Abnormal Development - TORCH Infections
|Embryology - 16 Nov 2018 Expand to Translate|
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|Educational Use Only - Embryology is an educational resource for learning concepts in embryological development, no clinical information is provided and content should not be used for any other purpose.|
Infections, collectively grouped under the acronym TORCH for Toxoplasmosis, Other organisms (parvovirus, HIV, Epstein-Barr, herpes 6 and 8, varicella, syphilis, enterovirus) , Rubella, Cytomegalovirus and Hepatitis. (some of these infections have additional pages and also see related pages on maternal hyperthermia and bacterial infections}.
Materal effects should really be called environmental (in contrast to genetic) removing the association of mother with the deleterious agent. Accepting this caveat, there are several maternal effects from lifestyle, environment and nutrition that can be prevented or decreased by change which is not an option for genetic effects.
Finally, when studying this topic remember the concept of "critical periods" of development that will affect the overall impact of the above listed factors. This can be extended to the potential differences between prenatal and postnatal effects, for example with infections and outcomes.
|Abnormality Links: abnormal development | abnormal genetic | abnormal environmental | Unknown | teratogens | ectopic pregnancy | cardiovascular abnormalities | Coelomic Cavity | endocrine abnormalities | gastrointestinal abnormalities | genital abnormalities | head abnormalities | integumentary abnormalities | musculoskeletal abnormalities | limb abnormalities | neural abnormalities | neural crest abnormalities | renal abnormalities] | respiratory abnormalities | placenta abnormalities | hearing abnormalities | vision abnormalities | twinning | Developmental Origins of Health and Disease | ICD-11|
Some Recent Findings
|More recent papers|
This table shows an automated computer PubMed search using the listed sub-heading term.
References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.
Manon Vouga, David Baud, Eugénie Jolivet, Fatiha Najioullah, Alice Monthieux, Bruno Schaub Congenital Zika virus syndrome…what else? Two case reports of severe combined fetal pathologies. BMC Pregnancy Childbirth: 2018, 18(1);356 PubMed 30176812
H Kumar, V A Singh, M Isha, S Mehta, R Garg, P Shinu Line Immunoassay: A Rapid Test for Screening TORCH Complex in Antenatal Patients with Bad Obstetric History. Mymensingh Med J: 2018, 27(3);641-644 PubMed 30141457
Amy Heerema-McKenney Defense and infection of the human placenta. APMIS: 2018, 126(7);570-588 PubMed 30129129
Connie Leeper, Andrew Lutzkanin Infections During Pregnancy. Prim. Care: 2018, 45(3);567-586 PubMed 30115342
Andres Moreira-Soto, Renata Cabral, Celia Pedroso, Monika Eschbach-Bludau, Alexandra Rockstroh, Ludy Alexandra Vargas, Ignacio Postigo-Hidalgo, Estela Luz, Gilmara Souza Sampaio, Christian Drosten, Eduardo Martins Netto, Thomas Jaenisch, Sebastian Ulbert, Manoel Sarno, Carlos Brites, Jan Felix Drexler Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil. mSphere: 2018, 3(4); PubMed 30089647
| These papers originally appeared in the Some Recent Findings table, but as that list grew in length have now been shuffled down to this collapsible table.
The causal agent of Toxoplasmosis is the protist Toxoplasma gondii. This unicellular eukaryote is a member of the phylum Apicomplexa which includes other parasites responsible for a variety of diseases (malaria, cryptosporidiosis). The diagnosis and timing of an infection are diagnostically based on serological tests.
|Toxoplasmosis lifecycle||Toxoplasma tachyzoites|
Recent findings suggest that pre-pregnancy immunization against toxoplasmosis may not protect against reinfection by atypical strains.
- Links: Toxoplasmosis
A general term covering a ranges of viruses: parvovirus, HIV, Epstein-Barr, herpes 6 and 8, varicella, syphilis, enterovirus.
Rubella virus (Latin, rubella = little red) is also known as "German Measles" due to early citation in German medical literature. Infection during pregnancy can cause congenital rubella syndrome (CRS) with serious malformations of the developing fetus. This association between infection and abnormal development was first identified in 1941. The type and degree of abnormality relates to the time of maternal infection.
|Infant rubella virus||Rubella virus (electron micrograph|
- Links: Rubella Virus
Human cytomegalovirus (HCMV, Greek, cyto = "cell", megalo = "large") or Human Herpesvirus 5 (HHV-5) is a member of the herpes virus family. A viral infection that causes systemic infection and extensive brain damage and cell death by necrosis. HCMV infection is ranked as one of the most common infections in adults, with the seropositive rates ranging from 60–99% globally. In Western countries, adults with advanced AIDS prior to the introduction of highly active antiretroviral therapy (HAART) this virus also a cause of blindness (CMV retinitis) and death in patients.
Estimated annual number of United States children with long-term sequelae caused by various disease conditions.
Congenital cytomegalovirus data are from a literature review, with varying collection periods spanning multiple years.
Assumes 4 million live births per year and 20 million children less than 5 years of age. Where applicable, numbers represent means of published estimates. All estimates should be considered useful for rough comparisons only since surveillance methodology, time periods, and diagnostic accuracy varied by study.
| Hepatitis (inflammation of the liver) is caused in humans by one of 7 viruses (A, B, C, D, E) with the 2 additional F has not been confirmed as a distinct genotype; and G is a newly described flavivirus.
"All of these viruses can cause an acute disease with symptoms lasting several weeks including yellowing of the skin and eyes (jaundice); dark urine; extreme fatigue; nausea; vomiting and abdominal pain. It can take several months to a year to feel fit again." (CDC text).
