TORCH Syndrome

TORCH syndrome might sound like a single ailment, but it actually refers to a collection of infectious diseases that pose potential risks—some quite serious—for your unborn baby:

1. Toxoplasmosis
2. Other agents (including HIV, syphilis, varicella, and fifth disease)
3. Rubella
4. Cytomegalovirus
5. Herpes simplex

So, what exactly does this mean?

If you contract any of these TORCH infections during pregnancy and it spread through your bloodstream to your baby, they can become infected too. This is particularly concerning because their immune system is still developing in the uterus, making it difficult for them to fend off these infections.

If the infection persists within their body, it can lead to improper development of their organs. The severity of your baby’s illness depends on various factors, including the specific infection and the stage of their development. However, a range of issues can arise—from jaundice (yellowing of the skin or eyes) and hearing impairments to miscarriage and stillbirth. It’s crucial to recognize and address TORCH infections promptly to safeguard both maternal and fetal health.

Toxoplasmosis within TORCH syndrome

Toxoplasmosis is a rare infection caused by a parasite. This parasite typically enters the body through the mouth, often via the consumption of undercooked meat. If you’re infected, there’s a risk of transmitting the infection to your unborn baby during pregnancy.

Exposure to toxoplasmosis can result in various issues for your baby, including:

1. Brain damage
2. Inflammation of the eye, potentially leading to blindness
3. Developmental delays, affecting motor skills and other areas
4. Seizures
5. Excessive fluid accumulation in the brain (hydrocephalus)

To minimize the risk of contracting toxoplasmosis:

1. Avoid consuming undercooked meat or raw eggs.
2. Steer clear of handling cat litter and feces.
3. Stay away from insects like flies that may have been in contact with cat feces.

Taking these precautions can help reduce the likelihood of toxoplasmosis infection during pregnancy and protect both you and your baby’s health.

Other agents” grouped within TORCH syndrome

Among the “other agents” grouped within TORCH syndrome are HIV, fifth disease, syphilis, and the varicella zoster virus.

HIV: Nearly all children under 13 in the U.S. who have HIV contracted it from their mothers during pregnancy. HIV might not show up in tests immediately at birth, but it can appear later, even after six months. Symptoms in babies can include delayed growth, pneumonia, or swollen lymph nodes and abdomen. If you’re HIV-positive and pregnant or planning to conceive, antiretroviral medications can significantly reduce the risk of transmitting the virus to your baby.

Syphilis: If untreated, pregnant women in the early stages of this sexually transmitted disease transmit it to their babies about 75% of the time. Syphilis, caused by bacteria, can lead to severe complications during fetal development. Many babies infected before birth won’t survive full term or will die shortly after birth. Babies born with syphilis may have deformed bones, anemia, meningitis, skin rashes, and nerve issues causing blindness and deafness. Pregnant women should undergo testing for syphilis, and if positive, treatment with antibiotics is crucial.

Fifth Disease: Caused by parvovirus B19, fifth disease typically doesn’t pose significant risks to pregnant women or their babies. Approximately half of women are immune, meaning their babies won’t contract the disease. However, babies who do get fifth disease may develop anemia. Miscarriage occurs in less than 5% of cases. Since there’s no specific vaccine or medication to prevent fifth disease, frequent handwashing and avoiding contact with sick individuals are recommended during pregnancy.

Varicella: Chickenpox, caused by the varicella zoster virus, can lead to congenital varicella syndrome in babies. The likelihood of passing varicella to your baby is low, even if you have chickenpox during pregnancy (about 2%). However, babies born with congenital varicella syndrome may have birth defects. If you haven’t had chickenpox or been vaccinated, it’s advisable to get vaccinated at least a month before planning pregnancy. Additionally, inform your doctor if you suspect exposure to chickenpox during pregnancy.

Rubella

Rubella, also known as German measles, is a contagious illness caused by a virus. If you contract rubella, you might experience symptoms like a mild fever, sore throat, and a distinctive rash. However, if you’re pregnant and catch rubella during the first trimester, there’s a high likelihood of passing it on to your baby.

The impact of rubella during pregnancy can be severe, potentially leading to miscarriage or causing serious birth defects in your baby. The first three months of pregnancy are particularly critical, as this is when rubella can pose the greatest risk to the baby’s development. It’s crucial to inform your doctor promptly if you suspect you’ve been exposed to rubella.

Thanks to the measles-mumps-rubella (MMR) vaccine, rubella has become rare in children. In the United States, there are only around 30 to 60 reported cases annually, with fewer than five babies born with the infection each year.

Preventing congenital rubella syndrome is paramount, as there’s no cure once the baby is affected. If you’re planning to conceive and haven’t been vaccinated with the MMR vaccine, it’s advisable to get vaccinated at least 28 days before conception to protect both yourself and your future baby from rubella-related complications.

Cytomegalovirus (CMV)

Cytomegalovirus (CMV), also referred to as CMV, is a type of infection within the herpes virus group. It’s estimated that around 50% of adults have been exposed to CMV by the time they reach 30 years old. While there’s no cure for CMV, the infection typically resolves quickly on its own and doesn’t lead to serious complications—unless you’re pregnant.

During pregnancy, there’s a risk of transmitting CMV to your unborn child. In fact, CMV is the most commonly transmitted viral infection to babies in the United States, occurring in about 1 in 150 births. Approximately 1 in 5 babies born with congenital CMV may experience illness or long-term issues, such as:

• Hearing and vision loss
• Jaundice
• Low birth weight
• Respiratory problems
• Seizures
• Muscle weakness
• Developmental disabilities

Herpes Simplex

Herpes Simplex is another lifelong infection like CMV, but it can remain dormant for periods. It’s also quite prevalent, with more than 50% of people in the U.S. infected by their 20s.

There are two types of herpes: HSV-1, which typically causes cold sores around the mouth but can also be transmitted to the genitals, and HSV-2, an STD responsible for genital herpes. HSV-2 can result in genital blisters or sores, as well as oral herpes

Herpes can be transmitted to your baby through various means:

1. In Utero Transmission: While rare, it’s possible for the baby to acquire the virus while still in the uterus.
2. During Delivery: The most common way babies contract herpes is if you have a genital outbreak during childbirth.
3. After Birth: Newborns can also become infected with herpes after delivery.

The highest risk to your baby occurs if you experience your first herpes outbreak during pregnancy. During the initial outbreak, you shed more virus particles for an extended period, and your body has fewer antibodies to combat the virus compared to subsequent outbreaks.

If you contract herpes later in your pregnancy, the likelihood of transmitting it to your baby may increase. It’s essential to discuss any concerns with your doctor. If you have an active outbreak at the time of delivery, opting for a cesarean section might be the safest choice, and additional precautions may be necessary.

Sources:

• Boston Children’s Hospital: “TORCH in Children,” “Cytomegalovirus,” “Toxoplasmosis,” “Cold Sores,” “Congenital Rubella,” “Congenital Varicella,” “Sexually Transmitted Diseases (STD) in Children.”
• National Organization for Rare Disorders: TORCH Syndrome.
• AIDS.gov: “Pregnancy & Childbirth.”
• CDC: “Parvovirus B19 and Fifth Disease,” “Cytomegalovirus (CMV) and Congenital CMV Infection.”
• National CMV Foundation: “CMV Prevention and Healthy Pregnancy Tips.”
• World Health Organization: “Herpes Simplex Virus”
• American Sexual Health Association: “Herpes & Pregnancy.”