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Torch infections during pregnancy. Analysis for TORCH infection

Infections are dangerous for any person, even absolutely healthy. And for women in position, they are even more dangerous. Therefore, gynecologists always emphasize that women plan their pregnancy and take tests for TORCH infections in advance. Why is this so important, and what do the results of such studies mean?

Briefly about diseases

Such infections are also called the TORCH complex. It includes four diseases. These are (TO), rubella (R), cytomegalovirus infection (C), herpes (H). Syphilis, gonococcal infection, trichomoniasis are not included in the above complex.

Why is it dangerous during pregnancy? Infection with the herpes simplex virus leads to miscarriage, polyhydramnios, pathologies of intrauterine development, and stillbirth. If we are talking about the primary episode of herpes when carrying a baby, then the risk of its transmission to the fetus is up to 50%.

Toxoplasmosis leads to spontaneous abortions and premature births, hydrocephalus, thrombocytopenia.

When a woman is infected with a virus for up to 16 weeks of pregnancy, intrauterine fetal death, defects in the development of the cardiovascular system, and macrocephaly are observed.

Infection with cytomegalovirus up to 12 weeks leads to congenital malformations, miscarriages, cerebral palsy, damage to the organs of vision, hearing. If infection occurs in the second or third trimester of the term, it can manifest itself as hepatitis, retinitis, pneumonia.

It is worth knowing that the greatest danger when carrying a baby is precisely the primary infection with TORCH infections. If it occurred in women before pregnancy (and this is determined by the presence of class G antibodies in the blood), then the percentage of complications is small.

About testing expectant mothers for TORCH infection

The main goal of diagnostics is to identify seronegative pregnant women, that is, those women who do not have protective IgG antibodies. They must take special precautions at all times, up until delivery. Expectant mothers with initially diagnosed infections are subject to treatment by a gynecologist and an infectious disease specialist. If protective class G antibodies to the above infections are found in the blood of a pregnant woman, then such patients are not subject to treatment.

How are women tested for TORCH infections? Testing is carried out by enzyme immunoassay (ELISA) with the detection of antibodies to infections in the blood serum. In this case, the detection of early class M antibodies and late class G antibodies plays a role.

Of course, few women undergo such tests at the stage of pregnancy planning. Therefore, in Russia, such studies are carried out at the first visit of a future mother to an obstetrician-gynecologist in accordance with the order of the Ministry of Health of the Russian Federation dated February 10, 2003.

About deciphering the analysis of TORCH infection

So, the essence of the procedure is to determine immunoglobulins (antibodies) to a group of infections. Antibodies are the protective proteins of the immune system. They are formed in the female body when foreign substances enter it. Immunoglobulins are denoted by the Ig icon. For TORCH infections, it is common to use IgG and IgM antibodies.

IgM antibodies indicate the acute phase of the disease. Sometimes these immunoglobulins remain in the body for a long time after the initial infection. To determine how long the expectant mother has been infected, the result of the detection of IgM and IgG is compared. An increase in the latter indicates that the female body has already met with such an infection in the past and has developed immunity.

In the laboratory, the qualitative and quantitative presence of IgG and IgM antibodies is determined for each TORCH infection.

So, if as a result of the analysis there are no IgG and IgM antibodies, then this means that the woman has no immunity to this infection, and the body has not met with it before. With a negative IgG value and a positive IgM, a recent infection, that is, the onset of the disease, is ascertained. When the value of both antibodies is positive, this means the acute stage of the disease and the risk of intrauterine infection.

If the analysis shows IgG +, and IgM-, then in the past the body with a viral disease has already met and developed immunity. That is, there is no threat to the baby.

To preserve the embryo, the woman's body is rebuilt, the production of hormones increases, immunity decreases. Therefore, the likelihood of diagnosing a torch infection during pregnancy increases. Such diseases are especially dangerous in the first half of gestation (1 trimester), when the development of all internal organs of the fetus begins. Pathogens cause anomalies, which often cause the death of a baby inside the womb.