Virus particles measure 42nm in overall diameter and contain a 27nm diameter DNA-based core.
Hepatitis Transmission Risk to the Fetus
- Hepatitis A - Fetal transmission of virus occurs with extreme rarity.
- Hepatitis B - Can occur as a consequence of intrapartum exposure, transplacental transmission, and breastfeeding.
20%–30% of HBsAg-positive/HbeAg-negative women will transmit virus to their infants. 90% of HBsAg- and HBeAg-positive women will transmit virus to their infants. Immunoprophylaxis at birth with both HBIG and Hepatitis B vaccine within 12 hours of birth decreases the risk of transmission. Passive (HBIG) and active immunization is 85%–95% effective in preventing neonatal HBV infection.
- Hepatitis C - The overall risk of transmission is approximately 5%–10% with unknown maternal viral titers.
All pregnant women with HCV should have viral titers performed.
Data: Hepatitis and reproduction
- Links: Hepatitis Virus
- Leeper C & Lutzkanin A. (2018). Infections During Pregnancy. Prim. Care , 45, 567-586. PMID: 30115342 DOI.
- Moreira-Soto A, Cabral R, Pedroso C, Eschbach-Bludau M, Rockstroh A, Vargas LA, Postigo-Hidalgo I, Luz E, Sampaio GS, Drosten C, Netto EM, Jaenisch T, Ulbert S, Sarno M, Brites C & Drexler JF. (2018). Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil. mSphere , 3, . PMID: 30089647 DOI.
- Vilibic-Cavlek T, Ljubin-Sternak S, Ban M, Kolaric B, Sviben M & Mlinaric-Galinovic G. (2011). Seroprevalence of TORCH infections in women of childbearing age in Croatia. J. Matern. Fetal. Neonatal. Med. , 24, 280-3. PMID: 20476874 DOI.
- van der Weiden S, Steggerda SJ, Te Pas AB, Vossen AC, Walther FJ & Lopriore E. (2010). Routine TORCH screening is not warranted in neonates with subependymal cysts. Early Hum. Dev. , 86, 203-7. PMID: 20227842 DOI.
- Brogly SB, Abzug MJ, Watts DH, Cunningham CK, Williams PL, Oleske J, Conway D, Sperling RS, Spiegel H & Van Dyke RB. (2010). Birth defects among children born to human immunodeficiency virus-infected women: pediatric AIDS clinical trials protocols 219 and 219C. Pediatr. Infect. Dis. J. , 29, 721-7. PMID: 20539252 DOI.
- Gregg NM. (1991). Congenital cataract following German measles in the mother. 1941. Epidemiol. Infect. , 107, iii-xiv; discussion xiii-xiv. PMID: 1879476
- Centers for Disease Control and Prevention, Congenital CMV Infection Trends and Statistics http://www.cdc.gov/cmv/trends-stats.html, viewed 6 November 2012 (EST).
- Practice Committee of American Society for Reproductive Medicine. (2008). Hepatitis and reproduction. Fertil. Steril. , 90, S226-35. PMID: 19007636 DOI.
Nickerson JP, Richner B, Santy K, Lequin MH, Poretti A, Filippi CG & Huisman TA. (2012). Neuroimaging of pediatric intracranial infection--part 2: TORCH, viral, fungal, and parasitic infections. J Neuroimaging , 22, e52-63. PMID: 22309611 DOI.
Ishaque S, Yakoob MY, Imdad A, Goldenberg RL, Eisele TP & Bhutta ZA. (2011). Effectiveness of interventions to screen and manage infections during pregnancy on reducing stillbirths: a review. BMC Public Health , 11 Suppl 3, S3. PMID: 21501448 DOI.
Stegmann BJ & Carey JC. (2002). TORCH Infections. Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes infections. Curr Womens Health Rep , 2, 253-8. PMID: 12150751
Helfgott A. (1999). TORCH testing in HIV-infected women. Clin Obstet Gynecol , 42, 149-62; quiz 174-5. PMID: 10073308
Newton ER. (1999). Diagnosis of perinatal TORCH infections. Clin Obstet Gynecol , 42, 59-70; quiz 174-5. PMID: 10073301
Greenough A. (1994). The TORCH screen and intrauterine infections. Arch. Dis. Child. Fetal Neonatal Ed. , 70, F163-5. PMID: 8198407
. (1990). TORCH syndrome and TORCH screening. Lancet , 335, 1559-61. PMID: 1972489
Vilibic-Cavlek T, Ljubin-Sternak S, Ban M, Kolaric B, Sviben M & Mlinaric-Galinovic G. (2011). Seroprevalence of TORCH infections in women of childbearing age in Croatia. J. Matern. Fetal. Neonatal. Med. , 24, 280-3. PMID: 20476874 DOI.
Abu-Madi MA, Behnke JM & Dabritz HA. (2010). Toxoplasma gondii seropositivity and co-infection with TORCH pathogens in high-risk patients from Qatar. Am. J. Trop. Med. Hyg. , 82, 626-33. PMID: 20348511 DOI.
Singh S. (2002). Prevalence of torch infections in Indian pregnant women. Indian J Med Microbiol , 20, 57-8. PMID: 17657031
Abdel-Fattah SA, Bhat A, Illanes S, Bartha JL & Carrington D. (2005). TORCH test for fetal medicine indications: only CMV is necessary in the United Kingdom. Prenat. Diagn. , 25, 1028-31. PMID: 16231309 DOI.
June 2010 "TORCH Infections" All (183) Review (37) Free Full Text (18)
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Cite this page: Hill, M.A. (2018, November 16) Embryology Abnormal Development - TORCH Infections. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_TORCH_Infections
- © Dr Mark Hill 2018, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G