如何重新评价与解释围产期TORCH感染筛查

妊娠期TORCH感染代表以病毒及其他微生物引起的一组围产期感染性疾病.在我国20多年前进行血清筛查后,较为明确地认为,TORCH感染对胎、婴儿危害较大,同时已具有较成熟的诊断与治疗手段.因此,必须对乙型病毒性肝炎、梅毒、HIV感染等做早孕期,甚至孕前筛查.对风疹的筛查最好在孕前进行,如风疹IgM+则不必处理;如阴性,最好在获得免疫力后再妊娠.然而,现不主张对巨细胞病毒感染、弓形虫病、单纯疱疹等病做孕期筛查.因这3种病原体感染所导致胎儿异常,可行孕期超声检查,并进一步行羊水或脐血穿刺查病原体以确诊.

Re-evaluation on perinatal screening of TORCH

TORCH infection during pregnancy is a group of infectious diseases resulting from viruses and other microorganisms. According to the past over 20-year experiences in serum screening in China, several infections which should be performed in the first trimester, or even much earlier in pregnant period, are hepatitis B, syphilis, HIV, and these three infections are confirmed to be harmful to the fetus or infants and also diagnostic methods and treatment are available. Screening for rubella should be better performed before conception and no specific management is required with IgM+, while immunization is recommended before pregnancy with IgM-. Screenings for cytomegalovirus, toxoplasmosis and herpes virus are not recommended. Scnography is warranted if fetal abnormalities were resulted from the above infections and amniocentesis or cordocentesis might be required for further investigations.