Tuesday, June 23, 2020

Eugenics and Eugenics will take you to a comprehensive understanding of TORCH screening

1. What is TORCH screening?

TORCH screening is mainly to check whether the mother who is preparing for pregnancy is infected with Toxoplasma gondii, rubella, cytomegalovirus, herpes simplex virus and other pathogens. The observed index is whether the antibodies IgG and IgM of the above pathogens are present in the maternal serum. IgG stands for long-term infection and can be pregnant without treatment; IgM stands for recent infection, and pregnancy after treatment is appropriate.

2. What does TORCH mean?

TORCH is an abbreviation for several viruses: T for Toxoplasma gondii infection; R for rubella virus infection; C for cytomegalovirus infection; H for herpes simplex virus infection; O for others, such as hepatitis B virus, HIV virus, Treponema pallidum, etc. . TORCH can infect the fetus through the placenta and birth canal, causing intrauterine infections, miscarriages, intrauterine growth retardation, stillbirths, congenital malformations, neonatal infections, and even adolescent developmental disorders.

3. When is it appropriate to check?

After TORCH infection, patient-specific antibodies IgM and IgG can increase rapidly. IgM appears early and can last 6 to 12 weeks; while IgG appears late, some antibodies can last a lifetime. Therefore, we often regard IgG positive as a previous infection, while IgM positive is used as a diagnostic indicator of the initial infection. TORCH screening is best checked 2 to 3 months before pregnancy, such as IGM antibody-positive treatment before pregnancy, and if necessary, re-examination in the early pregnancy.

4. What effect does TORCH have on mother and child?

Toxoplasma gondii is a zoonotic disease, cats and other animals are the source of infection. Acquired mild cases are often asymptomatic, but antibodies can be found in the serum; severe cases can cause various symptoms, such as high fever, muscle or joint pain, and enlarged lymph nodes. Intrauterine infection through the placenta can cause stillbirth, miscarriage, or premature delivery. After birth, it can show a series of central nervous system symptoms and congenital damage to the eyes and internal organs.

Pregnant women are usually infected with rubella from 1 to 6 weeks of pregnancy. In addition to miscarriage and embryonic death, congenital rubella syndrome can occur in babies born, causing fetal congenital cataracts, deafness, microcephaly, and heart deformities. A positive lgM antibody indicates a recent infection, and pregnancy should be terminated if necessary.

A positive cytomegalovirus lgM antibody indicates that the patient has a recent cytomegalovirus infection, but specific analysis should be combined with the clinical situation. In severe cases, it can cause fetal central nervous system and retinal dysplasia.

Herpes simplex virus mainly causes herpes stomatitis, eczema herpes, herpes keratoconjunctivitis, neonatal herpes, herpes vulvovaginitis and so on. Infections other than reproductive organs are mostly caused by herpes simplex virus type Ⅰ, while infections in the reproductive organs are mostly caused by simple herpes simplex virus type Ⅱ. Positive lgM antibody indicates recent herpes simplex virus infection, severe cases can cause miscarriage, premature delivery or fetal malformation.

Treponema pallidum can infect the fetus, causing neonatal sepsis and death. The survivors may also be congenital syphilis patients.

5. How to deal with TORCH screening?

The source of infection of Toxoplasma gondii is animals, and the route of infection is close contact with animals and raw meat. It is recommended to stay away from animals and pets during the first half of pregnancy, and be careful not to eat half-cooked meat, and pay attention to the use of raw and cooked cookware separately. People with high temperature are screened before pregnancy. IgM-positive persons are advised to get pregnant after 3 months.

Pre-pregnancy rubella virus antibody test is negative, rubella vaccine can be injected, the efficiency is up to 98%, and is life-long immunity. Cannot conceive within 3 months after vaccination, and there is no need to recheck rubella virus-related antibodies during the first trimester.

The adult infection rate of cytomegalovirus in our country exceeds 90%, and women who are planning to become pregnant can be tested for cytomegalovirus IgG antibodies before pregnancy. Those who are positive can no longer do relevant tests, and IgG can exist for life. Primary infections generally do not occur after pregnancy, but secondary infections with flu-like symptoms after pregnancy are not ruled out, and cytomegalovirus IgG antibody affinity index and IgM antibody testing can be performed if necessary.

Most adults in my country have had herpes simplex virus type Ⅰ infection, and most women have also obtained specific antibodies against herpes simplex virus, so intrauterine infections caused by such viruses rarely occur. Therefore, the detection of herpes simplex virus antibodies before pregnancy is basically not considered. If there are signs of genital herpes simplex virus infection during pregnancy, confirmed by laboratory testing, it is recommended to perform cesarean section during delivery.

Those who are positive for Treponema pallidum antibody before pregnancy need further diagnosis, timely treatment, and then pregnancy after cure. If you become infected during the first trimester, you should receive regular treatment before 16 weeks of pregnancy.

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