Pregnancy is a serious test for the female body. During this period of life, the immunity of the future mother decreases, which means that she and her baby become defenseless for the action of various infections and viruses.
Some diseases are considered relatively safe and easy to treat, while others can cause serious health complications for both mother and fetus.
In obstetrics and gynecology, there is a group of diseases that can cause a delay in the intrauterine development of a baby, and the appearance of various defects in him. They are called TORCH infections.
How does the abbreviation stand for?
TORCH infections are a group of diseases that can be deciphered by the first capital letters of their Latin names. So,
T – Toxoplasmosis (toxoplasmosis).
O – Others (others, that is, various sexually transmitted infectious diseases that pose a threat to the life and health of the mother and fetus).
R – Rubella (rubella).
C – Citomegalovirus ( cytomegalovirus infection).
H – Herpes simplex virus (herpes simplex virus).
In ordinary life, not complicated by pregnancy, the human body is difficult, but still copes with these diseases. But weakened by the serious processes of the development of a new life, a woman’s body is often powerless against the attack of severe infections. This causes the development of congenital pathologies, defects in the unborn baby, can provoke premature birth or death of the fetus even before birth.
The danger of diseases is their almost asymptomatic course. But the absence of vivid symptoms of the disease does not prevent harmful microorganisms from infecting the cells of a developing organism, leading to the appearance of incurable diseases.
The first trimester of pregnancy is the time when the components of the human body of the unborn child are just being formed. If the virus penetrates into cells that are in a state of growth and development, it will lead to a change in their structure and further improper formation of the organ.
Toxoplasmosis, which is part of TORCH infection, is a disease provoked by infection with parasites. The most likely carrier of this virus is a pet (usually a feline). A girl can get infections while cleaning the cat’s tray, since the favorite habitat of parasites is excrement.
Often expectant mothers are infected with toxoplasmosis long before pregnancy, and most of them are not even aware of it. These patients already have immunity to infection, so secondary infection does not pose a threat to their health.
According to medical statistics, when a future mother is infected with toxoplasmosis in the first trimester, the risk of transmitting the virus to the baby is 20%, in the second trimester – 30%, and in the third already 60%.
Preventing the entry of the virus into the blood of a pregnant woman is very simple. To do this, you need to follow the rules of personal hygiene familiar from childhood:
- wash hands thoroughly before eating;
- pour boiling water over fruits and vegetables, even if they grew up in their own summer cottage;
- fry or boil meat well.
During pregnancy, it is worth entrusting the duty of cleaning the cat’s tray to other household members or doing it with thick rubber gloves.
“Other” TORCH infections are the most dangerous for human health of any age and gender.
This complex includes:
- chicken pox;
- hepatitis B and C;
- HIV (human immunodeficiency virus).
Syphilis is caused by the bacterium Treponema pallidum, which is transmitted through unprotected intimate contact from the carrier of the infection to a healthy person, so you can only become infected with the disease during sex. If this happens, the virus will enter the patient’s bloodstream and be transmitted to the unborn baby.
The danger to the fetus is the secondary period of maternal syphilis, that is, one that was infected earlier than three years before pregnancy.
Why is this TORCH infection dangerous?
Syphilis can lead to spontaneous abortion (this usually happens at 12-16 weeks), premature birth, the birth of a baby already infected with this disease. Moreover, the manifestations of the disease can occur both after the baby is born (early syphilis), and at school age, from 7 to 14 years (late syphilis).
Chlamydia. Cause chlamydia disease, sexually transmitted during unprotected sex with an infected partner, that is, it also refers to sexually transmitted diseases. Often, chlamydia practically does not manifest itself, and only a special analysis allows to detect the presence of chlamydia – a smear for the vaginal microflora. Chlamydia is dangerous because it leads to various complications of pregnancy, its spontaneous termination in the early stages or premature birth. Also, in the future baby, chlamydia provokes damage to the mucous membranes of vital organs (conjunctivitis, otitis media, pharyngitis, pneumonia, etc.).
Chickenpox is the most famous childhood disease, which is desirable to recover at a young age. Adults are very difficult to tolerate chickenpox, and it threatens pregnant women with serious complications. First of all, chickenpox can give a complication to the health of the mother – about 15% of cases of transferring this disease lead to pneumonia, especially if the disease is detected at a later date. For the fetus, the disease is dangerous by premature birth, and the presence of congenital chickenpox syndrome in crumbs.
The manifestations of the syndrome include:
- birth with traces of “pockmarks” on the skin;
- deformed shape of the upper or lower limbs;
- too small head size;
- violation of visual functions.
