Infection of the hearth. TORCH infection during pregnancy. HORN-infection: interpretation of the results

Approximately two to three percent of congenital abnormalities of the fetus are perinatal infections. Most of them with primary infection are dangerous during pregnancy, and recurrence of herpes can be a threat in the process of childbirth or the postpartum period. ТОРЧ (TORCH) is an abbreviation, the abbreviated name of intrauterine infections developing most often and representing a great danger to the fetus.

TORCH infection during pregnancy. Explanation of the abbreviation

• T is toxoplasmosis.
• O - other infections (others), which are hepatitis B, C, chlamydia, listeriosis, syphilis, parvovirus and gonococcal infections. Also recently, the list was supplemented with chicken pox, HIV, and enterovirus infection.
• R is rubella.
• C - cytomegalovirus (cytomegalovirus).
• H is herpes.

There is also such a version that TORCH infections during pregnancy include only four of the above diseases, and the letter "O" in the abbreviation is not deciphered as others, but simply acts as the second letter in the word toxoplasmosis.

Use of the term

As we know, any person can be affected by rubella, cytomegalovirus, toxoplasmosis, herpetic infection. TORCH is a term that is not used for all people, but only for those preparing for pregnancy and pregnant women, the fetus and the newborn. Usually for the first time a meeting with the listed infections occurs even in childhood or adolescence. After the initial infection, the immune defense is produced. If the infection of a woman first occurred during pregnancy, fetal organs and systems (especially the CNS) can be detrimental, which increases the risk of spontaneous abortion, congenital malformations, stillbirths, malformations.

If a pregnant woman has any infection of the TORCH complex, microbes that can enter the child's body are actively circulating in the blood. If this happens, you often have to interrupt your pregnancy. The situation is complicated by the fact that in most cases, pathological symptoms are absent, and the problem is revealed only when a test for TORCH infection is carried out.

Conducting diagnostics

In order to avoid complications in the future, it is recommended that before the pregnancy or in the first trimester to undergo the examination, to find out if you already had an initial infection with TARC-complex infections or not. If it was, then you can breathe freely: there is no danger. If not, take care of your own health and take a number of preventive measures. For example, when it comes to toxoplasmosis, certain rules must be followed, which will reduce the risk of infection; About a rubella - it is possible to put an inoculation, etc. Also during pregnancy it is necessary to spend regular monitoring of a state of health concerning those infections to which you do not have protective bodies that in time to reveal a problem if suddenly she will appear. Many women are interested in how much it costs to analyze for TORCH infection. The price of complex diagnostics varies from two to five thousand rubles.

Laboratory research

As already mentioned, often after infection there are no clinical manifestations. Some lymph nodes increase, the temperature rises, a rash appears, but such signs are also nonspecific, so the diagnosis is only possible through external examination.

Laboratory analysis for TORH infection consists in determining the concentration (titres) of antibodies in the blood to the causative agents of rubella, herpes, toxoplasmosis and cytomegalovirus. If antibodies are present, then the woman in the past has already suffered this illness and has immunity to it. But if the antibody titer is very large or gradually increases, then the process is active at this particular moment. If there are no antibodies at all, it's too early to be happy. After all, there is always a risk of getting sick during pregnancy.

By the way, the severity of the symptoms is not related to the level of danger of exposure of the fetus to germs. For example, there are a lot of cases when women had bright manifestations of the disease, but the children remained healthy, and vice versa, when the patients did not observe any signs, and the fruits were badly affected.

Blood test

All mammalian species have five homologous classes of immunoglobulins, that is, they formed before the mammalian species was divided into species. This indicates the need for antibodies to survive. Immunoglobulins are special proteins that are produced when the body meets with a pathological agent. Antibodies are specific, that is, they act only on a specific agent. To clarify the specificity, the name of the immunoglobulins (Ig) is added to the name of the pathogen against which they act.

So, five classes of antibodies are distinguished: IgM, IgG, IgA, IgD, IgE. The first three of them are the most important. In a laboratory study for TORCH infection, the interpretation of the results is based on the indices of two classes of immunoglobulins: IgG and IgM. At different stages of the immune response, different antibodies appear. They are present in the blood at different times, which makes it possible for a specialist to analyze the data that showed the analysis for TORCH infection, to determine the time of infection, to predict the risks and correctly assign therapeutic measures.

IgM and IgG levels

Soon after the onset of the pathological process IgM increase, they reach their peak by the first or fourth week (depending on the type of infection), and then decrease within a few months. The duration of the presence of IgM in a significant amount with certain infections can be quite long. And then the analysis on avidity of IgG to the causative agent comes to the aid (more details about it we shall talk below).

