Analyses on the torch-infection when planning pregnancy and in early pregnancy - 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.
What ToRCH (TORCH) - infections
TORCH (TORCH) - infection, is the short name (acronym), the most common intrauterine infections, is very dangerous for the fetus.TORCH - Toxoplasma, Rubella, Cytomegalovirus, Herpes.In Russian: toxoplasmosis, rubella, cytomegalovirus and herpes.
deciphered TORCH abbreviation follows :
T - toxoplasmosis (toxoplasmosis)
O - other infections (others)
R - rubella (rubella)
C - cytomegalovirus infection (cytomegalovirus)
H - herpes (herpes simplex virus)
letter O -: others (other) - means those influencing fruit infection, hepatitis B and hepatitis C, syphilis, chlamydia, gonococcal infection, listeriosis, parvovirus (infection caused by parvovirus B19).Recently, the list including HIV infection, varicella, enterovirus infe
However, usually the group TORCH infections include only four listed diseases: toxoplasmosis, rubella, cytomegalovirus, and herpes.Under this option, the letter O stands for the second letter of toxoplasmosis.
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, after which remains immune protection.If the body is found to re-infection, it is called a secondary infection or reinfection.
Feature TORCH infections that during the primary infection by them during pregnancy they can have a detrimental effect on all systems and organs of the fetus, especially in its central nervous system, increasing the risk of miscarriage, stillbirth and congenital malformations of the child, the formation of defectsits development, up to disability.
often defeat pregnant woman infections TORCH complex is a direct indication for abortion. TORCH (TORCH) - the infection risk of developing deformities in the fetus or death .
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 on ToRCH-infection?
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 regularly monitored to avoid missing infection.
How is it diagnosed and how the survey is conducted on ToRCH-infection?
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
Diagnostics ToRCH (TORCH) - infections
blood for antibodies to TORCH-infections correct to take before pregnancy, during its planning.
most dangerous to the fetus is a primary infection ToRCH-infections on a background of pregnancy, especially in its early timing, so if screening for torch-infection prior to pregnancy in a woman's blood revealed antibodies against these infections, the woman can safely become pregnant - herbaby from this side is not in danger.If the antibodies before pregnancy to infections TORCH-complex is not found, it means that a pregnant woman will need to take additional measures in order to secure that they themselves and their future baby.
If before pregnancy analyzes on TORCH infections have not been handed over, it is absolutely necessary to do at the earliest possible time.And analyzes on TORCH infections need to pass, regardless of the state of health of pregnant women, since most infections TORCH-complex asymptomatic, and until serious complications with the fetus, a pregnant woman may not even be aware of their existence.
Diagnose TORCH (TORCH) - infection by examining the blood for antibodies to the causative agent of toxoplasmosis, rubella, cytomegalovirus and herpes.Determine the titers (concentration) of antibodies to pathogens listed.If an antibody is, it does not mean necessarily that the person is sick.This may mean that he had once been ill with this infection and it has immunity.However, if the antibody titer to the specific infection is very high and increases with time, it is indicative of process activity.Moreover, clinical disease may not occur or occur dim, blurred shapes.Intensity of the external manifestations of the disease has nothing to do with the danger of its effects on the fetus.With a strong disease fetus can stay healthy, and, on the other hand, in the absence of clinical manifestations of the fetus can suffer greatly.
And if immunity is not - then enjoy early.The woman, who has survived the infection of TORCH -complex before pregnancy is more likely to maintain a healthy fruit, than a woman newly diagnosed during pregnancy.Rubella during pregnancy - is a direct indication for abortion.
blood test for antibodies: details
All mammalian species are five classes of immunoglobulins are homologous, that is, those classes were formed before the separation of mammals species.This indicates the optimality of their properties and the need for survival.Antibodies (immunoglobulins) - a specific immune system proteins that are produced when encountering 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.
most common to identify TORCH infections diagnostic methods include ELISA (enzyme-linked immunosorbent assay) and PCR (polymerase chain reaction).
PCR method can detect the presence or absence of the DNA of the pathogen infection in the body.Moreover, this method allows the identification of the type of agent (e.g., herpes I or type II).
for analysis by PCR can be used blood discharge from the vagina or cervix, urine.PCR is characterized by high accuracy of the results (90-95%).The time from taking the material for study before the results are usually not more than two days.