The development of the fetus after the transfer of chickenpox is difficult: slow development is observed, the baby suffers from convulsions, there are violations of the physical tone and mental state. Pregnancy often ends in miscarriage or premature birth. The most dangerous time for chickenpox infection is considered to be a week before delivery and in the first days of a newborn’s life, when he cannot receive antibodies to the virus from his mother.
Hepatitis B and C. Hepatitis is an inflammatory process that affects the human liver. It has different forms, and being immune to one of them cannot mean immunity to the other.
Slow blood flow deprives the fetus of vital nutrients, which also affects its development and formation. Complications and malformations in hepatitis are different, their manifestation and severity depend on the general condition of the mother and the form of the disease itself.
With the diagnosis of hepatitis, natural delivery is impossible – the child will be born only by caesarean section.
Another mandatory analysis is a test for HIV infection. During pregnancy, a woman gives it up twice: when registering and after 3-4 months, usually before issuing a decree. The human immunodeficiency virus is a severe chronic and incurable disease that is transmitted through unprotected sexual contact, through blood and from mother to fetus. A feature of the disease is a six-month asymptomatic period, when it is impossible to detect it.
The main danger of infection is the possibility of passing it to the baby. If the result of the HIV test turned out to be positive, then the expectant mother is immediately prescribed antiretroviral therapy, which protects the fetus from possible infection. Also, to prevent the transmission of the virus, a caesarean section is performed, and artificial feeding is used. It will be possible to find out whether a newborn is infected six months after his birth.
Rubella during pregnancy
The next marker included in the TORCH analysis is antibodies to rubella. This is another childhood disease that poses a danger to adults. The sooner infection occurs (the most common cause is the oldest sick child in the family), the higher the likelihood of serious congenital malformations in the developing organism.
The disease can affect any organ of the fetus, but the most common combination of ailments such as cataracts, deafness, and heart disease. Less harmless complications include: reduced body weight during childbirth, diseases of the circulatory system, pneumonia, small growth of the newborn.
Cytomegalovirus, also included in the list of TORCH infections, is a disease provoked by a virus of the herpes family.
Transmission of the virus is possible in several ways: household, sexual, contact, airborne. If a pregnant woman was initially infected with cytomegalovirus, then the risk of infection of the fetus is about 45-50% – this is the most dangerous condition.
If the diagnosis was established before the happy event, the action of the pathogenic microorganism will be weaker, especially if the expectant mother carries out special treatment.
The virus is more dangerous in the early stages: often the penetration of a pathogenic microorganism threatens with a miscarriage or defects in the development of the crumbs. In the later months of pregnancy, defects are no longer diagnosed, but premature birth, excess amniotic fluid, “congenital cytomegaly ” of the baby are possible.
herpes simplex virus
This virus is present in every second person. But the danger is not a pathogenic microorganism lurking in the cells, but its relapse or re-infection during the bearing of the baby.
With re-infection, the risk of virus penetration through the placental barrier is 50% to 50%. If a pathogenic microorganism has entered the body of an infant, then the likelihood of self- abortion in the early stages increases, and the likelihood of developing severe health problems for the baby or stillbirth is also high.
IMPORTANT! Having suffered herpes even once before pregnancy, the expectant mother provides the fetus with complete protection from a harmful microorganism.
In case of late infection, doctors recommend a caesarean section or blocking the virus with special means so that the mother can give birth naturally.
How and when is the diagnosis carried out?
Analysis for the presence of TORCH infections should be carried out either at the stage of family planning, or in the early stages of waiting for crumbs. For the entire period of pregnancy, such a study will have to be carried out only once: when registering with an obstetrician-gynecologist.
The task of diagnosis is to establish the presence of antibodies to certain diseases (rubella, chickenpox, herpes) or their complete absence in the body of the expectant mother. If antibodies are detected, then this disease does not pose a threat to the life and health of the mother or her baby. If not, the doctor will tell you about preventive measures to prevent infection (vaccinations, precautions).
Testing for the presence of TORCH infections during pregnancy will help determine whether a severe infection entered the body of the expectant mother, and if so, when it was. To understand this, laboratory technicians examine the patient’s blood for the presence of antibodies (immunoglobulins).
Immunoglobulins are protein compounds produced by the immune system after encountering an antigen (pathogenic cell). Not only the presence of immunoglobulins is taken into account, but also their avidity – the overall stability of the antigen-antibody complex. Thus, high avidity is a sign of an acute course of the disease or a relatively recent infection.