The rapid appearance of IgM in the blood makes it possible to diagnose the disease already at the very beginning. IgG appear somewhat later - by the third week after infection; Their level grows slower, but they persist in the blood they take much longer (with some infections remain for life).

Polymerase chain reaction (PCR) and enzyme immunoassay (ELISA)

PCR can effectively detect TORCH infections. Deciphering the results, however, does not always provide answers to existing questions. With the help of such an analysis, it is possible to detect the absence or presence in the organism of the DNA of the causative agent and even to determine its type, but, for example, it will not be possible to distinguish the recent or acute infection from the carrier of the virus. The study uses blood, urine, discharge from the cervix or vagina. The accuracy of the results is 90-95 percent. The PCR method has proven itself in diagnosing asymptomatic and chronic infections. What is characteristic (and very important), it allows you to determine even the smallest number of pathogens.

ELISA is used when it is necessary to find out at what stage the pathological process is. ELISA is based on the definition of antibodies to the causative agent of the disease. The material for the study is the discharge from the cervix, vagina, urethra.

Still, the most reliable results are obtained by a blood test for TORCH infection. After all, the antibody contains the blood serum. Based on the findings, the doctor can conclude on what form of the disease a woman suffers (acute or chronic), to understand whether the disease is active or whether the patient is only a carrier of the TORCH infection. In pregnancy, blood should be examined in dynamics, only in this way it will be possible to obtain correct results. If the antibody titer rapidly increases, then there is a danger.

Preventive measures

Only a doctor can accurately interpret the tests for TORCH infection. Decryption requires the presence of certain knowledge, and you yourself can hardly understand what's what. If necessary, the specialist appoints an additional examination. He also proposes a scheme of preventive measures. Pregnant women who do not have antibodies to this or that infection need to pay special attention to a healthy lifestyle during the period of the child's bearing: move a lot, take more out of the open air, take vitamins that strengthen the immune system, fully and properly eat. For prophylaxis of toxoplasmosis, it is additionally necessary to monitor compliance with hygiene rules, avoid contact with cats. Also, during pregnancy, you should regularly give blood to the TORCH infection in order to catch in case of what, "intercept" them and take action. Further we will tell in more detail about the influence of each particular pathology on the organism.

Toxoplasmosis

This infection of the TORCH complex is extremely rare in pregnancy. Although the disease is very common, according to some sources, it affects 30 percent of all people in the world. The causative agent is toxoplasm - the parasite, whose primary host is the domestic cat - in its organism the parasite reproduces and then is released into the external environment. You can be infected through meat (undercooked or raw), dirty hands. If a person has good immunity, then toxoplasmosis does not carry danger, you can get sick without even noticing it. This is a so-called one-time illness, to which, after the first infection, permanent immunity is produced.

The only situation where toxoplasmosis becomes dangerous is the primary infection with it during pregnancy. However, the probability of this, as already mentioned, is small. According to statistical data, such an infection of the TORCH complex during current pregnancy occurs in only 1 percent of women. If the infection occurred more than six months before the onset of conception, the fetus does not threaten anything. And if the infection happened later, then the level of danger depends on what specific period of pregnancy the toxoplasm has penetrated into the body: the earlier, the higher the risk of severe consequences in fetal infection, but the lower the probability that this infection will occur at all.

Infection in the first twelve weeks is considered the most dangerous. In such cases, toxoplasmosis often leads to the development of serious lesions in the eyes, spleen, liver, nervous system in the child, and sometimes leads to fetal death. Therefore, doctors usually recommend the artificial termination of pregnancy. This once again confirms the need to test for TORCH infection before conception. The results will show whether it is possible to get pregnant now or wait six months.

Rubella

This virus disease is usually transmitted through saliva, manifested by the appearance of a rash on the body and an increase in temperature. As a rule, the pathology proceeds easily and harmlessly, after that the body develops immune protection, and it is already possible not to worry about secondary infection. Another thing is when infection occurs during pregnancy. All TORCH infections in children can lead to the development of violations, but rubella is simply deadly. At the initial stage, the eyes, the heart, the nervous tissue of the fetus are affected. Infection in the first trimester is an absolute indication for the termination of pregnancy, but if the infection occurs later, there is usually no threat to the life of the child, but it can have a variety of disorders, including developmental and growth retardation. Then you need to conduct general restorative therapy, prevention of placental insufficiency.

As in other cases, the test for antibodies to rubella should be carried out in advance, even during the planning of pregnancy. The presence or absence of danger can be judged when the analysis is done. TORCH infection, including rubella, is easy to diagnose - everything will show the level of immunoglobulins in the blood. Mandatory examination should be carried out if the woman is in contact with a person with rubella. If there are signs of acute infection, urgent measures must be taken.

