The term TORCH (toxoplasmosis, other, rubella, cytomegalovirus, herpes) has been applied to maternal infections with recognized detrimental effects on the fetus. TORCH testing refers to the testing for IgG (indicating past infection) and IgM (indicating recent infection) antibodies to the particular infectious agents described. Included in the category of other are such infections as syphilis. All of these tests are discussed separately:
• Toxoplasmosis
• Rubella
• Cytomegalovirus
• Herpes virus
The direct effects of these infections may be immediate or delayed. A majority of infants infected by toxoplasmosis in utero are asymptomatic at birth with neurologic sequelae appearing later in life. Prenatal rubella infections, on the other hand, may severely damage the fetus, causing congenital heart disease and mental retardation. Congenital cytomegalovirus infections can result in infant death, hearing loss, cerebral palsy, mental retardation, or chorioretinitis. Neonatal herpes infection (can occur in utero or during birth) presents as localized infection to the skin, eye, and mouth (SEM) or as disseminated infection (involving multiple organs, such as the liver, lung, adrenal glands, or brain). The earlier these infections are recognized, the earlier they can be treated or steps can be made to preclude the long-term effects of the disease. Other effects of TORCH infections on the fetus may be indirect and precipitate abortion or premature labor.
The accuracy of prenatal serology testing is variable. TORCH infections can be more accurately diagnosed by direct identification of the organism by polymerase chain reaction (PCR) testing or culture of amniotic fluid.
