JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES

Abstract

Introduction: Maternal infections caused by TORCH [Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV), Herpes simplex virus (HSV)] and others agents like Chlamydia trachomatis,Treponema pallidum, Neisseria gonorrhoeae, HIV, etc. are the major causes of bad obstetric history(BOH). Aim of the study: To evaluate the incidence of TORCH infections in pregnancy wastage in women with BOH. Methodology: The study included 87 pregnant women with bad obstetric history. Cases with hypertension, diabetes mellitus, eclampsia of pregnancy, and Rh incompatibility were excluded from the study. Serological evaluation for TORCH infections was carried out by IgM Enzyme Linked Immunosorbant Assay (ELISA) method. Antenatal follow-up and delivery outcome was recorded. Result: The IgM/IgG sero positivity to T. gondii, Rubella, CMV and HSV-2 was 5.8/8.0%, 4.6/90.8%, 9.2/95.4%, and 2.3/5.8% respectively. Adverse outcome occurred in, 66.8% and 43.1% cases of IgM and IgG seropositives. Maximum number of IgM seropositives cases of abortion (33.4%) were associated with Toxoplasma, Rubella and CMV infection, congenital malformations (25%) were associated with rubella and CMV infection , intrauterine fetal death (8.4%) was associated with CMV infection and the IgG sero positives showed abortion(31.3%),intra uterine death(7%), congenital malformations (3.5%) and still birth(1.2%) . Conclusion: A previous history of pregnancy wastage and the serological reaction for TORCH infections during current pregnancy must be considered while managing BOH cases so as to reduce the adverse fetal outcome.

Key words: Bad obstetric history, TORCH, ELISA