TORCH infection in women with bad obstetric history--a pilot study in Kumaon region

TORCH infections in the mother are transmissible to fetus in the womb or during the birth process and cause a cluster of symptomatic birth defects. In mother they are inapparent or asymptomatic and hence difficult to diagnose clinically. Over a nine months period 20 pregnant women with bad obstetric history were-studied. Seropositivity of Toxoplasma, rubella, CMV, and HSV infections (TORCH) were demonstrated by the presence of IgM and IgG antibodies by ELISA method. It was found that, IgM antibodies were positive in 4 cases (20%) for Toxoplasma, 4 cases (28.6%) for rubella and 4 cases (26.7%) for CMV and HSV each. IgG antibodies were positive in 11cases (55%) for Toxoplasma, 10 cases (66.6%) for rubella, 14 cases (93%) for CMV and 11 (73%) for HSV. Therefore all antenatal cases with BOH should be routinely screened for TORCH as early diagnosis and appropriate intervention will help in proper management and fetal outcome.     

TORCH感染与不良妊娠的大样本回顾分析

目的基于大样本资料分析本地区TORCH感染与不良妊娠的相关性。方法依据纳入标准,从4398份TORCH筛查病例中提取3752份有效资料,然后采用病例-对照研究分析TORCH感染与不良妊娠的相关性。结果本地区不良妊娠孕妇群体中TOX、RV、CMV和HSV-II的IgM抗体阳性率分别为11.96%、15.54%、21.54%和10.03%,与对照组比较差异性显著(P<0.01)。结论TORCH感染是不良妊娠结局的重要危险因素,应重视TORCH病原体感染的早期筛查和诊治。     

梅州市孕妇TORCH感染情况的调查

目的调查梅州地区孕妇TORCH感染情况,为孕妇保健和计划生育提供实验依据。方法采用ELISA方法,对4538例孕妇进行TORCH特异性IgM抗体的检测。结果弓形体（TOX）、巨细胞病毒（CMV）、风疹病毒（RUV）、单纯疱疹病毒HSVⅡ的IgM抗体阳性检出率分别为5.60%、1.70%、1.15%、8.14%,梅州地区孕妇HSVⅡ感染率最高,TOX次之。结论孕妇TORCH感染的筛查对优生优育意义重大,建议在妇女孕前进行TORCH感染筛查,重视高发病原体感染的预防,计划受孕,以提高优生优育质量。     

宁波地区1220例孕妇TORCH感染状况分析

目的了解宁波地区孕妇TORCH感染状况,为预防TORCH感染、降低新生儿出生缺陷发生率提供参考资料。方法采用酶联免疫吸附试验(ELISA)对1220例妊娠妇女进行TORCH-IgM及IgG抗体检测,然后采用病例-对照研究分析TORCH感染与不良妊娠的相关性。结果 TORCH的10项检测结果 ,包括TOX、RUV、CMV、HSV-Ⅰ和HSV-Ⅱ的IgM阳性率分别为2.42%,1.89%,4.26%,9.19%,2.54%,IgG阳性率分别为3.01%,65.4%,90.47%,52.86%,13.3%。本地区不良妊娠孕妇群体中TOX、RUV、CMV、HSV-Ⅰ和HSV-Ⅱ的IgM抗体阳性率分别为12.77%,10.20%,14.29%,21.28%,10.64%与对照组比较差异性显著(P0.01)。结论宁波地区妊娠妇女HSV-Ⅰ感染率最高,其次是CMV。TORCH感染是不良妊娠结局的重要危险因素,应重视TORCH病原体感染的早期筛查和诊治。     

宁德地区孕妇TORCH感染的调查分析

目的调查宁德地区孕妇TORCH的感染率.方法采用抗体捕获ELISA的检测方法,对2001年7月至2003年7月来我院产前检查并自愿接受TORCH检测的孕妇1812例检测了TORCH-IgM抗体.结果 (1)TORCH-IgM总阳性率为18.33%,弓形虫(TOX)、风疹病毒(RUV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV-I)、(HSV-II)IgM阳性率分别为5.30%、4.64%、3.53%、2.21%、2.65%;(2)有异常妊娠史的孕妇TOX-IgM、RUV-IgM明显高于无异常妊娠史的孕妇;(3)调查发现宁德地区TORCH的不同病原体感染具有不同的季节性.春夏季节弓形虫感染率高、夏秋季节风疹病毒感染率高、巨细胞病毒在冬季感染率最低,单纯疱疹病毒的感染季节性不明显.结论 TORCH感染与优生优育有重要关系,建议在孕前进行TORCH感染筛查,不同季节重视高发病原体感染的预防,计划受孕, 对优生学具有现实意义.     

