Abdul Hamid, Hamid Ali, Farhat Abbas.
Congenital Anomalies in the Offspring of Mothers with Torch Infections during Pregnancy.
Ophthalmol Update Jan ;13(4):325-8.

Objectives: To study the prevalence of congenital anomalies in the off springs of mothers suffering from TORCH infections during pregnancy. Material & Methods: The study was carried out in the Gynaecology and Obstetrics Unit of Kulsoom Maternity Home Peshawar during the study period from 01.06.2014 to 31.03.2015. A total number of 1000 pregnant women (both emergency and booked) admitted for the purpose of delivery, in the age group between 16 and 40 years, were included in the study sample. Complete history was taken on a printed performa. All the cases were screened for TORCH infections by Enzyme linked immune-sorbent assay (ELISA) technique during pregnancy. All the cases were subjected to repeated ultrasound examination during the pregnancy. After the delivery all the live newborns of TORCH positive mothers were thoroughly examined for congenital anomalies (CAs). Ultrasound of skull/brain and Echocardiography were done in newborns suspected of having intracranial and cardiovascular anomalies respectively. Cases with still births, intrauterine deaths, abortions, intrauterine growth retardation and prematurity were excluded from the study sample. Results: In the study population of 42 pregnant women were detected positive for TORCH infection. The patients had acquired some component of TORCH infection either during the present pregnancy or were unaware of the earlier acquired infection. Out of infected women, 35.71% (15/42) gave birth to babies with various congenital anomalies. Most important pathogens involved being, cytomegalovirus (CMV), toxoplasmosis, herpes simplex virus (HSV) and rubella, affecting the cases alone or in combination. The ratio of involvement of various TORCH components was, CMV, 1.5% (15/1000), Toxoplasmosis, 0.9% (9/1000), Rubella, 0.7% (7/1000), HSV, 0.5% (5/1000) and combination of pathogens, 0.6% (6/1000). Various congenital anomalies detected in these cases were, microcephaly, 20% (03/15), intracranial calcification, strabismus and cardiac anomalies, 13.33% (02/15) each. while an-encephaly, hydrocephaly and congenital cataract 6.66% (01/15) each. Cases with still births, intrauterine deaths, abortions, intrauterine growth retardation and prematurity were excluded from the study sample. Majority of the congenital anomalies were found in multigravida in the age range between 21 and 35 years. Male gender was predominantly affected. Conclusions: The problem of congenital abnormalities is serious in this part of the world, deserving serious attention; especially the presence of congenital abnormalities in the previous pregnancies is a matter of great concern. All the suspected pregnant women should be screened for TORCH infections. All TORCH positive cases should have repeated abdominal ultrasound to look for serious congenital malformations in the fetus and the required measures to be taken in time in order to reduce the number of handicapped children.

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