Encyclopedia TORCHTORCH refers to pathogens that can cause congenital intrauterine infections and perinatal infections resulting in perinatal malformations. It is the abbreviation for the English 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. Basic information TORCH infections 1, Toxoplasma (TOX): 2, Rubella virus (RV): 3, Cytomegalovirus (CMV): 4, Herpes simplex virus (HSV type I, II): TORCH test significance of TORCH test method of reading TORCH serology test report form 1, 1, IgG positive IgM negative 2, 2, IgG negative IgM negative 3. 3, IgG-positive IgM-positive 4, 4, IgG-negative IgM-positive Treatment of various TORCH test results 1, 1, Herpes simplex virus infection 2, 2, Rubella infection 3, 3, Toxoplasma gondii infection 4, 4, Cytomegalovirus infection TORCH and jaundice Prevention and treatment measures to be improved TORCH social significance of basic information TORCH infections 1, Toxoplasma gondii (TOX ): 2, Rubella virus (RV): 3, Cytomegalovirus (CMV): 4, Herpes simplex virus (HSV type I, II): TORCH test significance of TORCH test method of reading TORCH serological test report form 1, 1, IgG positive IgM negative 2, 2, IgG negative IgM negative 3, 3, IgG positive IgM positive 4, 4, IgG negative IgM positive various TORCH test results treatment 1, 1, herpes simplex virus infection 2, 2, rubella infection 3, 3, Toxoplasma gondii infection 4, 4, cytomegalovirus infection TORCH and jaundice prevention and treatment measures to be improved?The social significance of TORCH unfolded basic information this group of microbial infections share common features, that is, they can cause mother-to-child infection. Pregnant women are susceptible to primary infections due to endocrine changes and decreased immunity, and to recurrent infections due to the activation of potential viruses in previously infected women. When viraemia occurs in pregnant women, the virus can spread through the placenta or birth canal and infect the fetus, causing premature birth, miscarriage, stillbirth or malformation, as well as causing damage to multiple systems and organs in the newborn, resulting in various degrees of mental retardation and other symptoms. Especially in the first trimester of pregnancy, when the embryo is in the organ-forming stage, infection by the virus can destroy cells or inhibit cell division and proliferation. TORCH infection affects the quality of the population and has an important relationship with eugenics. Toxoplasma gondii (TOX) infection: Fetal malformations caused by Toxoplasma gondii infection in early pregnancy include: hydrocephalus, microcephaly, chorioretinitis and cerebral calcification. Bloodstream infection can cause fetal multi-organ necrotic damage, such as hepatosplenomegaly, myocarditis and thrombocytopenia. Rubella virus (RV): RV is mainly transmitted through the respiratory tract and can cause fetal teratogenicity in pregnant women. The virus infects the fetus through the placenta to form a congenital infection called congenital rubella syndrome (CRS), mainly congenital cataracts, congenital heart disease and neurological deafness, with little effect in those infected after 20 weeks. The earlier the rubella infection occurs in pregnancy, the more severe the teratogenicity of the fetus. Cytomegalovirus (CMV): Infection can cause intrauterine fetal growth retardation, microcephaly, encephalitis, retinal chorioretinitis, jaundice, hepatosplenomegaly, hemolytic anemia, etc. The neonatal mortality rate is high, and the rate of CMV infection due to perinatal breast milk detoxification is 63%. Herpes simplex virus (HSV type I and II): HSV is usually latent in the ganglia. Maternal physiological changes during pregnancy activate HSV, and infection in early pregnancy can destroy the germinal surface leading to miscarriage, and in mid- and late pregnancy can cause fetal and neonatal morbidity, although few malformations occur. Edit this section TORCH detection significance of TORCH syndrome patients cause miscarriage and stillbirth in pregnant women, serious mental retardation after birth, unable to take care of themselves, causing a great mental and economic burden. There are about 26,000 children born with TORCH in China every year, an average of 3 per hour, posing a great threat to eugenics and population quality, so its infection diagnosis and treatment work has attracted widespread attention. TORCH infection is one of the most important factors that seriously endanger the health of newborns. It can lead to multi-organ damage and a series of serious sequelae taunt . Therefore, in order to reduce the birth rate of sick and disabled children and improve the quality of the birth population, clinical workers should further strengthen the publicity and education for pregnant women and actively do serological screening for TORCH infection in order to detect adverse pregnancies early and deal with them in a timely manner. Serological screening for TORCH infection is of great practical importance for eugenics, and TORCH testing should be routinely performed in clinical practice. EditorialMethods of TORCH detectionAt present, the most convenient and commonly used method of early screening in China is to use ELISA enzyme immuno-diagnostic technique.ELISA enzyme immunoassay method is to detect specific IgM and IgG antibodies in human serum.Since IgM is an indicator of early infection and has great impact on the fetus, the detection of IgM is of great concern.The detection of specific IgM in the placenta is ELISA reagents are widely used in general laboratories because of their stability, high sensitivity, specificity and low cost, but they are generally used for qualitative and not quantitative purposes. The current quantitative assay uses chemiluminescence, and the methodological evaluation shows that the chemiluminescence CLIA assay has high sensitivity, low intra- and inter-batch variability, and good anti-interference ability, which can remove the possible interference of viral IgG antibodies and rheumatoid factor in the specimen, and is suitable for routine clinical work. Editor’s note: After TORCH infection, the patient-specific antibodies IgM and IgG may rise rapidly, with IgM appearing early and lasting 6-12 weeks and IgG appearing late but lasting a lifetime. Therefore, we often regard IgG positivity as a previous infection, while IgM positivity is used as a diagnostic indicator for the first infection. 1, IgG-positive IgM-negative had been infected with this virus, or vaccinated, and has developed immunity, the fetal baby is very unlikely to be infected. 