The international designation of immunoglobulins is Ig . To understand which antibodies to which virus have been detected, a capital letter of the Latin name of the causative agent is added to this designation. Antibodies are divided into five classes, but two of them are important for the diagnosis of the TORCH complex – IgM and IgG . Diagnosis is carried out by PCR (polymerase chain reaction), that is, the structure of the patient’s DNA is studied. The attending physician of the future mother will be able to decipher the results of the research, who will determine which disease the woman is a carrier of, or which disease she suffers from.
How to decipher the diagnostic results?
Labeling of immunoglobulins (M and G) allows the doctor to very quickly assess the health status of his ward.
This happens in three ways:
- The presence of only class G immunoglobulins in a patient is a sign that she has already suffered a certain ailment earlier, and has acquired a strong immunity to the disease. When re-entering the body, the virus will not pose a threat to the health or life of the developing fetus;
- The presence of class M antibodies in the blood is a sign of an acute course of the disease, even if its pronounced symptoms are absent, and the patient feels completely healthy;
- The absence of immunoglobulins is evidence that the woman has not encountered this type of disease, does not have immunity to it, which means that it is dangerous in case of possible infection.
Preparing for analysis
The best time to take tests for the TORCH complex is a few months before the expected onset of pregnancy. This will allow timely treatment of certain diseases or time to get vaccinated against them. If such an opportunity is missed, then the trip to the laboratory should not be postponed. Diagnosis will be required in the very first weeks of pregnancy, and the diagnosis of some diseases will need to be carried out not only by the patient, but also by her sexual partner – the future dad.
Most often, the study is carried out by PCR, but some laboratories use a different DNA research method – ELISA (enzymatic immunoassay). Although any biological fluids of the patient (urine, vaginal secretion) can be taken for diagnosis, the most reliable data (90 – 95% accuracy) is obtained from venous blood sampling.
In order for the results of the examination to reflect the picture of the health of the expectant mother as accurately as possible, it is necessary to conduct proper preparation for the upcoming diagnosis. So, the delivery of biomaterial is performed on an empty stomach, and between blood sampling and dinner the day before, not 8 hours should pass, as in a normal examination, but 12.
It is allowed to drink clean water, as it does not affect the test results. The best time to go to the laboratory is in the morning, when the activity of the body is just beginning.
A day before blood donation, you should abandon any physical activity, if it is not prohibited by the attending obstetrician-gynecologist observing the pregnant woman, switch to a dietary, but complete diet. Alcohol and cigarettes are strictly prohibited while waiting for the baby, but if the mother does not comply with this requirement, they should be abandoned at least two days before the study.
Additional examination methods
If the doctor needs to determine how long the patient has been infected, testing for immunoglobulin avidity is prescribed. The longer the virus is present in a woman’s body, the stronger the avidity of antibodies, as they tend to strengthen their bond.
So, in the presence of low-avid antibodies, we can talk about a relatively recent infection, and to confirm this assumption, the woman is prescribed another additional study – immunoblot .
If general studies of patients are of a screening nature, that is, they allow us to determine general data on possible past or existing diseases, then an immunoblot is necessary to diagnose a specific ailment, its features and duration of presence in the body. This study is a highly sensitive (97%) and highly specific (99%) diagnostic technique. It allows you to accurately determine the duration of infection, and assess the degree of negative impact on the body of the mother and her unborn child.
for immunoblot or avidity after the results of the screening TORCH study are ready and deciphered by the attending physician.
Treatment of infections
What to do if the disease is detected? It depends on the period at which the infection occurred, the general health of the patient, the risks to the fetus. If the diagnosis of the disease and its development took place in the first weeks of pregnancy, then the doctors will insist on its termination.
This is due to the fact that almost all ailments are fraught with the development of pathologies that are incompatible with life or threaten the full physical and mental health of the unborn child, that is, the chances that the baby will be born alive, healthy and on time are minimal. Most likely, such a pregnancy will end in spontaneous abortion at a later date.
If contact with the virus occurred in the second or third trimester, complex therapeutic therapy is prescribed. Her task is to save the pregnant woman from the disease or stop it as much as possible.
The set of preventive measures should include:
- compliance with the rules of personal hygiene;
- maintaining the purity of sexual relations (permanent healthy partner, the use of barrier contraceptives);
- control of the sterility of medical procedures in which infection through the blood is possible;
- avoidance of communication with persons who may suffer from serious diseases transmitted by household, contact or airborne droplets.
It is also very important to strengthen the immune system so that, in case of possible contact with pathogenic microorganisms, both the woman and her baby are protected. In addition to following the rules of a healthy diet, proper physical activity, the inclusion of fresh gifts of nature and the sea in the diet, care should be taken to have a more narrowly focused effect on the immune system.
Taking care of her own health, mom can be calm about the life of her little miracle, which she wears under her heart.