What do TORCH infections mean during pregnancy?

Torch infections are a number of infectious diseases that often have a latent form and carry the threat of the formation of anomalies and defects in the infant. The greatest danger is infection before the 12th week, when the internal organs and systems of the child's body begin to develop.

Torch infections during pregnancy have the ability to penetrate the embryo through the placental barrier and affect the formation of organs and tissues, as well as adversely affect the nervous system.

When to get tested for torch infection during pregnancy

At the present stage of the development of medicine, it is not a prerequisite to be tested for torch infections during gestation. Such a study is prescribed only if there is a suspicion of the existence of an infectious lesion. Many doctors insist on undergoing testing to exclude the possibility of complications, it is better to do this during the planning period for conceiving a child.

Torch infection and pregnancy combination in most cases dangerous in the primary infection. So, rubella, cytomegalovirus and toxoplasmosis do not threaten the fetus if the woman had already had the disease before this period, so antibodies appeared in the blood that prevent the development of viruses.

In pregnant women, the presence of the pathogen very often does not manifest itself externally, that is, it is asymptomatic, which increases the risk of malformations in the baby. Therefore, it is recommended to donate blood for torch infections before the 12th week of gestation in order to diagnose the pathology in time.

Norms and concepts for understanding analysis

Before deciphering the tests, you need to familiarize yourself with the designations of antibodies or immunoglobulins, since these are the main factors by which the presence of TORCH in the blood is determined.

Antibodies are specific protein compounds produced to destroy foreign cells, bacteria and viruses. In total, 5 types of immunoglobulins are known, which are designated in Latin letters, but for a blood test for torch infection during pregnancy, only two types of antibodies G and M of the classification are required.

IgG-immunoglobulin is formed only during the first contact with a harmful microorganism, but after the IgM class antibodies have been developed. Thus, an increase in class G immunoglobulins indicates permanent immunity to a particular disease.

Upon initial contact with the virus, the M-class is initially produced, while the concentration and volume increase sharply in the first days, after which it drops to zero, then it is replaced by G-immunoglobulins, which create a long-term protective reaction in the fight against re-infection with this disease.

In order to determine the strength of IgG antigens, there is the concept of avidity, a special test that shows, in percentage terms, the duration of infection, which leads to the emergence of highly avid antibodies. The decoding of the analysis is carried out according to the norms and classifications, which are presented in the table.

Table of normal values of immunoglobulins

Test name	Result	Unit ism	Negative	Weakly put	Pos.
	50,55	IU/ml	<16	16-22	>22
IgM antibodies to HSV type 1 (HSV-1)	0,33		<0,8	0,8-1.1	>1,1
IgG antibodies to HSV type 2 (HSV-2)	1,07	IU/ml	<16	16-22	>22
IgG antibodies to HSV type 1 (HSV-1)	0,32		<0,8	0,8-1.1	>1,1
IgG antibodies to cytomegalovirus (CMV)	80,06	IU/ml	<10	10-30	>30
IgM antibodies to cytomegalovirus (CMV)	0,25		<0,8	0,8-1.1	>1,1
IgG class antibodies to toxoplasma	0,42	IU/ml	<8	8-11	>11
IgM class antibodies to toxoplasma	0,54		<0,8	0,8-1.1	>1,1
IgG antibodies to rubella	200,00	IU/ml	<15	15-30	>30
IgM antibodies to rubella	0,56		<0,8	0,8-1.1	>1,1
Antibodies to parvovirus B19 lgG	100,00	IU/ml	<4	4-5,5	>5,5
Antibodies to parvovirus B19 lgM	0,25		<0,8	0,8-1.1	>1,1
IgG antibodies to V2V	433,96	IU/ml	<8	8-11	>11
IgM antibodies to V2V	0,12		<0,8	0,8-1.1	>1,1

Deciphering the analysis for torch infection during pregnancy

To correctly decipher the results of the study, medical specialists compare the parameters of IgM and IgG immunoglobulins for each disease separately, which makes it possible to determine the presence of the disease or exclude such a possibility.

