Analysis of TORCH- infections - Causes, Symptoms and Treatment .MF .
perinatal infections account for about 2-3% of all congenital anomalies of the fetus.Most infections with the dangerous primary infection during pregnancy.Recurrences of herpes can be dangerous during childbirth and the postpartum period.
Abbreviation T. o.R. C. H. emerged from the first letters of the most dangerous to the fetus infections - Toxoplasma (Toxoplasma infection) - Rubella (German measles) - Cytomegalovirus (CMV) - Herpes (cold sores).This is the classic infection.Besides them, also talk about infections such as parvovirus (infection caused by parvovirus B19), listeriosis, hepatitis B and C, and others.All they can affect people of any age and gender, but the term is used in relation to women, who are preparing for pregnancy, pregnant women and the fetus and newborn.Rubella, toxoplasmosis, cytomegalovirus, and herpes infection are widespread infections.In most cases, the first meeting with them occurs in childhood and adolescence - this is called a primary infection,
more dangerous ToRCH-infection?
When pregnancy is dangerous primary infection of any group of TORCH-infection.That is, the meeting with the infection, to which no immunity.This infection is accompanied by severe blood circulation microbes that may enter the body of the child.
infections important feature of this group is that the symptoms can not be or may be malovyrazheny.At this time, the infection will adversely affect the condition of the fetus and during pregnancy.
Why the survey is conducted?
It was before the pregnancy (or early), we need to learn - has an infection or not.When was - do not worry, this infection is not dangerous for a pregnant woman.If it was not, the doctor will tell you about the complex of preventive measures (eg, in the case of rubella - it is possible to be vaccinated if it comes to Toxoplasma - it is possible to observe certain rules in order to reduce the risk of infection, etc.).In addition, the infections for which there is no protective antibodies, it is important to carry out regular monitoring in order not to miss the infection during pregnancy.
How is it diagnosed and what is the examination?
diagnosis only by clinical manifestations (rash, swollen lymph nodes, temperature etc.) often causes difficulties, since in most cases the symptoms are non-specific or malovyrazheny.More accurate is the laboratory diagnostics - determination of antibodies in the blood.
blood test for antibodies may show:
- whether there was a meeting with the infection
- if so, when.
Interestingly, all five species of mammals are homologous to immunoglobulin classes, ie those classes were formed before the separation of mammals species.This indicates the optimality of their properties and the need for vyzhivaniya.Antitela (immunoglobulins) - are special proteins of the immune system that are produced when meeting with any agent.The antibodies are specific, that is, act on a specific agent.To verify the specificity of the antibody is added to the designation of the name of the pathogen against which the antibodies are directed.In this case, for example, the matter concerns antibodies to rubella, parvovirus B19, Toxoplasma, and so on.The international designation of immunoglobulins - Ig.Latin capital letter after the Ig indicates immunoglobulin class.Such classes isolated 5: M, G, A, E, D. five classes of antibodies are allocated, of which the most important - G, M, A (IgG, IgM, IgA).
To diagnose TORCH-infections are significant IgM and IgG.Different immunoglobulins appear at different stages of the immune response and are found in the blood at different times, so their definition allows the doctor opredlit time of infection and, therefore, predict risks, assign diagnostic and therapeutic procedures correctly.
IgM increased soon after onset, peak to reach 1-4 week (this figure is an average, there may be differences for different infections), then reduced in a few months.For some infections term presence of significant amounts of specific IgM antibodies can be quite large.In these situations, the analysis helps to avidity IgG antibodies (see below).The speed of appearance of IgM antibodies to diagnose an acute form of the disease in its very early.
IgG determined later (not earlier than 2 weeks after the onset of the disease), their levels rise slower than IgM, but they are much longer (for some infections throughout life).Increased levels of IgG suggests that the body had already met with the infection.
survey before pregnancy
|detected||not found||meeting organism with the pathogen has already taken place, and the serious danger this pathogen to the unborn child is not|
|notfound||not found|| meeting with the infection during pregnancy may pose a risk to the unborn child.During pregnancy it is recommended to monitor the levels of antibodies (once a month) |
* Antibodies may also be absent in the earliest period after infection.
|detected||detected||not excluded recent meeting with the infectious agent, but at the time of pregnancy the immune system has already formed and the danger will not.|
survey during pregnancy
|detected||not found|| If the analysis was put in the very early stages of pregnancy, the meetingorganism with the pathogen has already taken place, and the causative agent of the serious danger to the unborn child is not. |
If the analysis is not put at the very early stages, the presence of IgG may be due to recent infection, even during pregnancy.In this case, it is recommended to carry out additional methods of examination (see below IgG avidity).
