TORCH Infections in Pregnancy

Study Notes

Group of infections transmitted from mother to fetus, potentially causing fetal abnormalities, miscarriage, or stillbirth.
Includes Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes simplex virus (HSV).

Caused by Toxoplasma gondii, a protozoan commonly found in cats.
Infection occurs through ingestion of oocysts from contaminated soil or undercooked meat.
Transmission methods include contaminated food, water, and cat feces; also through organ transplants and blood transfusions.
Maternal infection can lead to congenital toxoplasmosis, especially harmful during 2nd to 6th months of gestation.
Classic symptoms in newborns include hydrocephalus, chorioretinitis, and intracranial calcifications.
Diagnosis involves serological tests (IgM, IgG) and MRI.
Treatment includes pyrimethamine, sulfadiazine, and leucovorin.

Caused by HSV type 2, primarily affecting the genital area.
Contagious through skin-to-skin contact, especially during the first outbreak.
Not transplacental but can infect the fetus during delivery.
Manifestations include skin lesions, CNS involvement (encephalitis), and disseminated disease.
Diagnosis uses HSV PCR; treated with acyclovir.

Caused by Treponema pallidum, presenting as maculopapular rash, runny nose, and jaundice in newborns.
Early findings can include skeletal abnormalities and hearing loss.
Late findings may involve facial deformities (saddle nose), Hutchinson teeth (notched), and saber shins (bowed legs).

Causes chickenpox (primary infection) and shingles (reactivation).
Maternal infection during the first trimester can lead to fetal complications such as limb atrophy and microcephaly.
Newborns can exhibit dermatomal scarring and neurological deficits.

An RNA virus transmitted via respiratory droplets.
Maternal infection presents as mild illness with a maculopapular rash.
Congenital rubella syndrome can lead to sensorineural deafness, cataracts, and cardiac malformations (e.g., PDA).
Diagnosis through serological titers and echocardiogram; no specific treatment.

A herpes virus often asymptomatic in mothers (90%).
Can cause mild febrile illness or "mononucleosis-like" symptoms.
Major risk for newborns includes congenital deafness; can also present as small for gestational age, microcephaly, and seizures.
Diagnosis involves urine testing for CMV and cranial MRI showing periventricular calcifications.
Treatment may include prolonged ganciclovir.

A non-enveloped, single-stranded DNA virus responsible for Fifth disease in children, presenting with a “slapped cheek” rash.
In adults, commonly leads to arthritis.
Particularly dangerous for fetuses, potentially causing miscarriages or hydrops fetalis due to its effects on red blood cell production.
Diagnosis often through clinical presentation and serological testing.

Maternal infections can lead to significant fetal outcomes, emphasizing the importance of prenatal care and monitoring.
Preventive measures, including vaccination and hygienic practices, are crucial for minimizing risks associated with TORCH infections.