welcome to this video tutorial on the torch syndrome torch syndrome refers to an infection in a developing fetus or newborn of any one of a group of diseases the disease is passed from mother to child during pregnancy or child birth torch is an acronym for the following group of infections t for toxoplasmosis o for other agents including syphilis ver and HIV R for rubella C for cytomegalo virus and H for herpes simplex virus once the mother is infected with a disease the organism circulates in the mother's blood and reaches the fetus by way of the placenta in most cases the maternal illness is mild but the impact on the developing fetus can be severe enough to cause fetal loss or result in iugr intrauterine growth restriction prematurity or chronic postnatal infection toxoplasmosis is a disease that is caused by a protozoa that is parasitic usually acquired by the pregnant woman eating raw or poorly cooked meat raw eggs or by contact with the feces of an infected cat such as improper handling of a cat litter box the infant exposed prenatally may have Coro retinitis which is inflammation behind the retina which can progress to blindness however this may not appear until adolescent also hydris which is a buildup of cerebral spinal fluid in the brain intracranial calcifications which are linked to mental retardation seizures or motor and developmental delays to avoid infection with toxoplasmosis instruct the pregnant woman to avoid poorly cooked or raw meat especially pork beef or lamb wash fruits and vegetables thoroughly avoid contact with a cat litter box make sure someone else is cleaning it regularly and wear loves when gardening and avoid garden areas frequented by cats diagnosis of congenital toxoplasmosis can be done by blood test and treatment is with antibiotics Andor an antimalarial agent as we continue in our acronym o stands for other agents and this can include things such as syphilis HIV and vericella syphilis is a bacterial sexually transmitted infection that is transmitted from mother to fetus during pregnancy or at Birth resulting in congenital syphilis untreated early syphilis results in miscarriage premature birth still birth deformities developmental delays or seizures newborns with congenital syphilis May develop Snuffles in which the mucus is highly infectious and a Palmer or solar rash seen on the hands or feet as the child ages after 2 years old they develop Hutchinson's teeth which have notched incizors or widely spaced Peg teeth they also develop a saddle nose which is a collapse of the Bony part of the nose frontal bossing is also seen this is an unusually pronounced forehead almost half of fetus is infected with syphilis and utero do not make it to term or die soon afterwards most children born with syphilis do not show symptoms of the disease for several weeks or months after birth if left untreated the disease becomes severe and affects the neurological and cardiovascular systems a newborn with syphilis can be treated with antibiotics and if the mother is treated early in pregnancy the infant is at minimal risk for infection the vericella virus also known as chickenpox can be spread from the pregnant mother to her fetus through the bloodstream there's only a 2% chance that the baby will develop congenital vericella syndrome but it does involve several different types of birth defects congenital vericella Sy Drome birth effects include limb atrophy damage to the brain abnormally small head vision problems such as cataracts psychomotor skill problems learning disabilities and mental retardation a pregnant woman with vericella may be treated with an IV antiviral medication if the woman was immunized or previously infected with vericella before pregnancy antibodies were formed and will be transferred to the fetus neither the woman woman nor her fetus will become infected during the pregnancy HIV mothers with HIV May transmit the virus to their child during pregnancy child birth or breastfeeding with the appropriate anti-retroviral therapy or art the risk of motherto child infection can be reduced to less than 1% whereas the risk of transmission without treatment is 15 to 45% approximately 1.4 million HIV positive women become pregnant every year anti-retroviral therapy can be used before during and after pregnancy even if the woman is on Art she should avoid breastfeeding because HIV can still be transmitted through breast melt newborns should receive a six- we course of a and then be tested for HIV at 2 to 3 weeks of life again at 4 to 8 weeks and then at 4 to 6 months of age most HIV babies appear healthy at Birth but if left untreated the following signs or symptoms May develop Within 2 to 3 months poor weight gain repeated fungal mouth infections such as thres enlarged lymph nodes multiple bacterial infections such as pneumonia and neurological problems the r and