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Screening for TORCH Infections - TORCH Screen


Overview & Description

toxoplasma infection, also called toxoplasmosis \ \other infections, such as hepatitis B, syphilis, and herpes zoster, the virus that causes chickenpox \ \ rubella, the virus that causes German measles\ \ cytomegalovirus, or CMV\ \ herpes simplex virus, the cause of genital herpes \ ',CAPTION,'TORCH Infections');" onmouseout="return nd();">TORCH is an acronym for a special group of infections. These may be acquired by a woman during pregnancy. "TORCH" stands for the following infections:

  • toxoplasma infection, also called toxoplasmosis
  • other infections, such as hepatitis B, Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\ ',CAPTION,'Syphilis');" onmouseout="return nd();">syphilis, and herpes zoster, the virus that causes chickenpox
  • rubella, the virus that causes German measles
  • cytomegalovirus, or CMV
  • herpes simplex virus, the cause of genital herpes
  • Children, men, and non-pregnant women can also catch these infections. However, the TORCH infections are mainly important because they can be transmitted to the fetus while it is in the womb. If a mother is exposed to these infections during the first 5 months of pregnancy, serious fetal complications may occur. These include:

  • miscarriage
  • congenital heart disease, or heart defects that are present when the child is born
  • cataract, or a clouding of the lens of the eye
  • blindness, or significant vision change
  • hearing impairment, including deafness
  • small head size, also called microcephaly
  • communication\ \education, including reading, writing, and basic math\ \motor function\ \personal care, such as bathing, dressing, eating, and toileting\ \social skills\ \thinking skills, such as decision making, problem solving, and self-direction\ \working\ ',CAPTION,'Mental Retardation');" onmouseout="return nd();">mental retardation or other learning, behavioral, or emotional problems
  • low blood counts, also called anemia
  • liver or spleen enlargement
  • pneumonia
  • Who is a candidate for the test?

    Any pregnant woman who has been exposed to the above infections may be a candidate for screening. A pregnant woman who believes she has been exposed should speak with her healthcare provider right away.

    How is the test performed?

    A small amount of blood is withdrawn from a vein in the arm. This blood is sent to the lab for testing. A blood test called an antibody titer is used to detect antibodies to any the suspected TORCH organism.

    An antibody is a special protein made by the immune system that helps fight infections. The body makes specific antibodies in response to specific infections. These antibodies are made in large amounts when an infection occurs. When the initial sample of blood is taken shortly after exposure, the body may not have had enough time to start making antibodies yet. However, a woman can have antibodies to the infection in her blood because of an old infection or from a vaccine.

    A second sample of blood is usually taken 10 to 21 days later to see if blood antibody levels or titers against the infection are rising. This generally means that a new infection, instead of an old one, is present. If an old infection is the cause of antibodies in the blood, the level of antibodies will not rise with the second blood sample, as it does with a new infection. This is important, because old infections usually do not result in harm to the fetus, except in the case of herpes. Only infections that are newly caught during the early part of pregnancy usually put the fetus at risk.


    Preparation & Expectations

    What is involved in preparation for the test?

    No preparation is needed for this test.


    Results and Values

    What do the test results mean?

    A "negative" test means that the woman does not seem to have a new toxoplasma infection, also called toxoplasmosis \ \other infections, such as hepatitis B, syphilis, and herpes zoster, the virus that causes chickenpox \ \ rubella, the virus that causes German measles\ \ cytomegalovirus, or CMV\ \ herpes simplex virus, the cause of genital herpes \ ',CAPTION,'TORCH Infections');" onmouseout="return nd();">TORCH infection. It is important to realize that there are many other causes of birth defects. In other words, a negative TORCH screen does not guarantee a healthy baby.

    A positive test means that high or increasing levels of antibodies were detected. This generally means that the mother has caught a new TORCH infection. A positive test does not mean that the fetus will catch the infection or develop birth defects. However, close monitoring of the pregnancy may be advised.

    Pregnancy ultrasound may be used to look for birth defects. This is an x-ray test that uses sound waves to look at the fetus inside the womb. The option of ending the pregnancy, or having an elective abortion, may be discussed. The exact risk of having a child with birth defects depends on the specific TORCH infection. It also depends on when during the pregnancy the mother caught the infection. The healthcare provider will discuss the results in the event of a positive test.


    Attribution

    Author:Eva Martin, MD
    Date Written:
    Editor:Slon, Stephanie, BA
    Edit Date:07/21/00
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:07/13/01

    Sources

    Essentials of Obstetrics and Gynecology, 1996, Hacker et al.


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