1307例育龄妇女血清TORCH抗体定量检测结果分析

目的 了解昆明地区育龄妇女弓形虫（TOX）、风疹病毒（RV）、巨细胞病毒（CMV）、单纯疱疹病毒（ HSV）,总称为TORCH的感染状况,为预防妊娠TORCH感染、降低新生儿出生缺陷发生率提供参考资料。方法 采用德国virion/serion酶联免疫吸附试验（ELISA）定量试剂,对1307例育龄妇女血清TORCH感染特异性IgM及IgG抗体进行检测,并对其结果进行分析。结果 1307例育龄妇女TORCH感染特异性IgM抗体总阳性率为1.45％,其中TOX：2.83％;RV：2.37％;CMV：0.46％;HSV：2.45％。特异性IgG抗体总阳性率为63.60％,其中TOX：3.98％;RV：72.30％;CMV：97.78％;HSV：80.34％。不同孕期妇女TORCH感染特异性抗体检出率差异无统计学意义。结论 本次调查中,1307例育龄妇女存在一定比例的TORCH现症感染,建议妊娠妇女尽可能进行TORCH筛查,以便尽早采取相应措施,避免由TORCH感染导致出生缺陷发生。     

Socioeconomic status and prevalence of toxoplasmosis during pregnancy

Two hundred and thirty-six women with previous bad obstetric history (BOH), belonging to different socio-economic groups were investigated for the presence of Toxoplasma specific antibodies (IgG/IgM) using commercial diagnostic kits. The study showed a higher percentage of IgG seropositivity in women of low socioeconomic group (LSG) compared to those of high socioeconomic group (HSG). Specific IgM positivity indicative of possible acute infection, was higher in women of HSG, emphasizing the need for educating pregnant mothers on preventive measures. However, there is a need to undertake in-depth studies to understand the significance of the presence of IgM in women with BOH.     

广西地区免费孕前优生健康检查21万对象TORCH筛查结果分析

目的分析符合生育政策计划怀孕妇女TORCH筛查结果,了解待孕妇女TORCH感染情况。方法对广西66个国家免费孕前优生健康检查项目县（市、区）计划怀孕妇女的TORCH筛查结果进行分析,比较城镇对象与农村对象的TORCH感染发生情况,了解县、乡两级服务机构TORCH筛查结果的差异。结果RV—IgG筛查阳性率48．31％,CMV—IgM筛查阳性率0．45％,CMV—IgG筛查阳性率44．02％,TOX—IgM筛查阳性率0．18％,TOX—IgG筛查阳性率2．27％;城镇对象RV—IgG、CMV—IgM、CMV—IgG阳性率高于农村对象（P〈0．01）;TOX—IgM阳性率与农村对象相近（P〉0．05）;TOX—IgG阳性率低于农村对象（P〈0．01）。结论了解计划怀孕妇女TORCH感染情况,指导其选择合适的怀孕时间,有利于减少TORCH感染所致的出生缺陷。     

2005年-2008年宁波地区孕妇TORCH-IgM检测结果分析

目的了解宁波地区孕妇中TORCH-IgM的阳性率,探讨选择性TORCH-IgM筛查的临床价值,为有效预防TORCH感染提供科学依据。方法采用酶联免疫法(ELISA)检测9385例孕妇血清的TORCH-IgM抗体水平,根据有无高危因素比较不同孕妇的血清抗体阳性率。结果高危因素组的孕妇TORCH-IgM阳性率分别为:TOX-IgM 1.02%、RV-IgM 1.86%、CMV-IgM 3.76%、HSVⅠ-IgM 7.75%、HSVⅡ-IgM 3.85%;无高危因素组的孕妇TORCH-IgM阳性率分别为:TOX-IgM 0.35%、RV-IgM 1.23%、CMV-IgM 2.26%、HSVⅠ-IgM 5.23%、HSVⅡ-IgM 2.64%;两组比较差异有显著性(P0.05)。结论对具有高危因素的孕妇应常规进行TORCH-IgM筛查,以便及早发现宫内感染,干预不良妊娠。     

弓形体感染导致自然流产的病因学分析

目的探讨自然流产与弓形体感染的关系。方法用ELISA法检测自然流产妇女和健康孕妇血清内TORCH系列病原体的IgM。结果自然流产妇女血清中弓形体TOX-IgM阳性率为35.17%,健康孕妇仅为3.12%,两组相比具有高度显著性差异,而两组的风疹病毒(RUV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)的IgM阳性率差异无显著性。结论弓形体感染是自然流产的重要原因之一。     

