0 TORCH infections

Reactions: 

TORCH infections


Toxoplasma
Others
  • Syphilis
  • HIV
  • Hep B
  • Varicella
Rubella
CMV
Herpes

If Mother gets Rubella after 16wks - Nothing to fetus
But if 10-11 wks - Increased chances of fetal abnormalities

Common points :
1. 50 - 60 % are asymptomatic
2. If symptomatic :
  • IUGR
  • Failure to thrive
  • Anaemia
  • HepatoSpleenomegaly
  • Thrombocytopenia
  • Rash
  • Cholestasis


Infectivity 
1. All of them - at time of delivery.
2. Rubella - 2 peaks -
  • 10-11 wks
  • At time of delivery


If HIV to mother - 
  • Zidovudine after 14 wks pregnancy
  • then For delivery - do elective LSCS
  • If in labor - intrapartum Nevirapine
  • Neverapine to child (oral) x 4-6wks

Diagnosis is based on Serology :

1. IgM - is made by the child itself

2. IgG - is transmitted from mother 
     Considered marker only if :
  • IgG persists 6-9 months
  • or increases in titre


Note : in HIV cases - 
  • No IgM in child
  • IgG persisting >18months is taken as marker. (not 6-9 months)
Thus for 1st 18 months : (as Child of HIV mother will be having +ve ELISA)
  • p24 assay
  • PCR (best but difficult)
  • Viral Culture




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