Prevention of this virus disease can not be prevented, so the best thing that can be done to protect yourself is to vaccinate. It should be vaccinated before the onset of pregnancy. The introduction of a vaccine is simply necessary for those women whose blood contains no antibodies to rubella. The modern vaccine is improved to such an extent that it gives almost an absolute guarantee of protection and almost never causes negative effects, with the exception of a slight increase in temperature and redness at the injection site. The immunity produced after immunization persists for twenty years.

Cytomegalovirus

This TORCH infection in pregnant women occurs an order of magnitude more often than others, although in general this disease was discovered only in the twentieth century. Cytomegalovirus is transmitted through the blood, sexually, with the mother's milk. The degree of influence on the human body will depend on the state of immunity: if it is healthy, the disease of danger is practically not present, but if weakened, the virus can hit almost all organs and systems. And yet most people endure the infection very easily. The produced antibodies remain for life, so the disease is never reactivated.

But if the primary infection occurs during pregnancy, the consequences can become catastrophic. The situation is exacerbated by a high risk of intrauterine transmission of cytomegalovirus to the fetus. By the way, infection of the fetus can occur not only from the mother, but also from the father in the process of conception, because as in the sperm of the man also contains the causative agent. But this happens rarely, most often the infection occurs either through the fetal membranes, or through the placenta. Even during childbirth, when passing through the birth canal, infection is possible, although this option is the least dangerous for the child. But intrauterine infection is fraught with severe consequences: the fetus may die, or the child will be born with a congenital pathology, which is immediately manifested by such vices as a dropsy of the brain, jaundice, enlarged spleen or liver, brain underdevelopment, cardiac dysfunction, pneumonia, congenital malformation And so on, or makes itself felt only by the second-fifth year of life. A child may suffer from epilepsy, deafness, muscle weakness, mental retardation and intellectual development, cerebral palsy, speech inhibition. Therefore, the detection of primary TORCH infection in pregnancy is an indication for its interruption.

In the event that a woman has contracted before conception, and during the process of bearing a child, the illness worsens, such terrible consequences as described above do not arise. If during the analysis it will be determined that antibodies to cytomegalovirus are absent, that is, a woman has not yet encountered this disease, during pregnancy it will be recommended to undergo a new examination monthly, which will allow not to lose the fact of infection, if any.

If a blood test reveals that the expectant mother acts as a passive carrier of the infection, she will need to make extra efforts to maintain immunity in a healthy state. As already mentioned, cytomegalovirus can be "gifted" to a child not only by the mother, but also by the father, so the man should also be examined for the presence of antibodies.

Herpes

It should be noted that herpes is not even a disease, it is a whole group of viral diseases. The virus of the first type manifests itself in the form of a so-called cold on the lips, and the second - most often affects the genitals (it is also called urogenital herpes). Infection is transmitted by air and sexually, in addition, through the placenta can pass from mother to fetus. If the condition is triggered, herpes can manifest itself not only by damage to the mucous membranes and skin, but also by impaired functioning of the internal organs, eyes, and nervous system.

When infected with a virus, as in the case of other infections of the TORCH complex, the body develops antibodies that largely suppress the further progress of the pathological process. Therefore, often herpes causes symptoms only when the immune system is weakened. When infected during pregnancy, antibodies along with the virus itself pass from mother to fetus, so in most cases, there is no danger to the child. The life threat comes when the primary infection of the mother with a virus occurs at the initial stage of pregnancy (when the future child is laid all the systems and organs). In such a situation, the risk that the fetus will die or the baby will be born with congenital anomalies or deformities increases threefold.

When infection with urogenital herpes occurs in the second half of pregnancy, the likelihood that the baby will be born with an abnormality of development, for example, with retinal pathology, microcephaly, congenital viral pneumonia, heart disease, cerebral palsy, blindness, epilepsy, deafness. Preterm labor can also occur. If the fetus is not infected during the intrauterine period, it can occur directly during childbirth, at the time of passage through the birth canal. This is possible, if during the gestation of a child, the woman's genital herpes became aggravated and the eruptions were localized in the zone of internal genital organs and cervix. As a rule, if a situation is revealed one month before the expected birth, the woman is given a cesarean section in order to minimize the risk of infection of the baby.

The conclusion here will be the same as in the previous cases: you need to be examined before conception, and both partners should take the analysis. If an infection is detected, the doctor will prescribe a treatment, after which it will be possible to become pregnant. In this case, you will be sure that the virus will not bother you or the baby.

Finally

So, TORCH infections carry a huge danger if infection occurs during pregnancy. Prevent adverse events can be very simple: you should know in advance which infections you have antibodies, and to which - not. Based on the results, the doctor will tell you whether you can get pregnant now or wait a bit. Begin to take care of the health of your future baby even before his conception takes place! All the best!