IgM and IgG negative
Antibodies are absent, which indicates the possibility of infection with the virus. It is required to limit contact with children and animals, monitor personal hygiene, thoroughly wash hands with soapy water before eating food, cook meat, and wash vegetables and fruits.
IgM - positive
IgG - negative
The infection occurred within 1.5 to 2 months ago. In order to exclude false or distorted results, a second study is required.
IgM and IgG positive
Indicates an infectious infection for a period of 2 to 6 months. Urgent treatment is needed or interruption will be recommended to avoid the formation of abnormalities in the baby inside the womb.
IgM - negative
IgG - positive
In the circulatory system of a pregnant woman, there are antibodies to viruses; when determining avidity, you can find out how stable they are. With this result, nothing threatens intrauterine development.

When diagnosing any of the infections, treatment may adversely affect the formation of the embryo, since the majority of drugs are not intended for pregnant women. During drug therapy, there is a danger of harming the baby, so doctors always prescribe a second data test to avoid erroneous results.

Hello everyone, this is Olga Ryshkova. How dangerous are infections during pregnancy? What is TORCH infection during pregnancy? This is an abbreviation made up of capital letters of the main infections that women are examined for when planning pregnancy and during pregnancy.

Why were they singled out?

The cause of the pathology of pregnancy in 90% of cases are TORCH infections. Everything else - the Rh factor, genetic factors, the hormonal background of a woman is only 10%. The main overwhelming cause of miscarriages, miscarriage, congenital pathologies are precisely TORCH infections. Therefore, the question should not even arise whether it is necessary to take blood tests for TORCH infections. Be sure to submit.

What are these infections?

What is included in the complex TORCH (TORCH) infections during pregnancy? It is currently recognized that there are only 12 TORCH infections that are dangerous for a pregnant woman and her child.

toxoplasmosis (Toxoplasma),
herpes simplex virus (HSV, HSV),
Epstein-Barr virus (EBV),
cytomegalovirus (CMV, CMV),
chicken pox (Varicella zoster),
measles (Morbilli or Morbillivirus),
rubella (Rubella),
genital chlamydia (Chlamydia trachomatis)
viral hepatitis B (analysis for HBsAg)
viral hepatitis C (HCV, HCV)
syphilis (lues)

These 12 infections largely determine the future health of the child.

There are 5 letters in the abbreviation, but 12 infections?

It's true, there was a time when TORCH included only 4 infections

Toxoplasmosis - toxoplasmosis
rubella - rubella
Cytomegalovirus - cytomegalovirus
Herpes - herpes, meaning the herpes simplex virus

But the one who came up with this abbreviation inserted the letter “O” into it from the English “other” - others.

What to do if an infection occurs?

You should not be under the impression that contracting any of the TORCH infections is a disaster. There is no woman in the world who does not have her own menu of TORCH infections. The question is how to properly treat these infections.

Let's divide 12 infections into 3 groups.

The first group is those acute infections that you need to either get sick before pregnancy, or get vaccinated and get immunity to them again before pregnancy. For what? To avoid getting these infections during pregnancy. If they become infected during pregnancy, you can lose a child or live in fear for several months, and what will happen to the child, with what pathology will he be born. These are acute drip infections -

measles,
rubella,
chickenpox.

In the same group I will include viral hepatitis B, from which you can be vaccinated in your clinic.

Second group.

The second group of infections are those TORCH infections that cannot be vaccinated against. And if a woman did not get sick with them before pregnancy and she does not have immunity, then one must be very careful not to get infected with them during pregnancy.

toxoplasmosis,
genital chlamydia,
hepatitis C,
syphilis.

Let's say the analysis showed that the woman has no antibodies to toxoplasmosis. She thinks it's wonderful. Actually it's bad. A woman who has antibodies to toxoplasmosis before pregnancy is protected, she has immunity. And an acute infection of toxoplasmosis, which is very dangerous for a child, does not threaten her during pregnancy. Women without immunity should take precautions and be tested at least three times for the absence of toxoplasmosis during pregnancy.