PCR method is well established in the diagnosis of chronic and asymptomatic infections, it is important that it allows to identify even small quantity of infectious agent.
However, the PCR method can not answer all questions relating to TORCH infections.For example, to distinguish between PCR acute or recent infection is not possible from the carrier of infection.This is done using the ELISA method based on the detection of antibodies against infectious agents.
have material for the study of men are discharge from the urethra;female - discharge from the urethra, cervix, vagina.
However, more reliable results are obtained by a blood test, since it is blood serum contains antibodies against infectious agents.In addition, what kind of antibodies identified and what is their concentration, the doctor concludes that the patient suffering from acute or chronic form of the disease or merely a carrier of infection.
Of course, the precise interpretation of the analyzes on TORCH infections can give only a doctor, who is also, if necessary, prescribe additional tests and offer treatment regimen or measures TORCH-infection prevention.
is better to err in advance, that is to be tested for TORCH-infection prior to pregnancy.If necessary, you can be vaccinated.Just soak the required period after vaccination before conception.
It should be tested for TORCH (TORCH) - infection.When antibody titers for some increased infection, blood must examine in dynamics.If the antibody titer increases - the process is active, and there is a risk to the fetus.It is necessary to treat and monitor the development of the fetus very carefully.
Tests for TORCH-infection is best not to take during pregnancy, but for 2-3 months prior to the planned conception.In this case, detection of acute or subacute form of the infection the doctor can prescribe the effective treatment without having to worry about what drugs can harm the fetus.
If during the examination it is found that antibodies to the infection of TORCH complex in the body there and their number is correct, then it says that during pregnancy TORCH infections will not threaten the fetus.
Finally, if the antibodies will not be detected for TORCH infections, during pregnancy, women will need to pay increased attention to preventive measures: taking drugs that strengthen the immune system, a healthy lifestyle, properly and fully fed, to move a lot, spend a few hoursin the fresh air per day.
In addition, there is an additional measure of prevention of toxoplasmosis - they include the careful observance of rules of hygiene, avoiding contact with cats or process handling raw meat.
for rubella prophylaxis for several months prior to the expected pregnant women are advised to be vaccinated against rubella.
addition Torch-infection prevention measures doctor must recommend the woman having no antibodies to these diseases, undergo additional testing for TORCH-infection during pregnancy.It is absolutely necessary to time "intercept" started primary infection and take appropriate action.Recall that the tests for infections such as cytomegalovirus and herpes, it is necessary to pass not only women planning a pregnancy, and her partner.
When tested for TORCH-infection was not possible prior to pregnancy, this should be done at the earliest possible stages of pregnancy, because it is in the first few weeks of pregnancy, primary infection TORCH infections may be the most dangerous in terms of infection of the fetus.
details on each of the TORCH infections and their effects on the body of the pregnant woman and the fetus.
Toxoplasmosis - this is a very widespread disease, which infected nearly 30% of people in the world.Its pathogen - microorganism called Toxoplasma.The primary host of toxoplasma, in which the body the parasite reproduces, is the domestic cat, which often becomes a source of human infection.
addition, Toxoplasma infection can occur through dirty hands (so commonly infected children in kindergartens), through raw or undercooked (underdone) meat.For a person with a healthy immune systems, toxoplasmosis is not dangerous - they can recover, even without realizing it.In addition to toxoplasmosis human body produces a stable immune system, so it's a "one-off" disease.
The only situation in which toxoplasmosis is a serious threat - it is a primary infection with toxoplasmosis during pregnancy.In fairness, it should be said that the probability of such an infection is not great - according to statistics during pregnancy toxoplasmosis infects no more than 1% of women, 20% of which transmit toxoplasmosis to the fetus.Yet one percent - is one pregnant woman out of a hundred - not too little, in the long run.
It is also important that the danger is only toxoplasmosis, a woman who was infected during the current pregnancy.This means that if a woman has already had toxoplasmosis before pregnancy (at least six months before it) it does not threaten the future of toxoplasmosis child.Moreover, in a tragic situation where because of toxoplasmosis during pregnancy, a woman loses baby after six months she can get pregnant, have no fear of toxoplasmosis.
