Overview
This lecture covers TORCH syndrome—a group of infections transmitted from mother to fetus during pregnancy or childbirth, detailing causes, symptoms, prevention, and treatment.
What is TORCH Syndrome?
- TORCH syndrome is a collection of infections affecting fetuses or newborns, transmitted from mother to child during pregnancy or birth.
- TORCH stands for Toxoplasmosis, Other agents, Rubella, Cytomegalovirus, and Herpes simplex virus.
T: Toxoplasmosis
- Caused by the protozoa Toxoplasma gondii, often from raw meat or cat feces.
- Fetal effects: chorioretinitis (eye inflammation), hydrocephalus (brain fluid buildup), intracranial calcifications, mental retardation, and seizures.
- Prevention: avoid raw/undercooked meat, wash produce, avoid cat litter, and wear gloves when gardening.
- Diagnosis: blood test; Treatment: antibiotics/antimalarial.
O: Other Agents (Syphilis, Varicella, HIV)
- Syphilis: bacterial STI causing miscarriage, deformities, rashes, and Hutchinson's teeth in infants; treatable with antibiotics.
- Varicella (chickenpox): causes limb atrophy, small head, cataracts, and learning disabilities; prevention via vaccination; antiviral treatment available.
- HIV: can transmit during pregnancy, birth, or breastfeeding; antiretroviral therapy reduces risk; symptoms include poor weight gain and infections; avoid breastfeeding.
R: Rubella
- Caused by Rubella virus; leads to flu-like symptoms or a rash in mother.
- Fetal effects: miscarriage, congenital rubella syndrome (PDA, cataracts, deafness, bone/growth issues, blueberry muffin rash).
- Prevention: MMR vaccination before pregnancy (not during).
C: Cytomegalovirus (CMV)
- Belongs to the herpes virus group; often asymptomatic in adults.
- Fetal effects: premature birth, low birth weight, rash, small head, hearing loss, mental retardation, seizures.
- Prevention: handwashing, avoid sharing utensils, avoid kissing toddlers on the mouth.
H: Herpes Simplex Virus (HSV)
- Causes genital lesions in mother; highest risk with first infection near delivery.
- Transmission via membranes rupture or vaginal birth.
- Infant effects: skin/eye/mouth lesions, liver involvement, CNS infection with seizures and poor feeding.
- Treatment: antiviral therapy.
Key Terms & Definitions
- TORCH Syndrome — group of infections harmful to fetuses/newborns.
- Chorioretinitis — inflammation of the retina and choroid in the eye.
- Hydrocephalus — buildup of fluid in the brain.
- Palmar/Plantar Rash — rash on hands/feet.
- Hutchinson's Teeth — notched, peg-shaped incisors from congenital syphilis.
- Blueberry Muffin Rash — purplish skin lesions due to extramedullary hematopoiesis.
- Antiretroviral Therapy (ART) — medication regimen for HIV.
Action Items / Next Steps
- Educate pregnant women about TORCH infection prevention.
- Ensure appropriate prenatal screening for TORCH infections.
- Assign reading on TORCH syndrome in course textbook.