Vol 4 | Issue 2 | 2014 | 118-120.

ISSN 2249 - 7641

Print ISSN 2249 - 765X

International Journal of Pharmacology Research

www.ijprjournal.org

TORCH POSITIVE ANTENATAL CASES AT TERTIARY CARE

CENTER
Bhuvaneshwari S1*, Mekala L2, Geetha V. Shastri3, Bhuvaneswari K4
1
Professor, Department of Pharmacology, 2Former MBBS Student, 3Former Professor of Pharmacology, 4Professor & HOD of
Pharmacology, PSG IMS &R, Peelamedu, Coimbatore-641004, Tamilnadu, India.

ABSTRACT
TORCH stands for Toxoplasama gondii, Rubella virus, Cytomegalovirus (CMV), Herpes simplex virus (HSV).
These infections are transmitted transplacentally from mother to fetus. They show vertical transmission of infection. They
are grouped together as they evoke similar clinical and pathological manifestations – fever, encephalitis, chorioretinitis,
hepatosplenomegaly, pneumonitis, myocarditis and hemolytic anemia. They cause malformation of the embryo by disturbing
its development resulting in fetal growth retardation. In the infant they cause mental retardation, cataract, congenital cardiac
anomalies and bone defects. Therefore it is necessary to detect these viruses early during pregnancy and manage
appropriately. Detection of IgM against the virus is more important than IgG as it indicates recent infection. So this study
was planned to find out the number of antenatal case positive for any one of the infections coming under TORCH in a
tertiary care hospital. A descriptive study was planned out. The protocol was approved by Institutional Human Ethics
Committee. 40 was the estimated sample size. All outpatients who were tested for TORCH infection were included. The data
was collected retrospectively. Details on incidence of TORCH positive cases, incidence of each component of TORCH
among TORCH positive cases were recorded using case record form. Personal details like, name, Date of Birth, telephone
number and address were not taken. Patient details were kept confidential. The collected data was analysed statistically. 15%
of the cases were positive for TORCH in suspected cases. It was concluded that 67% were tested positive for CMV and 33%
for Toxoplasma. There was no incidence of Rubella/Herpes infection. Toxoplasma infection was treated with Spiramycin.
And there is no specific treatment for CMV during pregnancy. All the patients were advised to postpone the pregnancy till
the IgM titers come down.

Keywords: TORCH, Pregnancy, Antenatal cases tertiary care center.

INTRODUCTION
TORCH stands for Toxoplasama gondii, Rubella
virus, Cytomegalovirus (CMV), Herpes simplex virus
(HSV). These infections are transmitted transplacentally
from mother to fetus. They show vertical transmission of
infection [1]. They are grouped together as they evoke
similar clinical and pathological manifestations – fever,
encephalitis, chorioretinitis, hepatosplenomegaly,
pneumonitis, myocarditis and hemolytic anemia. They
cause malformation of the embryo by disturbing its
development resulting in fetal growth retardation. In the
infant they cause mental retardation, cataract, congenital
cardiac anomalies and bone defects. Therefore it is
necessary to detect these viruses early during pregnancy
and manage appropriately. Detection of IgM against the
virus is more important than IgG as it indicates recent
infection.
Incidence of primary toxoplasmosis in pregnant
women ranges from 1-10 per 1000 pregnancies depending
on the part of the world, life style & socio-economic status
[2]. It can be treated with spiramycin, pyrimethamine,
sulfadiazine, folinic acid during pregnancy.
Congenital Rubella syndrome (CRS) can be

Corresponding Author:- Bhuvaneshwari S E-Mail ID: bhuvana1421@gmail.com

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prevented by giving rubella vaccine. Pregnant women
should not receive the vaccine. Pregnancy should be
avoided for three months after receiving vaccine. The
maximal theoretical risk for CRS after first trimester
vaccination is estimated at 1.6%. But greater than 700
infants delivered to mothers inadvertently vaccinated in the
first trimester had signs of CRS [3]. This suggests that the
vaccine strains are not teratogenic despite ability to infect
fetus. Susceptible women should be given rubella vaccine
in the immediate post partum period before discharge.
There are no reports of successful antiviral therapy in
congenitally infected infants.
There are no current protocols for the use of
antiviral agents like acyclovir or gancyclovir during
pregnancy to treat severe CMV infection or to decrease the
risk of mother to child transmission of CMV while
pregnant [4]. Live attenuated CMV vaccine (towne strain)
has been used in renal transplant patients at high risk for
acquired CMV. The possible benefits and risk of this
vaccine for susceptible pregnant women have not been
established.
Because HSV infection during pregnancy is self
limited and generally resolves without ill effect on the
fetus, Acyclovir treatment is currently recommended as IV
therapy for severe or complicated maternal infection only
[5]. In more than 1000 cases reported to the has not
Acyclovir pregnancy registry, adverse effect on the fetus
DISCUSSION AND CONCLUSION
TORCH tests are not routine investigations done
during antenatal period. They are done only if the patient
shows clinical symptoms or has history of recent abortions.
So the cases reported as TORCH positive in the hospital
were detected after abortion and not during the course of
pregnancy. Spiramycin was given for Toxoplasmosis. And
they were advised to postpone the conception for three to
six months and were prescribed periconceptional folic acid.
Symptomatic treatment was given for CMV patients with
paracetamol and vitamin B complex. And these patients
were advised to postpone the conception for six months to
one year till the IgM titers come down.
been described. So this study was planned to find out the
number of antenatal case positive for any one of the
infections coming under TORCH in a tertiary care hospital.
METHODOLOGY
A descriptive study was planned out. The protocol
was approved by Institutional Human Ethics Committee. 40
was the estimated sample size. All outpatients who were
tested for TORCH infection were included. The data was
collected retrospectively. Details on incidence of TORCH
positive cases, incidence of each component of TORCH
among TORCH positive cases were recorded using case
record form. Personal details like, name, Date of Birth,
telephone number and address were not taken. Patient
details were kept confidential. The collected data was
analysed statistically.
RESULTS
 Out 40 patients who were tested for TORCH infection
15% of patients were positive for TORCH infection (Figure
1).
 Among these patients 33% were positive for
Toxoplasma and 67% were positive for CMV (Figure 2).
 Abortion has occurred in all the TORCH infected
pregnant mothers
To conclude,
 15% of the cases were positive for TORCH in
suspected cases
 67% were tested positive for CMV and 33% for
Toxoplasma. There was no incidence of Rubella/Herpes
infection.
 Toxoplasma infection was treated with Spiramycin.
And there is no specific treatment for CMV during
pregnancy.
 All the patients were advised to postpone the
pregnancy till the IgM titers come down.
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REFERENCES
1. Pathologic Basis of disease, Robbins and Cotran. Seventh edition 2004, 480.
2. Pregnancy at Risk- current concept, Usha Krishna, DK Tank, Shirish Daftary. Fourth edition 2001, 76.
3. Medical complications during pregnancy, Burrow and Duffy. Fifth edition 2001, 349.
4. Management of high risk pregnancy, John T Queenan. Fourth edition 2000, 315.
5. Medical complications during pregnancy, Burrow and Duffy. Fifth edition 2001, 343.

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