I. Introduction of the Eugenics IV (5) test
The so-called “Eugenics IV test”, also known as “Infection IV test”, is designed to check whether the mother of a woman preparing for pregnancy has Toxoplasma gondii, rubella, cytomegalovirus and herpes simplex virus infections. The presence of antibodies to these pathogens – IgM and IgG – in the maternal serum is an indicator of the presence of IgM, an acute antibody, indicating a recent infection, and IgG, a chronic antibody, indicating a previous infection.
Toxoplasma gondii infection in pregnant women may cause hydrocephalus, microcephaly, and central nervous system dysplasia in the fetus; rubella virus infection may also infect the fetus and cause congenital cataracts, eye defects, ear defects, deafness, microcephaly, and heart malformations, i.e., “congenital rubella syndrome”; cytomegalovirus The active infection of cytomegalovirus may cause the fetus to develop brain, central nervous system, retina, etc.; the infection of herpes simplex virus may induce miscarriage, premature birth, malformation, etc.
The so-called “five tests for eugenics” are the above-mentioned “four tests for infections” plus some other tests for reproductive tract infections, mainly the syphilis spirochete antibody test which has a greater impact on fertility and fetus. Syphilis spirochetes can infect the fetus, resulting in sepsis and death of the newborn, and those who survive may also be congenital syphilis patients, even if they are asymptomatic in childhood, they may show up as syphilis stage 3 in adolescence.
The initials of the five eugenic tests in English are arranged to form an English word (torch, torch), so they are also called “TORCH tests”. In general, the above five pathogens can infect the fetus through the placenta and birth canal, causing intrauterine infection, miscarriage, intrauterine growth retardation, stillbirth, congenital malformation, neonatal infection, and even developmental disorders in adolescence. The clinical manifestations are complex and varied, ranging from invisible to overt infections, from fetal death to serious malformations and sequelae, and are a serious risk to the mother, fetus and newborn, which should be prevented by active measures. Therefore, the eugenics five tests are best carried out before pregnancy, and then rechecked in early pregnancy if necessary.
Response to the results of the five preconception eugenics tests
1.Toxoplasma gondii
The source of Toxoplasma gondii infection is animals, and the way of infection is close contact with animals and raw meat consumption. Women who are planning to get pregnant should stay away from pets and animals and not consume raw meat and milk products six months before pregnancy to avoid Toxoplasma infection. Women who have a history of animal contact or raw food habits can be tested for Toxoplasma gondii antibodies before pregnancy and those who are IgM positive are advised to wait 3 months before pregnancy.
2.Rubella virus
Rubella is an acute respiratory infection characterized by fever, skin rash and swollen lymph nodes behind the ears.
Women who are planning to get pregnant should be tested for rubella virus antibodies six months before conception. If IgG antibodies are positive, this indicates a previous rubella virus infection and immunity, so there is no need for rubella virus-related antibody testing or rubella virus vaccination, and if rubella virus IgG antibodies are negative, rubella virus vaccination can be given three months before conception. Rubella vaccination is 98% effective and is a lifelong immunity. If the rubella vaccine is administered before conception.
(1) It is important to use careful contraception and not to conceive for 3 months;
(2) it is not necessary to retest for rubella virus-related antibodies in early pregnancy.
If you have not been tested for rubella virus antibodies before pregnancy, and you are found to have rubella virus infection in early pregnancy, terminate the pregnancy and conceive again after 6 months.
3. Cytomegalovirus
For cytomegalovirus infection, there is no safe and effective treatment drug and no vaccine. Primary infection in early pregnancy can cause much more damage to the fetus than secondary infection, and the main preventive measure is timely and accurate detection of primary infection in early pregnancy.
Women who are planning to get pregnant can be tested for cytomegalovirus IgG antibodies before conception, and those who are positive can stop doing the relevant tests. Those who are negative can be tested for cytomegalovirus IgG antibody affinity index and IgM antibody in early pregnancy.
4.Herpes simplex virus
There are two types of herpes simplex virus, type I and type II. Type I mainly causes infections of the skin and mucous membranes and organs above the waist and outside the genitals, while type II mainly causes infections below the waist and in the genital area. Most adults in China have had herpes simplex virus type I infection and most women have acquired specific antibodies against herpes simplex virus, so intrauterine infections caused by these viruses rarely occur. According to the literature, only a dozen cases of intrauterine infection with herpes simplex virus occurred worldwide in the 20 years from 1983 to 2003. Therefore, basically, this test can be disregarded before and during pregnancy. If there are signs of herpes simplex virus infection in the genital tract during pregnancy and confirmed by laboratory tests, a cesarean section is recommended during delivery.
5. Syphilis spirochetes
Syphilis spirochete infection is one of the traditional classical STDs and a global sexually transmitted disease. In the past two or three decades, the incidence rate in China has been on the rise.
Syphilis spirochete antibody test should be conducted before pregnancy, and those who are positive need further diagnosis and timely treatment. Cure before pregnancy. If infected early in pregnancy, the patient should receive regular treatment before 16 weeks of pregnancy.