Okay, let's tackle this question about congenital toxoplasmosis. The question is asking which statement is not true. First, I need to recall the key points about congenital toxoplasmosis.

Congenital toxoplasmosis occurs when a pregnant woman gets infected with Toxoplasma gondii and transmits it to the fetus. The main issue is that the infection can lead to severe complications in the newborn, like chorioretinitis, hydrocephalus, or intracranial calcifications. The mother might not show symptoms, but the baby can have serious issues.

Now, the correct answer is the one that's not true. Let's think about the options. If one of the options says that it's transmitted via the placenta, that's true. If it mentions that the most common transmission route is from mother to fetus during pregnancy, that's correct. But if an option states that the infection is always symptomatic in the newborn, that's not true. Many infants are asymptomatic at birth but develop symptoms later. Another incorrect point might be about treatment—like saying there's no treatment, which is wrong because pyrimethamine and sulfadiazine are used. Also, if an option says that the primary infection in the mother occurs postpartum, that's incorrect because it's during pregnancy that transmission happens.

Clinical pearls: Remember that congenital toxoplasmosis is a TORCH infection. The classic triad is chorioretinitis, hydrocephalus, and intracranial calcifications. Diagnosis is done via PCR or serology. Treatment includes spiramycin for the mother and pyrimethamine/sulfadiazine for the infant. The key is that the mother's primary infection during pregnancy leads to fetal infection, not reactivation. Also, many cases are asymptomatic at birth but can develop later.

**Core Concept**
Congenital toxoplasmosis results from *Toxoplasma gondii* transmission from a seronegative mother to the fetus during primary maternal infection. Key manifestations include chorioretinitis, hydrocephalus, and intracranial calcifications. The condition is part of the TORCH (Toxoplasma, Other, Rubella, Cytomegalovirus, Herpes) syndrome differential.

**Why the Correct Answer is Right**
The incorrect statement is that "congenital toxoplasmosis is always symptomatic at birth." In reality, **~20-30% of infants** with congenital toxoplasmosis are asymptomatic at birth but may develop ocular or neurological complications later. Early diagnosis via PCR or serology and treatment with pyrimethamine/sulfadiazine can reduce long-term sequelae.

**Why Each Wrong Option is Incorrect**
**Option A:** "Transmitted via placenta" is **true**—maternal infection during pregnancy leads to vertical transmission.
**Option B:** "Primary maternal infection causes fetal infection" is **true**—reactivation of latent infection does not transmit to the fetus.
**Option C:** "Diagnosis confirmed by TORCH panel" is **true**—IgM antibodies or PCR in amniotic fluid/infant blood are diagnostic.

**Clinical Pearl / High-Yield Fact**
**"Think TORCH"** when evaluating

✓ Correct Answer: C. IgG is diagnostic