Third group.

These are chronic TORCH infections that a woman already has and that can be activated at any stage of pregnancy - these are all viruses of the herpes group

herpes simplex virus,
epstein-Barr virus,
cytomegalovirus.

For chronic infections, for herpes viruses, it is desirable to be checked literally 9 times during pregnancy, starting from the first week of delay.

This is the main thing.

But today there is not a single TORCH infection, due to which an infected woman could not give birth to a healthy child. Today, say, with hepatitis C, the risks of having an infected child are 1-2%, no more, and 98% of women infected with the hepatitis C virus give birth to healthy children. True, at the same time, if the level of virus activity is high, delivery is best done by caesarean section. The same applies to toxoplasmosis, hepatitis B virus, herpes virus. With the right approach to controlling TORCH infections, any woman can give birth to a healthy baby.

When to be examined?

When to take blood tests for TORCH (TORCH) infection during pregnancy? With a planned pregnancy, it is necessary and important to be examined for these infections in advance. If acute infections are detected - treat, where necessary - vaccinate. But who did not have time in advance, does not mean that they missed the train. You can be examined in the first week of pregnancy, and at any time, and at the moment when the threat of abortion has developed. But it is optimal to do an analysis for TORCH infection when planning pregnancy in advance.

How are analyzes done?

Diagnosis includes the detection of antibodies to the pathogen by ELISA (enzymatic immunoassay),

and the pathogen itself by PCR (polymerase chain reaction).

How to submit?

How to take blood tests for TORCH infection? If a woman went to the antenatal clinic about pregnancy, this issue should not worry her. They will write out directions for all 12 tests and explain where and how to pass. When planning a pregnancy, you need to apply for directions either to the antenatal clinic or to the pre-medical office. But in the pre-medical office, you need to show a list of infections for which you want to be examined. This list is at the beginning of the article.

I advise you to contact the antenatal clinic, the gynecologist will prescribe treatment if necessary and give a referral for vaccination.

Paid or free?

For pregnant women, examination for TORCH infection is completely free, blood will be taken at your clinic in the direction of the antenatal clinic. If a woman decides to be examined before pregnancy, these will be tests “for herself”, and the examination will most likely be paid.

Whether it is necessary to survey the husband?

The husband should be examined only for "blood" infections (hepatitis B, hepatitis C, HIV) and sexual infections (syphilis, genital chlamydia). It is absolutely not necessary to check it for infections such as herpes, toxoplasmosis, rubella. It is possible to examine the husband only at the request of the couple, this examination cannot be imposed.

Very dangerous for a child.

If a woman did not suffer from any of the TORCH infections before pregnancy and is not vaccinated, then she has no immunity and it is very bad if she becomes infected during pregnancy. Why? Immunity is antibodies in the blood, and they are of two types. When infected, IgM antibodies (immunoglobulin em) first appear, later - IgG antibodies (immunoglobulin ji). After vaccination in the blood, too, IgG antibodies.

IgG are small antibodies that easily cross the placenta and protect the baby.
IgM are large antibodies, they do not cross the placenta and do not protect the baby.

If a woman becomes infected during pregnancy, the pathogen easily crosses the placenta, but IgG is not yet present, IgM cannot protect. This threatens with intrauterine infection, impaired development of the child, and complications.

Intrauterine infection with the herpes simplex virus is a severe infection. Half of the children may die or the nervous system will suffer. Chickenpox is especially dangerous in the last two months of pregnancy. Rubella in the early stages almost always causes birth defects, therefore, in this case, abortion is recommended. If a woman has not had rubella, then 3 months before the planned pregnancy, vaccination is done, immunity is developed within 3 months.

How are they examined?