新生儿TORCH感染的血清学检测与临床分析

目的 对新生儿进行TORCH感染的血清学检查及临床表现分析。方法 用ELASA法检测血清中TORCH(弓形体、风疹病毒、巨细胞病毒、单纯疱疹病毒)IgM。结果 2000年1月至2003年1月本院新生儿重症监护室(NICU)共收治新生儿l554例，其中48例为TORCH感染，巨细胞病毒感染率最高占52．1％；风疹病毒感染占33．3％；单纯疱疹病毒感染占14．6％。未发现弓形体抗体阳性的患儿。结论 新生儿TORCH感染可造成多器官损伤，主要为听力异常、高胆红素血症和肝功能异常、神经系统损伤、心肌损伤、血小板减少、先天性心脏病。计划免疫、母亲孕期筛查、新生儿早期筛查、干预治疗非常重要。     

太原地区妊娠期感染TORCH的母婴传播及围产儿结局

目的：探讨妊娠妇女ＴＯＲＣＨ感染的母婴间传播及其围产儿不良结局。方法：收集８８６例孕妇的静脉血及其新生儿脐血,用ＥＬＩＳＡ法检测血清ＴＯＲＣＨ－ＩｇＭ抗体和ＨＢｓＡｇ及梅毒血清抗体。结果：孕妇血ＴＯＸ（弓形体）、ＲＶ（风疹病毒）、ＣＭＶ（巨细胞病毒）、ＨＳＶ－２（单纯疱疹病毒２型）ＩｇＭ抗体和ＨＢｓＡｇ,梅毒血清抗体的阳性率分别为０．２％、０．３％、１．７％、１．０％、０．７％、０．１％。２９例孕     

东莞地区1982例孕妇的TORCH检测与分析

目的了解东莞地区孕妇TORCH（TO、RCV、CMV、HSVⅠ和HSVⅡ）感染情况。方法ELISA法检测孕妇血清1982例,回顾性分析TORCH检测结果。结果TOX—IgM,RVU—IgM,CMV—IgM,HSVI—IgM及HSVⅡ—IgM的阳性率分别为6．77％,0．81％,0．86％,11．30％及8．94％。结论孕妇由于内分泌的改变和免疫力的下降,易于发生某些病原体（如TORCH）的原发感染和复发感染,故应进行TORCH感染的检测与预防,以避免出现流产、死胎、先天畸形、发育迟缓等综合征,从而提高人口生育质量。     

乌鲁木齐地区正常妊娠妇女和不同次数自然流产妇女TORCH感染比较

目的 比较乌鲁木齐正常妊娠妇女和不同自然流产次数妇女血清TORCH感染情况。方法 选取我院420例正常妊娠组妇女、451例1~2次流产组妇女和430例≥3次流产组妇女,采用ELISA法检测血清中特异性TORCH系列,包括弓形虫、巨细胞病毒、风疹病毒、单纯疱疹病毒IgM并比较其阳性率。结果 正常妊娠组TOX、CMV、RUV、HSV IgM阳性率分别为2.62%、5.24%、3.10%、6.67%,阳性率合计为17.62%;1~2次流产组妇女中上述抗体阳性率分别为7.10%、9.53%、7.76%、13.53%,阳性率合计为37.92%;≥3次流产组妇女上述抗体阳性率分别为3.49%、4.42%、3.95%、7.44%,阳性率合计为19.30%。1~2次流产组女性TORCH感染高于正常妊娠组（P＜0.05）,而≥3次流产组妇女TORCH感染与正常妊娠组比较,差异无统计学意义（P＞0.05）。结论 有1~2次自然流产的女性流产发生可能与TORCH感染有关,≥3次自然流产的女性流产发生与TORCH感染无明显相关性,可能与其它因素有关。建议在孕前进行TORCH感染筛查,尤其是对1~2次自然流产的女性,应重点筛查,做好孕期预防保健工作,以提高优生优育质量。     

370例孕前检查女性TORCH感染情况分析

目的 分析目前孕前检查女性风疹病毒(RV)、巨细胞病毒CMV、弓形虫(TOX)感染状况,为孕前优生咨询提供依据.方法 用电化学发光法检测孕前妇女血清RV、CMV、TOX的IgG、IgM抗体.结果 370例孕前妇女RV-IgG阳性率为91.62％,CMV-IgG阳性率为88.64％,CMV-IgM阳性率为1.08％,TOX-IgG阳性率为4.59％,TOX-IgM阳性率为1.35％.TORCH感染与籍贯及文化程度无相关性.结论 风疹病毒及巨细胞病毒感染人数超过检测人群的88％,应早期接种疫苗,避免感染的发生.弓形虫的感染率超过检测人群的4.5％,建议孕前妇女远离宠物.孕前进行巨细胞病毒、风疹病毒、弓形虫IgG、IgM的检查意义重大.提前检测,避免感染期怀孕,有助于减少妊娠不良结局发生的概率,降低先天畸形的发生率.     

