Euro Surveill. 2008;10;13(15). pii:18834. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740836/
  • 28. Society of Obstetricians and Gynaecologists of Canada (SOGC) (2013b) Clinical Practice Guideline. Toxoplasmosis in Pregnancy: ‎Prevention, Screening, and Treatment. J Obstet Gynaecol Can 2013;35(1 eSuppl A):S1–S7. https://www.sogc.org/guidelines/toxoplasmosis-in-pregnancy-prevention-screening-and-treatment/
  • 29. Mittendorf R, Pryde P, Herschel M, Williams MA. Is routine antenatal toxoplasmosis screening justified in the United States? Statistical ‎considerations in the application of medical screening tests. Clin Obstet Gynecol. 1999;42(1):163-73. https://www.ncbi.nlm.nih.gov/pubmed/10073309
  • 30. Saadatnia G, Golkar M. A review on human toxoplasmosis. Scandinavian j İnfect Dis. 2012;44(11):805-14. https://doi.org/10.3109/00365548.2012.693197
  • 31. Hokelek M, Uyar Y, Gunaydin M, Cetin M. [Investigation of Toxoplasma Antibodies Seroprevalence in Samsun Region] (in Turkish). J Exp Clin ‎Med. 2010;17(1):50-55. http://www.parazitoloji.dergisi.org/pdf/pdf_TPD_447.pdf
  • 32. Royal College of Obstetricians Gynecologists. http://www.rcog.org.uk/womens-health/clinical-guidance/infection-and-pregnancy-study-group-statement
  • 33. Centers for Disease Control and Prevention. Preventing congenital toxoplasmosis. Recommendations and reports. MMVR. 2000;49. ‎ https://www.cdc.gov/mmwr/preview/mmwrhtml/rr4902a5.htm
  • 34. Turkish Ministry of Health, Institution of Public Health, Women and Reproductive Health Department. [Obstetric Care and Management Guideline].(in Turkish) 2018. Ankara. https://sbu.saglik.gov.tr/Ekutuphane/kitaplar/dogumonubakim.pdf
  • 35. Müngen E. Toxoplasmosis screening in pregnancy. Perinatal Journal. 2010;18(3):69-71. http://www.perinataldergi.com/Files/Archive/tr-TR/Articles/PD-1111.pdf
There are 34 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology, Primary Health Care
Journal Section Review Article
Authors

Esra Cinar Tanriverdi 0000-0001-8857-3986

Zulal Ozkurt 0000-0001-5554-8768

Yasemin Cayir 0000-0001-9133-5460

Hakan Uslu 0000-0003-1478-7441

Publication Date August 30, 2019
Submission Date February 19, 2018
Acceptance Date July 22, 2019
Published in Issue Year 2019Volume: 4 Issue: 2

Cite

APA Cinar Tanriverdi, E., Ozkurt, Z., Cayir, Y., Uslu, H. (2019). Pregnancy and Toxoplasmosis: should screening be a routine practice?. Family Practice and Palliative Care, 4(2), 74-78. https://doi.org/10.22391/fppc.396866
AMA Cinar Tanriverdi E, Ozkurt Z, Cayir Y, Uslu H. Pregnancy and Toxoplasmosis: should screening be a routine practice?. Fam Pract Palliat Care. August 2019;4(2):74-78. doi:10.22391/fppc.396866
Chicago Cinar Tanriverdi, Esra, Zulal Ozkurt, Yasemin Cayir, and Hakan Uslu. “Pregnancy and Toxoplasmosis: Should Screening Be a Routine Practice?”. Family Practice and Palliative Care 4, no. 2 (August 2019): 74-78. https://doi.org/10.22391/fppc.396866.
EndNote Cinar Tanriverdi E, Ozkurt Z, Cayir Y, Uslu H (August 1, 2019) Pregnancy and Toxoplasmosis: should screening be a routine practice?. Family Practice and Palliative Care 4 2 74–78.
IEEE E. Cinar Tanriverdi, Z. Ozkurt, Y. Cayir, and H. Uslu, “Pregnancy and Toxoplasmosis: should screening be a routine practice?”, Fam Pract Palliat Care, vol. 4, no. 2, pp. 74–78, 2019, doi: 10.22391/fppc.396866.
ISNAD Cinar Tanriverdi, Esra et al. “Pregnancy and Toxoplasmosis: Should Screening Be a Routine Practice?”. Family Practice and Palliative Care 4/2 (August 2019), 74-78. https://doi.org/10.22391/fppc.396866.
JAMA Cinar Tanriverdi E, Ozkurt Z, Cayir Y, Uslu H. Pregnancy and Toxoplasmosis: should screening be a routine practice?. Fam Pract Palliat Care. 2019;4:74–78.
MLA Cinar Tanriverdi, Esra et al. “Pregnancy and Toxoplasmosis: Should Screening Be a Routine Practice?”. Family Practice and Palliative Care, vol. 4, no. 2, 2019, pp. 74-78, doi:10.22391/fppc.396866.
Vancouver Cinar Tanriverdi E, Ozkurt Z, Cayir Y, Uslu H. Pregnancy and Toxoplasmosis: should screening be a routine practice?. Fam Pract Palliat Care. 2019;4(2):74-8.

Family Practice and Palliative Care       ISSN 2458-8865       E-ISSN 2459-1505