Chagas disease in pregnancy

BACKGROUND: Chagas disease is a tropical disease now making its appearance in the United States as more immigration from Latin America occurs. Pregnant women with chronic infection with Trypanosoma cruzi may present with cardiac or gastrointestinal symptoms and transmit the infection to their fetuses. CASE: A 32-year-old Mexican woman presented with cardiac symptoms at 16 weeks' gestation. She was found to have a left anterior hemiblock on her electrocardiogram. Her indirect immunofluorescent antibody titer for T cruzi was positive at greater than 1:2048. Subsequently, she had a normal pregnancy and delivery. The infant's T cruzi immunofluorescent antibody titer was 1:256 at birth and had not declined at his 6-week follow-up. CONCLUSION: Obstetric care providers in the United States need to be familiar with American trypanosomiasis because it may present during pregnancy. Serious maternal disease is possible, and perinatal transmission may be seen in 2-10% of cases.