|not found||not found||meeting with the infection during pregnancy may pose a risk to the unborn child.The analysis should be repeated once a month.|
|detected||detected||presence of IgG and IgM may be associated with recent infection, even during pregnancy.But also do not exclude an infection before pregnancy.In this case, it is recommended to carry out additional methods of examination (see below avidity, immunoblot ).|
|not found||detected||presence of IgM may be associated with recent infection, even during pregnancy.But it does not rule out infection and reactivation is not dangerous in pregnancy.In this case, it is recommended to carry out additional methods of examination (see below immunoblot ).|
Additional and supporting research: avidity IgG
antibodies When you need to find out how long ago the present IgG antibodies in the body (ie, how long ago there was an infection), carried out a special test on the avidity of IgG antibodies (from the Latin Avidity - greedy.).IgG antibodies in the development of an immune response is gradually increased bonding strength with an infectious agent.This is called the binding strength of avidity.At the beginning of IgG binds the pathogen, but the connection is rather weak.Such low avidity IgG is called.A few weeks later an antibody capable of binding its target much more.Such antibodies are called vysokoavidnymi.
Thus, the emergence of low avidity antibodies indicates that a dangerous meeting with a virus or Toxoplasma held recently.In case of low avidity antibodies during pregnancy to be appointed by a decision confirming the research methods (see below immunoblot).The result of the analysis presented avidity index, expressed as a percentage.
Additional and supporting research: immunoblot
Conventional assays for antibodies to infections by ELISA is a screening, that is, that suggest an acute infection or recent infection, requiring specific action.In case of suspected acute infection during pregnancy prior to treatment require more specific (confirmatory) test.
Immunoblot - highly specific and highly sensitive method:
sensitivity of 97%
specificity of 99%
High resolution between negative and positive results!
more precise identification of the term contamination
The method immunoblotting (blot - from English, blot, blur) as follows.During an immune response the body produces antibodies to different infectious agent proteins at different times.For example, at a meeting with Toxoplasma occurs first appearance of IgG antibodies to ROP1, then to the MAG1 protein, and later to the protein SAG1.If we define the serum antibodies to each of these proteins, we can tell when antibody production has begun, up to 2-3 weeks if the infection has been recent.
Research immunoblot method is more expensive and time consuming than screening tests for antibodies.Therefore, usually a survey carried out in two stages: first, the risk is allocated a group (serological testing for the presence of IgG and IgM antibodies).Further, in cases of suspected contamination of the previously conducted study by immunoblot.
Important: Immediately after receiving the results of the screening study on the content of antibodies should consult your doctor.
More O6 dangerous infections
Rubella .When the infection in the first trimester, almost 90% of fetal loss.
Rubella - a problem that is specific to Russia.Many of the women suffered from as a child - he is no longer afraid of infection.But often it is mild and the disease goes unnoticed.Infection can be prevented by being vaccinated - you only need to be tested!If IgG and IgM antibodies is no - go for vaccination.
Toxoplasmosis - infection is less common disease suffered about 15% of women of reproductive age, that is, 75% of women are infected with Toxoplasma during pregnancy!Very effective prevention and treatment during pregnancy.It is important to know exactly what the infection status prior to pregnancy or in the very early period.If IgG and IgM antibodies is not - ask your doctor how not to get infected with toxoplasmosis during pregnancy and how to control the level of antibodies (1 per month).
Herpes type 1 and 2 - particularly dangerous in childbirth and after childbirth.In the absence of antibodies to herpes infection in addition to prophylaxis during pregnancy, it is necessary attention to the baby after birth.
Cytomegalovirus - is transmitted by airborne droplets, most women of reproductive age have already met with the virus (90%).In 10% of women do not have the antibodies, it means that there is a risk of contracting CMV, and the probability of infection of the fetus is 30%!If the antibody is not necessarily check with your doctor, it does not get infected and how to control the level of antibodies.It is especially dangerous in the autumn and winter!
Parvovirus B19 - increasing the risk of infection in the autumn-winter period.It may be asymptomatic or oligosymptomatic for, so it is important to pregnancy testing for antibodies to parvovirus B19.If no antibodies - monthly monitoring of antibodies during pregnancy.
As for tests naTORCH infection?
tests shall be on an empty stomach (at least 6 hours after the last meal).Hand over analyzes at any convenient day for you - all our offices are open 7 days a week!
For analysis is taken blood from a vein.If you want to bring stuff with them, it is necessary to take blood in a test tube with a clot activator or an empty tube (without anticoagulant) and prepare serum.Serum can be stored and transported at + 4 ° C for 1 day, then at -20 ° C.