First, the presence of IgM and IgG antibodies to all infections is checked by ELISA (enzymatic immunoassay).
When examining before pregnancy, if there are no antibodies, it is necessary to vaccinate against measles, rubella, chicken pox.
If antibodies to any infections are detected, they do not do more analysis for antibodies, they already exist, and these infections are monitored by PCR (polymerase chain reaction). If the PCR is negative, it is an inactive form of the infection and does not require treatment.
Infections for which there are no antibodies remain a risk zone. Beware of infection. To control (whether infection occurred during pregnancy), it is necessary to be examined for antibodies to these infections by ELISA, and it would not be bad every month.

How not to get infected during pregnancy?

Prevention - Wash your hands frequently

reduce contact with preschool children, do not come into contact with raw meat, do not work outdoors, do not come into contact with animals, especially cats and goats.

If you have any questions, ask them in the comments. If you understand everything, please click on the buttons of social networks.

One of the first tests that a gynecologist will offer you to take after learning that you are planning a pregnancy is an analysis for TORCH infection. Contrary to a fairly common misconception, this analysis has nothing to do with sexually transmitted infections. Infections included in the TORCH complex are dangerous not so much for the health of the mother as for the health of the unborn child, as they can be transmitted to him in utero and cause serious malformations. That is why it is important to determine whether you have such infections and whether you have encountered them in the past.

What infections belong to the TORCH complex:

TORCH-complex got its name from the first letters of the names of infections.
To- Toxoplasma - toxoplasma;
R- Rubella - rubella;
C– Cytomegalovirus, CMV – cytomegalovirus;
H- Herpes simplex virus, HSV - herpes. There are several types of herpes virus. In preparation for pregnancy, an analysis is carried out for herpes simplex type I and type II.
TORCH infections, contrary to popular belief, do not include chlamydia. An analysis for them, as well as for other infections that can lead to intrauterine infection of the fetus, the doctor must prescribe separately. Sometimes all such infections are attributed to the letter O in the abbreviation TORCH, from English other - others.

How is the analysis given?

For analysis, blood is taken from a vein, on an empty stomach, it is advisable to exclude fatty foods in the last meal. In the blood, antibodies to infections are determined - immunoglobulins (Ig). They come in 5 classes, but for the diagnosis of TORCH infections, an analysis is prescribed for two of them - IgM and IgG. Many laboratories offer the delivery of these tests as a complex, but it is possible to determine the presence of immunoglobulins and selectively. The determination of antibodies can be carried out both qualitatively (the analysis will show whether there are antibodies or not) and quantitatively (the analysis will show titers - the amount of antibodies). Quantitative analysis will of course give more information to the physician when interpreting the results.

Immunoglobulins of class M (IgM) indicate a recent infection and an acute stage of the disease. Immunoglobulins of class G (IgG) are formed in the body after a certain time after infection and represent "immunity" to infection, indicating a previous illness. Sometimes, when it is necessary to know the time of infection more precisely, an additional analysis is prescribed to determine the avidity of IgG, showing how long ago the body began to produce these antibodies.

Interpretation of results

The results of the analysis are deciphered based on the fact that during pregnancy, the primary infection of the mother with TORCH infections is dangerous. Therefore, if the woman's body met with the causative agent of the disease earlier, then the primary infection is no longer possible.

Based on this, if IgG is detected during the analysis, but IgM is not detected, this is an ideal option for pregnancy planning. It means that the body has previously encountered an infection, has developed protective antibodies against it - immunity. Primary infection during pregnancy does not threaten the mother and unborn child.

If both IgG and IgM are absent in the blood, there is a danger of encountering an infection during pregnancy. It is recommended to periodically monitor the appearance of antibodies, and when diagnosing pregnancy, re-test as soon as possible.

If IgM is detected, this indicates that the body has recently met with an infectious agent, primary infection has occurred (in some cases, infection has been reactivated). The duration of infection can be judged by the presence of IgG. If they are not there yet, then very little time has passed since the “meeting”. Toxoplasmosis, cytomegaly (a disease caused by cytomegalovirus), herpes can be asymptomatic or with minor symptoms similar to those of a common ARVI, so a woman can often find out about the presence of an “acute” form of TORCH disease only from the results of such an analysis. Planning can begin after recovery.

When and why to donate?