2, IgG negative IgM negative indicates that the pregnant woman is a susceptible person. It is best to repeat the IgG test during pregnancy to observe if there is a positive turn. 3.IgG positive IgM positive indicates that the pregnant woman may be primary infected or reinfected. It can be identified by IgG affinity test. 4.IgG negative IgM positive has been infected recently or is an acute infection; it may also be a false positive IgM caused by other interfering factors. Need to recheck after 2 weeks, such as IgG positive turn, for acute infection, otherwise judged as false positive. Edit this paragraph of various TORCH test results processing 1, herpes simplex virus infection hazard: pregnant women infected 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, use heat-clearing and detoxifying herbs (such as Panax notoginseng) to inhibit the proliferation of the virus and control the infection, and keep the lesions dry with 1% gentian violet. Since the chance of the baby 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 hazards: early pregnancy infection rubella virus through the placenta can infect the fetus, causing miscarriage, intrauterine growth retardation and congenital rubella syndrome (CRS). Congenital rubella syndrome is a syndrome of fetal malformations caused by rubella virus infection. It mainly includes eye malformations (such as congenital cataract, microphthalmia, strabismus), small head size, congenital heart disease, deafness, cleft palate, short and parallel fingers, 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 (positive serum IgM antibodies) in early pregnancy 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 and late stages of pregnancy, prenatal diagnosis should be conducted to exclude the fetal baby from infection before continuing the pregnancy, and the pregnant mother should be cautious with the medication, mainly symptomatic treatment, and pay attention to avoid the damage of the medication to the fetal baby. 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 abnormal fetal development. 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 pregnancy (within 24 weeks) with positive Toxoplasma IgM antibodies, it is better to abort or give medication 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 section causes 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. EditorialTORCH and jaundiceTORCH infection is one of the important causes of neonatal hyperbilirubinemia. In neonatal hyperbilirubinemia cases, children with TORCH infection have no obvious clinical symptoms at birth and first show jaundice, and the duration of jaundice is significantly longer in the TORCH-infected group than in the non-TORCH-infected group, which is due to the fact that TORCH infection first inhibits glucose This is because TORCH infection first inhibits the activity of glucuronosyltransferase, which affects bilirubin metabolism and delays the resolution of jaundice, and TORCH infection has a certain incidence in neonatal hyperbilirubinemia, which is one of the important causes of neonatal hyperbilirubinemia. To improve euglycemia, it is the physician’s effort to accurately diagnose the presence and extent of TORCH infection before the birth of a newborn, so emphasis should be placed on prenatal screening for TORCH infection, and routine screening should be performed in neonatal jaundice. Editorial preventive and therapeutic measures need to be improved To date, various preventive measures for intrauterine infections are not well developed. For cytomegalovirus infection, high-valent immunoglobulin and inactivated vaccines are ineffective, and there are still difficulties in the application of live attenuated vaccines; for herpes simplex virus and toxoplasma infection, both vaccines are under development; for rubella virus infection only, live attenuated rubella vaccine is available and can be given once to girls aged 15 months to 12 years, but it cannot be used in pregnant women. Therefore, the prevention of TORCH infection should focus on personal hygiene and protection of pregnant women. For example, pregnant women should avoid contact with TORCH patients and animals during pregnancy; do not consume undercooked meat and food, not to mention raw meat; wear gloves when touching raw meat and handling cat and dog feces, or at least wash hands carefully and repeatedly afterwards; and feed cooked food to domestic cats and dogs. In addition, it is important to screen pregnant women for prenatal TORCH infection. If an infection is found early in pregnancy, termination of pregnancy may be considered; pregnant women with syphilis or toxoplasmosis should be treated; pregnant women with cytomegalovirus or herpes simplex virus infection in the reproductive tract should be delivered by cesarean section. Regarding the treatment of intrauterine infection, in addition to general supportive treatment and enhanced nursing care for children, herpes simplex virus infection can be treated with acyclic guanosine, propoxyphene or adenosine, but there are certain toxic side effects; for congenital melioidosis, penicillin can be used, and if penicillin allergy can be switched to vincristine; for toxoplasmosis, sulfadiazine, ethacrynic acid or spiramycin can be used, and all the above diseases should be treated under the All these diseases should be treated under the guidance of an experienced physician. It is important to note that even uninfected infants in utero can be infected through the hands, droplets, utensils, clothing, and even mother’s milk and blood transfusions of caregivers. Therefore, health care workers should be better managed and transferred out of their positions as soon as they are found to be carriers of the virus. Blood transfusion workers should be screened for TORCH infection to eliminate blood-borne infections. Lactating mothers whose milk is found to contain the virus should stop breastfeeding. From the perspective of eugenics, it is necessary to conduct TORCH-specific antibody screening for pre-pregnant women and regular monitoring of IgM-positive women, especially for those with a history of pet ownership or exposure or other exposures who should undergo TORCH-specific antibody screening 3 to 5 months prior to planned pregnancy. Those who are RV-IgG negative should be vaccinated promptly to obtain immunity, and those who are TORCH-IgM positive should postpone the planned pregnancy to avoid possible acute infection stage. If possible, the appropriate TORCH-specific antibody test should be repeated at 1 to 3 months of gestation.