torch stands for rubella this is a disease also called German Measles and is caused by the virus Ruba virus it causes mild flu like symptoms and a rash on the skin or no symptoms at all rubella can be passed from mother to fetus through the bloodstream during pregnancy rubella can cause miscarriage still birth premature birth or congenital rebella syndrome which causes birth effects such as PDA or patent ductus arteriosis cataracts deafness intellectual disabilities bone or growth problems liver or spleen damage and a blueberry muffin rash which is also seen in CMV most damage is done to the developing fetus during the first trimester whereas if the mother gets rebella towards the end of the second trimester it is less likely to harm the fetus there is no cure for congenital rubella syndrome so prevention is the key rubella can be prevented by getting the MMR measles Ms rubella vaccine usually given in childhood if the woman is nonimmune she may receive the vaccine at least 28 days prior to the pregnancy or after delivery of the infant since it is a live virus it cannot be given during pregnancy in the acronym C stands for cytomegalo virus also known as CMV this is a virus that belongs to the herpes simplex virus group that may be inactive at times but is an incurable lifetime infection to the generally healthy adult the virus normally produces no symptoms and we have produced antibodies which can be passed on to the fetus and protect the fetus however CMV is a major concern if a mother becomes first infected while pregnant because she has no antibodies to pass on to the fetus symptoms in the mother are similar to mononucleosis fever swollen glands fatigue tonsilitis and liver malfunction the virus can be found in blood saliva urine semen cervical mucus and breast milk and can be transmitted from the infected mother across the placenta to the fetus or by the cervical root during birth or by breastfeeding symptoms of congenital CMV may or may not be seen at Birth but can cause premature birth low birth weight blueberry muffin skin rash liver or spleen enlargement micral or a small head hearing loss mental retardation and seizures a child with CMV may be treated with an antiviral medication which may reduce some of the effects of the infection prevention is so important the pregnant woman should practice good personal hygiene especially handwashing after contact with diapers or saliva of toddlers especially if they are in daycare avoid sharing food or eating and drinking utensils avoid kissing young children on the mouth or putting their pacifier in your mouth CMV can be transmitted by saliva the final letter in our acronym is H which stands for herpes simplex virus or HSV herpes simplex virus infection can cause painful lesions in the genital area area women who contract their first herpes infection near the time of birth have the highest risk of transmission to the newborn transmission of HSV to the fetus almost always occurs after the membrane's rupture or during vaginal birth placental transfer of infection is rare when HSV transfers to the newborn it is evidenced by one or more following forms first there is skin eyes and mouth herpes these are external lesions on the Infant but no inter internal organ involvement second there are disseminated herpes this affects the internal organs particularly the liver and third central nervous system herpes an infection of the nervous system and brain the infant presents the seizures trimers lethargy irritability poor feeding unstable temperature and bulging fontals antiviral treatment reduces the morbidity and mortality of the infant now for a brief review of the torch infections their causes and symptoms toxoplasmosis it's caused by a protozoa found in raw meat and cat litter boxes the signs and symptoms in the child include blindness hydris and mental retardation other agents include syphilis which is a bacteria that is sexually transmitted the symptoms include Snuffles Palmer or solar rash Hutchinson's teeth saddle nose and frontal bossing vericella is a virus it is Airborne and by contact signs and symptoms include limb atrophy damage to the brain and eyes which include cataracts HIV is a virus which is sexually transmitted and bloodborne the infant shows poor weight gain and repeated infections rubella is a virus that is Airborne and contact and the infant shows PDA C and deafness cytomegalo virus is a virus caused by close contact with any bodily fluids the infant shows micro hearing loss and mental retardation herpes simplex virus is sexually transmitted and by saliva and is shown by skin lesions or CNS infections as a nurse educating your pregnant patient on how to prevent torch infections is vitally important to the health of her newborn thank you for watching this video tutorial on Torch infections and be sure to subscribe and like us on Facebook