Motherhood is a beautifully rewarding and transformative journey. While parents often prepare for a child’s arrival — be it selecting attractive toys, setting up a lovely nursery, or removing sharp objects in the house — protecting the baby before birth is just as crucial. During pregnancy, infections from the TORCH group can pose serious risks to fetal health. As February is marked as International Prenatal Infection Prevention Month, experts shed light on these infections and how to prevent them.
What is TORCH?
TORCH is a group of perinatal infections that cause congenital abnormalities in babies. “The infections are toxoplasmosis, other infections like syphilis and varicella (chickenpox), rubella, cytomegalovirus, and herpes,” said Dr Smita Pawar, senior consultant in fetal medicine, Fernandez Hospital.
Certain infections like toxoplasmosis, rubella, and cytomegalovirus are more likely to cause serious effects if contracted during the first trimester. “Sexually transmitted diseases can affect the newborn if the mother is infected soon before delivery,” she explained.
TORCH infections can cause growth restriction, poor organ development, ocular and hearing abnormalities, and limb hypoplasia, which means underdeveloped limbs. “After birth, these infections can cause high-grade fever, rashes, sepsis, hearing or vision problems, jaundice, seizures or intellectual disabilities in the baby,” the fetal medicine specialist added.
What causes these infections?
Dr Smita delved into how TORCH infections occur.
Toxoplasmosis: Caused by the parasite Toxoplasma gondii and transmitted through consumption of undercooked or raw meat, unwashed fruits and vegetables, and contaminated water. Coming in contact with cat faeces while cleaning a litter box can put you at risk of contracting this infection.
Other infections: Syphilis is sexually transmitted, and varicella spreads via contact with an infected person.
Rubella: Usually present in children below 10 years, this is an air-borne infection that a pregnant woman can contract. Symptoms include cold, cough, rash, or headache. A pregnant woman can pass it to her baby through the bloodstream.
CMV: Caused by the virus cytomegalovirus and contracted through sexual contact and ingestion of bodily fluids (for instance, by sharing food or beverages). The symptoms are fever, fatigue, sore throat, enlarged lymph nodes, and mild jaundice.
Herpes: An STD caused by the herpes simplex virus.
Prevention is the only route
The fetal medicine specialist underscored the importance of preconception counselling, screening, and vaccination. “Live vaccines such as varicella and rubella vaccines cannot be taken during pregnancies, so they must be taken at least one month before you conceive,” she said.
Both doctors agreed that prevention is key. “If a couple is planning a pregnancy, they should first reach out to their healthcare provider or gynaecologist to assess the woman’s immunity to the infections,” said Dr Padmavathi Kapila, chief consultant obstetrician and gynaecologist, Renova Hospitals.
Gynaecologists also take a look at the health history of the woman. “For instance, if we find that she has had miscarriages, stillbirths, or a child with congenital defects, it helps us assess the situation better,” she revealed.
A gynaecologist will conduct a TORCH test, which involves doing an Immunoglobulin G (IgG) and Immunoglobulin M (IgM) blood test. This basically assesses IgG and IgM titers — or quantity of immunoglobulins — in your blood. “Essentially, this can tell you if there was any recent exposure to an infection source,” she noted. The senior gynaecologist added that STDs, if present, can be treated before conception.
But Dr Padmavathi stressed that a woman should boost her immunity by avoiding drinking and smoking. “It’s simple — don’t consume undercooked or raw meat, unwashed produce, and contaminated water. Don’t expose yourself to cat litter. Practice hand hygiene, especially after coming in contact with children,” she advised.
The gynaecologist stated that if the mother tests positive for any TORCH infection, they screen for abnormalities to understand the extent to which it has affected the baby. She further added, “Then, we take a decision regarding termination of pregnancy. Couples, it is your responsibility to report any symptoms promptly and be honest with the gynaecologist. At the end of the day, what matters most is your health and your baby’s health.”