TORCH refers to pathogens that can cause congenital intrauterine infections and perinatal infections resulting in perinatal malformations. It is the acronym for the name of a group of pathogenic microorganisms, of which T(Toxopasma) is Toxoplasma gondii, R(Rubella.Virus) is rubella virus, C(Cytomegalo.Virus) is cytomegalo, and H(Herpes. Virus) which is Herpes simplex type I/II.
TORCH serological test report form interpretation
1, IgM (+), IgG (-), indicating recent infection or false positive, can be dynamically observed IgM and IgG, need to be rechecked after 2 weeks, such as IgG positive, for acute infection, otherwise judged as false positive.
2.IgM(-),IgG(+), suggesting a previous infection, immune protection and no recurrence;
3.IgM(+),IgG(+), indicating infection, but it is difficult to determine the time of infection;
4.IgM(-),IgG(-), no secondary infection, susceptible, need to be followed up every 2 months during pregnancy.
TORCH is now not routine in pregnancy at Concordia because the false positive rate of TORCH-IgM is too high and TORCH results are often difficult to interpret.
Treatment of TORCH test results
1.Herpes simplex virus infection
Hazards: Infection in early pregnancy can cause miscarriage or fetal malformation. Its teratogenic effect is weaker than cytomegalovirus infection. Common malformations include eye malformations (such as small eyes, one-eyed, cataracts and optic papillary atrophy), neurological defects (such as cortical atrophy and dementia) and bone and skin damage.
Treatment: If the serum is positive for herpes simplex virus IgM antibody, clearing and detoxifying herbs (e.g. Panax notoginseng) can be used to inhibit the proliferation of the virus and control the infection, and the lesions are painted with 1% gentian violet to keep them dry. Since the chance of the fetus being affected is small, it is usually not necessary to terminate the pregnancy. Even if the lesion has been cured, if the first infection is less than one month old, a cesarean delivery is still appropriate.
2.Rubella infection
Risk: Rubella virus infection in early pregnancy can infect the fetus through the placenta, causing miscarriage, intrauterine growth retardation and congenital rubella syndrome (CRS).
Congenital rubella syndrome is a syndrome of fetal malformations caused by rubella virus infection. These include eye malformations (e.g., congenital cataract, microphthalmia, strabismus), microcephaly, congenital heart disease, deafness, cleft palate, short and syndactyly, hypospadias, and hemolytic anemia. The earlier a pregnant woman is infected with rubella, the higher the incidence of fetal malformations and the more severe the malformations.
Treatment: Rubella infection in early pregnancy (positive serum IgM antibodies) has a high probability of leading to malformed development of the fetus, and the pregnant mother should terminate the pregnancy. If the infection occurs in the middle or late pregnancy, prenatal diagnosis should be conducted to exclude the fetus from infection before continuing the pregnancy.
3.Toxoplasma gondii infection
Hazards: Fetal malformations caused by Toxoplasma gondii infection in early pregnancy. Mainly include: hydrocephalus, microcephaly, chorioretinitis and cerebral calcification. Bloodstream infection can cause fetal multi-organ necrotic damage, such as hepatosplenomegaly, myocarditis and thrombocytopenia. Asymptomatic infections can cause intrauterine growth retardation and preterm delivery. Infection in late pregnancy usually does not cause fetal developmental abnormalities.
Treatment: Early pregnancy should be actively tested for Toxoplasma gondii antibodies, and acute infection should be treated with antihelminthic treatment as soon as possible according to medical advice. For early and mid-term pregnancies (within 24 weeks) with positive IgM antibodies to Toxoplasma gondii, abortion or drug treatment is preferable to reduce the occurrence of intrauterine fetal infection.
4. Cytomegalovirus infection
Hazards: Early pregnancy infection can cause miscarriage and fetal death; middle and late pregnancy infection can cause fetal jaundice, hepatosplenomegaly, cerebellar malformation, hydrocephalus, cerebral softening, cataract, cytomegalovirus pneumonia, congenital heart disease, cleft lip, cleft palate, etc.
Treatment: If the serum cytomegalovirus antibodies are positive for IgM or IgG, both indicate that the pregnant mother is infected. Generally, if the infection is early in pregnancy, the pregnancy can be terminated immediately or wait until 20-24 weeks of gestation for cord blood IgM antibody, cord blood and amniotic fluid pathogen DNA test to find out whether the baby is congenitally infected. If the infection is confirmed, the pregnancy should be terminated at the appropriate time.