Before starting planning. If a woman does not have IgG antibodies to rubella, she is vaccinated against this disease. Pregnancy planning can be resumed at least 3 months after immunization. There are no vaccines for other TORCH diseases.

If the analysis revealed diseases in an acute form, planning should be postponed for a while.

During pregnancy(upon registration in the antenatal clinic). If a blood test revealed a lack of “immunity” to TORCH infections, then a pregnant woman should be more attentive to her health. So, if a woman does not have IgG antibodies to Toxoplasma, you should avoid contact with other people's cats and limit your participation in caring for your own, take precautions when cutting raw meat, working with the ground. The general recommendation in the absence of class G immunoglobulins is to avoid, if possible, situations and contacts in which you can become infected. If high IgM titers are detected, indicating a recent infection or an acute course of the disease, a consultation with a doctor is necessary to prescribe further examination and, if necessary, treatment.

Infections that pose a particular threat to the human embryo, in all likelihood, have been present for many centuries, but no one knew about them, and the appearance of intrauterine development anomalies was considered "God's punishment for human sins."

The term "TORCH" (TORCH), like many others in the medical lexicon, appeared only at the end of the 20th century. Now analysis for TORCH infection is considered mandatory during pregnancy. And even better - to do it when planning a replenishment in the family, because a pregnant woman is much more difficult to treat than one preparing for this important event. The TORCH-complex includes the most significant diseases from the group of IUI (intrauterine infections), including a number of STIs (sexually transmitted infections).

What does TORCH mean?

TORCH is not just one disease, it is several diseases that occur in a woman during pregnancy and pose a serious threat not only to the patient, but also to the fetus in the process of antenatal (intrauterine) development. Of particular danger are infections that are present before the 12-week period, that is, in the first trimester, when the main organs and systems of the new organism are laid. TORCH infections in children born to infected mothers may present with various deformities immediately after birth or have long-term consequences such as mental and physical retardation.

A number of infectious agents, united in one group, are classified by gynecologists as pathogens that pose a serious danger to the health of a woman and the normal development of her child. To get rid of the need to repeatedly list all these pathogens, doctors came up with an easy-to-remember abbreviation, the decoding of which explains the meaning of each specific letter:

O- a group of infections, including pathogens:

venereal diseases -,;
viral infections - varicella-zoster, Epstein-Barr, associated with a wide range of diseases, as well as parvovirus B19, the transmission of which is possible in a vertical way;
other infectious processes caused by representatives of various classes of microorganisms -, etc .;

R- Rubella, which means rubella. It is caused by a highly contagious airborne virus. Rubella transferred in childhood is considered harmless and gives strong immunity. It is more difficult for women who were not vaccinated in childhood or were not “lucky” to get sick. Meeting such a pregnant woman with rubella is fatal and is the basis for termination of pregnancy for medical reasons;

FROM– CMV (CMV). able to be quietly present in the body and not manifest any symptoms whatsoever. In the case of primary infection during the onset of pregnancy, the issue of terminating it is decided;

H- HSV (Herpes simplex virus) - two types of herpes simplex virus. For the virus, the placenta is not a particular obstacle, so there is a rather high risk of infection of the fetus, both in the process of embryonic development and during childbirth.

The list of microorganisms encrypted in this way that cause intrauterine damage to the fetus and pose a threat to the health of the expectant mother, called the TORCH complex, is considered mandatory when registering for pregnancy and recommended if a woman is only planning it.

Basic methods for detecting TORCH infections

The preferential right when conducting research on the presence of specific antibodies in human blood serum to pathogens of TORCH infections belongs to, which is considered the cheapest and most affordable.

Also used for similar purposes, it detects not antibodies, but DNA or RNA of the virus itself in biological fluids (blood, urine, secretions from the genital tract), and in the smallest concentration, therefore it is especially good for detecting carriage (asymptomatic). However, the cost of PCR diagnostics is higher, and not every laboratory has the equipment. Meanwhile, it should be noted that the combined use of ELISA and PCR significantly increases efficiency, allowing you to determine not only the presence of the virus, but also its type. Often, in addition to or as an independent study, which is also best done with PCR, the direct immunofluorescence (DIF) technique is used, which is also considered highly informative studies.

