Ans. is 'c' i.e., Spiramycin * Classic congenital toxoplasmosis is characterized by the tetrad described by Sabin in 1942: chorioretinitis, hydrocephalus, intracranial calcification and convulsion.Signs such as intracranial calcification, microcephaly, hydrocephalus, and severe intrauterine growth restriction strongly suggest in utero infection in the presence of documented maternal infection.* Maternal-fetal transmission occurs between 1 and 4 months following placental colonization by tachyzoites* There are 2 goals of drug therapy for toxoplasmosis, depending on whether or not fetal infection has occurred. If maternal infection has occurred but the fetus is not infected, Spiramycin is used for fetal prophylaxis (to prevent spread of organisms across the placenta from mother to fetus). Spiramycin is a macrolide antibiotic that is concentrated in but does not readily cross the placenta, and therefore is not reliable for treatment of fetal infection. Use is aimed at preventing vertical transmission of the parasite to the fetus, and it is indicated only before fetal infection* It is given at a dose of 1 g (3 million U) orally every 8 hours.lt will be prescribed for the duration of the pregnancy if the amniotic fluid polymerase chain reaction is reported negative for T. gondii.* If fetal infection has been confirmed or is highly suspected, pyrimethamine and sulfadiazine are used for treatment. Pyrimethamine is a folic acid antagonist that acts synergistically with sulfonamides. This drug should not be used in the first trimester because it is potentially teratogenic. It produces a reversible, dose related depression of the bone marrow and therefore must be combined with folinic acid. The combination of pyrimethamine and sulfadiazine results in a significant decrease in disease severity.