Seroprevalence of rubella in pregnant women in Kashmir

The present study was conducted to determine the seroprevalence of rubella in pregnant women in Kashmir. One thousand nine hundred and eighteen pregnant women in age group of 20-35 were divided into two groups. Group I (n=892) consisted of women with previous history of repeated abortion (507), single abortion (220), intrauterine death (149), stillbirth (14) and premature delivery (2). Group II (n=1028) pregnant women with previous normal delivery. A total of 1918 pregnant women were screened for rubella IgM antibodies out of which 16.74% were positive. In women with bad obstetric history (Group I) 26.12% were positive as compared to 8.96% in women with no significant obstetric history (Group II). The IgM antibody positivity was higher in women with previous history of intrauterine death (IUD) 58.38% followed by stillbirth 57.14%, premature delivery 50%, abortion 21.8% and recurrent abortion 17.55%. The high prevalence of disease in this region demands urgent needs for prevention. Moreover antenatal cases should be screened as early diagnosis and time intervention will help in proper management of these cases.     

Seroprevalence and incidence of rubella in and around Delhi (1988-2002)

National Institute of Communicable Diseases (NICD) has been engaged in rubella testing for serodiagnosis of the infection and screening for immunity status. The compiled and evaluated data of the work done on rubella testing for the past fifteen years has been presented here to show the trend and changing scenario of the disease in Delhi. Blood samples were from 7424 patients referred to NICD, Delhi for serodiagnosis of congenital Rubella syndrome (CRS) in malformed babies, in utero rubella infection in women and immunity status of pregnant women and women with bad obstetric history. They were tested for rubella IgG and/or rubella IgM antibodies using commercially available reagents and kits. The data from the 15 years of testing was then compiled and evaluated. From the available data it was seen that immunity status against rubella in childbearing age group of women increased steadily from 49% in 1988 to 87% in 2002. Reported cases of CRS at NICD are also on the decline over the time period. There is periodic indication of high incidence of rubella in the year 1988; 1991 and 1998 as the reported cases of acute rubella infection in childbearing age group is high during these years.     

Evaluation of the Abbott AxSYM Cytomegalovirus (CMV) Immunoglobulin M (IgM) Assay in Conjunction with Other CMV IgM Tests and a CMV IgG Avidity Assay

The measurement of the avidity of cytomegalovirus (CMV) immunoglobulin G (IgG) antibodies has been shown by several investigators to be useful in identifying and excluding primary CMV infections in pregnant women. In this work, we examined the diagnostic utility of reflex testing of CMV IgM-positive specimens from pregnant women by using a CMV IgG avidity assay. The utility of this approach was directly dependent on the sensitivity of the CMV IgM assay employed during the initial screen. The higher initial reactivity rate of the AxSYM CMV IgM assay was necessary in order to detect CMV IgM in specimens containing low-avidity CMV IgG antibodies, indicative of a primary CMV infection, which other CMV IgM assays (Behring, Vidas, Captia, and Eurogenetics) fail to detect in some cases. The use of the AxSYM CMV IgM assay, followed by an avidity test, should result in more accurate diagnosis of CMV infection in pregnant women.     

Evaluation of the Abbott AxSYM cytomegalovirus (CMV) immunoglobulin M (IgM) assay in conjunction with other CMV IgM tests and a CMV IgG avidity assay

The measurement of the avidity of cytomegalovirus (CMV) immunoglobulin G (IgG) antibodies has been shown by several investigators to be useful in identifying and excluding primary CMV infections in pregnant women. In this work, we examined the diagnostic utility of reflex testing of CMV IgM-positive specimens from pregnant women by using a CMV IgG avidity assay. The utility of this approach was directly dependent on the sensitivity of the CMV IgM assay employed during the initial screen. The higher initial reactivity rate of the AxSYM CMV IgM assay was necessary in order to detect CMV IgM in specimens containing low-avidity CMV IgG antibodies, indicative of a primary CMV infection, which other CMV IgM assays (Behring, Vidas, Captia, and Eurogenetics) fail to detect in some cases. The use of the AxSYM CMV IgM assay, followed by an avidity test, should result in more accurate diagnosis of CMV infection in pregnant women.     

乌鲁木齐地区孕妇人细小病毒B19与TORCH感染的比较

目的了解我区孕早期妇女TORCH及人细小病毒B19的感染情况.方法用ELISA法检测185例孕早期妇女血清中特异性 TORCH/HPVB19-IgM抗体.结果感染率分别为弓形体(TOX)2.16%,风疹病毒(RV)1.62%,巨细胞病毒(CMV)1.62%,单纯疱疹病毒Ⅱ型(HSV-Ⅱ)1.08%,人细小病毒B19(HPVB19)8.11%,其HPVB19-IgM抗体阳性率与TORCH各项相比,差异有显著的统计学意义(P＜0.01).结论我区孕妇中人细小病毒B19新近感染率明显高于其它TORCH各项病原体的新近感染率,有必要把HPVB19列入TORCH监测项目中,以提高妊娠质量.