Direct methods for detecting TORCH pathogens include a nutrient medium (for example, gonococcus requires just such an approach) and cytological diagnostics, but the latter still cannot be considered reliable, since it only finds indirect signs of infection (gonorrhea, chlamydia, herpes infection), which require confirmation by other methods (ELISA, PCR, bakposev).

If there is a need for examination

It is now absolutely easy to pass an analysis for the TORCH complex. When planning a pregnancy, you can contact your antenatal clinic, where the gynecologist will surely direct the patient in the right direction. By the way, the husband or alleged biological father will not have to be disturbed, since he is not subject to such an examination. When planning a pregnancy, it should be borne in mind that the analysis may turn out to be paid and its cost, depending on many factors, including the region, the status of the clinic, the characteristics of test systems and methods, can vary between 1.5 - 6.5 thousand (average price 2000 - 4000). Of course, the residents of Moscow and St. Petersburg will pay the highest price, but the periphery will win in this situation.

There are special rules for pregnant women. In most cases women registered in the antenatal clinic are subject to a free examination or on preferential terms, when the price of the analysis is 3 times cheaper.

You can take an analysis for TORCH, except for the antenatal clinic, where the study is mandatory, at any clinic or medical center that has an ELISA laboratory equipped with special equipment and test kits. It should be noted that the analysis is quite laborious, carried out in two stages and often on a semi-automatic analyzer, which involves only automatic reading of the results, while the rest of the process is performed manually. Of course, it is clear that the “automatic machine” available in the laboratory will take on almost all functions.

In addition, patients are often outraged by the fact that they offer to come for an answer in two weeks, or even a month. This means that a certain number of serum samples are required to use the test system, since it would be very impractical and expensive to spend a whole set for 1-2 people. For this reason, pregnant women it is better to take tests in specialized institutions that conduct a lot of research and do not delay results.

For analysis by enzyme immunoassay, blood is taken from the patient's vein, the serum is separated, which goes to work. Blood, as with all biochemical studies, is taken on an empty stomach, usually in the morning, so it is assumed that a person will be hungry for at least 8 hours. Antibiotic therapy before the test should be excluded for 3-4 weeks otherwise you may get false negative results.

When conducting PCR on other biological media (urine, secretions from the genital tract), the range of rules is noticeably expanded. To obtain reliable results, the test person is offered:

Exclude sexual contact a day before the examination;
Do not urinate 2 hours before receiving the material:
Do not use intimate hygiene products, do not douche;
Take an analysis immediately after menstruation (when planning a pregnancy).

The doctor, as a rule, informs the patient about all the nuances or gives a specially designed memo so that the person does not forget anything.

How to understand the results?

Considering that ELISA is the most popular method in detecting TORCH, it may be interesting for readers to find out what unfamiliar Latin symbols and numbers in the answers mean. Of course, a positive and negative result is always clear, but how to interpret it, is it good or bad, should you still be afraid of the disease or is it already there, only its course is hidden, which means the designation IgG or IgM and much more.

An example of the results of an analysis for the TORCH complex with detected toxoplasmosis

Developed for a foreign antigen at some stage of the disease, they are called immunoglobulins and are designated Ig. Depending on the period of the disease, antibodies appear, they are classified into different classes: A, E, M, G, D, etc. In the case of TORCH infections, the appearance of immunoglobulins of classes M and G (IgM, IgG) is considered.

Class M immunoglobulins are produced early in the infection process, while class G immunoglobulins appear later and indicate a state of remission or the presence of immunity. In addition, when examining serum for these pathogens, antibody titer and avidity index are often indicated. However, it should be noted that only a doctor is allowed to fully interpret the results, so we will focus only on positive and negative responses in immunoglobulin studies.