If during pregnancy toxoplasmosis infection does occur, then a lot depends on what order, at what stage of pregnancy Toxoplasma entered the body of a pregnant woman.
What was earlier the gestational age - the greater the risk of severe consequences if the fetus is infected with toxoplasmosis, but, at the same time, the less likely that this infection occurs.
Conversely, in the later stages of pregnancy, the percentage of transmission of toxoplasmosis to the fetus is very high (about 70%), but the risk of severe fetal lesions decreasing.
most dangerous is toxoplasmosis infection in the first 12 weeks of pregnancy.In these cases, often resulting in congenital toxoplasmosis fetal death or to severe lesions eye, liver, spleen and nervous system (especially brain) child.Therefore, toxoplasmosis infection at an early stage of pregnancy a pregnant woman often offer to make abortion.
All this shows once again that the tests for the presence of antibodies to toxoplasmosis need to take not during pregnancy, and to her: If these antibodies in the future mother of blood there is, nothing to fear, if the analysis shows a fresh infection, you should waitsix months, and then quietly become pregnant.If antibodies are not found, you need to take extra precautions during pregnancy.
Toxoplasmosis is one of those diseases that are very easy to prevent, following the basic rules of hygiene.
course for pregnant women without antibodies to toxoplasmosis, these rules are particularly strict.Firstly, during pregnancy should not be any contact with cats, especially young, because cats infected with toxoplasmosis, age also are immune to it.If the cat can not attach to a friend at the time of the mistress of pregnancy, the pregnant woman, at least, should be freed from the care of her.If it is impossible, and it is all manipulation, especially cat litter, should be undertaken only in rubber gloves.The same applies to work with the earth in the garden - if you can not give it up completely, it is necessary to work in gloves.All vegetables, fruits, herbs should be thoroughly washed.Contact with raw meat should be avoided, too, and the meat dishes are sure to boil thoroughly or properly roast thoroughly.After any work in the kitchen should be particularly careful to wash their hands with soap and water.Under these rules risk of toxoplasmosis infection is practically comes to naught.However, several times during the pregnancy for complete peace of mind should be tested for toxoplasmosis, preferably in the same laboratory.
Rubella - contagious virus spread by a healthy person sick more often airborne.Rubella refers to the innocuous "childish" infections, to any serious consequences, it usually does not.
manifested rubella fine pink rash all over the body, raising the temperature to about 38 ° C.The general condition of the patient in this case is satisfactory.
Intrigue rubella is the infection that often occurs during the incubation period of the disease still does not manifest itself and the person does not know that he is sick.However, after the disease rubella human body develops immunity resistant, so there is no secondary infection with rubella.
When rubella infection of a pregnant woman, this harmless infection becomes lethal to the fetus.In the initial stage of pregnancy rubella virus most often affects fetal neural tissue, eye tissue, heart.
rubella in the first trimester of pregnancy is an indication for termination of pregnancy.If rubella infection occurred during the second or third trimester of pregnancy, the consequences of such fatal to the fetus, as a rule, does not arise, but, nevertheless, it may be growth retardation and other abnormalities.In such cases, a restorative therapy, placental insufficiency prevention.
Finally, when rubella infection in the last month of pregnancy, the baby may be born with symptoms of rubella, after which it flows from him as well as in children infected after birth, and the serious consequences does not usually cause.
tests for antibodies to rubella must pass before a planned pregnancy.If the analysis shows that a woman had been ill with rubella before pregnancy, then this side is no hazard to the fetus.
Always held on the analysis of antibodies to rubella and, if a pregnant woman made contact with a patient with rubella.If this happens in the first trimester of pregnancy and the analysis will show signs of acute infection, the woman will be advised to terminate the pregnancy.
Since rubella infection can not be prevented by prevention measures, then the most appropriate option is a prophylactic vaccine.Make it should be before pregnancy, and for women planning pregnancy, the blood of which no antibodies to rubella, the vaccine is needed.
Modern rubella vaccine efficacious nearly 100 percent and have virtually no side effects, except for a small increase in temperature and redness at the injection site.Immunity to rubella, which is produced after vaccination, of about 20 years is stored.