TORCH Infections In Pregnancy: Causes, Symptoms And Treatment

TORCH infection is an acronym used for a group of pathogenic infections contracted by a pregnant woman and passed on to the developing fetus through the placenta. This infection can be caused by virus, bacteria and protozoa. TORCH infections in mother can adversely affect the fetus.

The fetus can be born with abnormal growth, congenital defects or even die inside the womb. These defects in fetus can last throughout life; such as deafness, microcephaly (small brain and head), optic atrophy, enlarged spleen and liver, etc.

The five infections that comprise to form acronym of TORCH are as follows:

  • T: – Toxoplasmosis.
  • O: – Other Infections (congenital syphilis, varicella zoster virus, measles virus, adenovirus, HIV, parvo virus B19).
  • R: – Rubella.
  • C: – Cytomegalovirus.
  • H: – Herpes simplex virus 2.

TORCH infection is extremely important to be diagnosed on time so that proper treatment can be commenced.

Causes Of TORCH Infections

Transmission of TORCH infection occurs via placental blood flow during the period of pregnancy of an infected woman. It can also occur at the time of labor when the fetus is passing through the birth canal.

  • Toxoplasmosis: It is caused by a parasite called toxoplasma gondi. This organism is often present in cats.
    Humans are intermediate host.
  • Other Infections: Other infections such as syphilis is sexually transmitted disease, Hepatitis B and E virus are spread through sexual contact, use of unsterilized needles, shaving with infected blade, Varicella zoster virus can cause chickenpox. If mother suffers from any of these infections during her pregnancy or harbors the pathogen in her body, the fetus inside her womb can be affected.
  • Rubella: This infection is caused by rubella virus. If a pregnant woman suffers from rubella during the first three months of pregnancy, the risk of congenital birth defects in the fetus is very high.
  • Cytomegalovirus (CMV): This virus can spread easily through sexual contact, saliva or from blood transfusion.
  • Herpes simplex 2: It is a virus disease, mainly transmitted through sexual contact with an infected person. The baby can be infected with the virus while passing through the birth canal.

Signs And Symptoms Of TORCH Infections

There are host of infections that are grouped under one umbrella term TORCH. The symptoms manifested may therefore sometimes differ with different infective conditions. The clinical symptoms may be seen soon after birth or may develop later in life. For example:

  • Toxoplasmosis infection can cause death of the infant if the infection in contracted in first 3 months. During the second trimester it can cause enlarged head, retinal damage leading to vision loss. Other symptoms with which the fetus may be born are; microcephaly, fever, skin rash, hearing loss, jaundice, enlarged lymph nodes.
  • The child born with congenital syphilis may have skin rash, enlarged lymph nodes, tiny red spots under the skin due to bleeding from tiny blood vessels, perforation in upper palate, hearing loss, bleeding gums and widely spaced small teeth.
  • Rubella infection in pregnant woman can cause these symptoms in the child after birth. They are; cataract, retinal damage, jaundice, hepatosplenomegaly. Still births are common in pregnant woman who has suffered from rubella during her pregnancy.
  • Child born to mother suffering from herpes simplex infection may present with skin rash, eye problems, ulceration in mouth, palate, and tongue, poor feeding, fever, hepatitis, etc.

Diagnosis: If the doctor during the physical examination of the newborn finds some abnormality, he may recommend blood tests, urine test, and spinal fluid test, to rule out TORCH syndrome. Often blood and urine are sent for culture so as to identify specific pathogen. The doctor may also recommend PAP smear during pregnancy to know if the woman is suffering from herpes infection.

Treatment For TORCH Infections In Pregnancy

Early detection and prompt treatment are key factors to resolve many health problems that may occur to the newborn or the child later in life who has been exposed to TORCH infection in utero.

Certain TORCH infections such as toxoplasmosis or syphilis can be treated with antibiotics, if the mother has been diagnosed with this infection during her pregnancy.

Viral infection does not have any particular treatment. However, an unimmunized woman takes rubella vaccine few months before she plans to conceive, will be safe from contracting the infection during her pregnancy.

If the mother is affected with herpes simplex virus, a planned Cesarean section will prevent exposure of the fetus to the virus present in birth canal.

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