Indicators of TORCH infections - immunoglobulins of classes M and G

Tests to identify the causative agent of a particular infectious process are based on determining the level of antibody titers to the antigen of this pathogen:

Immunoglobulins of class M, which appear in the acute period of the disease;
Immunoglobulins of class G, indicating remission or the presence of immunity.

For cytomegalovirus, toxoplasmosis, rubella virus, and herpes infection, test results may look like this:

AbsenceIgMandIgG indicates that although there is no infection, there is no immunity, therefore, during pregnancy measures to prevent these diseases should be strengthened:

Toxoplasmosis - communicate less with cats and dogs, thoroughly wash vegetables and fruits, do not eat non-thermally processed meat products;
Rubella - a negative result indicates a lack of immunity, therefore, when planning, vaccination is possible, then control of IgM and IgG after 2 - 2.5 months (not earlier). During pregnancy - a risk group, control of immunoglobulins of both classes every month in case of contact with a sick child;
Cytomegalovirus infection - no infection was encountered. Pregnancy is at risk. Control of Ig of both classes every month. Prevention measures: vitamins, microelements;
Herpes - there was no meeting with the infection. Pregnancy is at risk. Control of Ig of both classes every month. Strengthening the body's defenses, vitamin therapy;

IgM - the result is positive, IgG - negative – sign of recent infection:

Toxoplasmosis, rubella - the results correspond to the initial phase of an acute infection or a false positive reaction, therefore, one way or another, the analysis should be repeated after a couple of weeks;
Herpes, CMVI - possible manifestations of primary infection. Re-control after 2 weeks. When planning pregnancy - general strengthening therapy, in the presence of pregnancy - consultation of an infectious disease specialist. Tactics is determined by the doctor observing the pregnant woman, who, depending on the period, chooses the treatment;

IgM - negative, IgG - positively this result means:

Toxoplasmosis - infection occurred more than a year ago, at the moment there is immunity, so there is no threat to the health of the child;
Rubella - a similar result may indicate the presence of immunity and, accordingly, the absence of a threat to the fetus if the IgG level is > 10 IU / ml. However, in the case of low IgG levels (< 10 МЕ/мл) при планировании беременности рекомендована ревакцинация с контролем уровня иммуноглобулинов через 2 – 2,5 месяца;
Herpes, CMVI - the indicators indicate a remission of the disease, therefore, constant monitoring of changes in the titer of antibodies is necessary;

In the blood of the patient are present in sufficient concentration andIgM, andIgG:

Toxoplasmosis - possibly the development of an acute infection or the presence of "delayed" IgM, therefore, for clarification - repeated control of immunoglobulins of both classes after 14-15 days. In the presence of pregnancy - consultation of an infectious disease specialist, monitoring the level of immunoglobulins of both classes after 14-15 days, conducting additional tests for avidity of AT class G;
Rubella - the result may correspond to the acute phase of the infectious process. Infectionist consultation is indicated, re-examination after 2 weeks;
Herpes, CMVI - reinfection or the development of an acute infection is possible. To clarify the prescription of the process, re-analysis after 14 days (rubella) and an additional study on the avidity of class G immunoglobulins (CMVI). During pregnancy, tactics are determined by a gynecologist observing a woman, depending on the clinical picture and laboratory diagnostic data.

table: TORCH analysis results and possible diagnoses

Treatment of TORCH infection

Treatment of TORCH infections directly depends on whether the woman is currently planning a pregnancy or is already in an “interesting position”. In addition, the primary task is to identify the pathogen, because each of the infections requires its own, individual approach.

The treatment of a pregnant woman is associated with certain difficulties, since many drugs that have shown themselves remarkably well in the fight against infections are simply capable of having a detrimental effect on the developing fetus. That's why It is recommended that all therapeutic measures be carried out before the onset of pregnancy., that is, even while planning it. However, anything can happen in life, so infected pregnant women periodically appear. In such cases, the attending physician prescribes the necessary examinations, consultation of an infectious disease specialist, and in treatment proceeds from the positions of the least risk with the addition of immunomodulators and general strengthening vitamin complexes to drugs with directed action.