TORCH plus panel

In what case TORCH plus panel is recommended?

The acronym TORCH is a collective name that refers to pathogens that can harm the fetus during pregnancy: Toxoplasma gondii, “Others” (other microbes), Rubella virus, Cytomegalovirus, Herpes simplex viruses.

The aim of the test is to determine whether the mother’s body has already been infected by these pathogens, with the detection of IgM and IgG antibodies in the blood serum. The screening of women before or during pregnancy, the panel could help to prevent or reduce severe and less severe fetal diseases caused by these viruses.

The infections during pregnancy can cause developmental anomalies, miscarriage, intrauterine death, or premature birth.

The TORCH plus panel test should be performed before the planned pregnancy to find out which pathogens have developed long-term protection, which infections the patient has already came through and which pathogen may be reactivate, and which pathogen has not been infected her yet, so it may be susceptible during pregnancy.

What kind of antigen tests are included in the TORCH plus panel?

TORCH plus panel helps to detect the antibodies of the following viruses:

• Toxoplasma gondii (IgG, IgM): The parasite most commonly spread by feces of cats can cause eye and nervous system infections and lead to cysts in the brain and muscles. In pregnancy, the parasite can enter the fetus through the placenta, which can lead to birth defects or miscarriage.
• Rubella (IgG, IgM) immunity: (roseola) is a rash that occurs in childhood and is now a relatively minor problem in adulthood due to mandatory vaccinations. With the bloodstream, the virus can pass through the placenta into the fetus causing developmental anomalies, especially in the first trimester of pregnancy. Infection can lead to heart failure, vision- or hearing loss.
• Cytomegalovirus (CMV) (IgG, IgM): The virus is carried asymptomatically by many people, mostly, it is causing complaints only when the immune system is weakened. Unlike other viruses, protection does not develop after the infection. The fetus can become infected in the womb, during birth, or even with breast milk, but if it is detected in time, it can be treated successfully with medication.

• Herpes simplex I/II (IgG, IgM): Two types – HSV-1, which causes lesions on the lips, and HSV-2, that causes symptoms in the genitals – are the most dangerous, when the infection is acute and shows severe symptoms. It can cause miscarriage in the first trimester of pregnancy and serious birth defects during childbirth. Once the mother has been through it, antibodies are produced in her body that also protect the fetus.
• Varicella (IgG, IgM) immunity: the virus is responsible for chickenpox, which gives us lifelong protection after the infection. In the case of uninfected mothers, protection against the virus is essential, as in the first trimester of pregnancy, it could cause developmental anomalies of the fetus, in the last weeks of the pregnancy the infection can even be fatal for the fetus.
• Parvovirus B19 (butterfly smallpox) (IgG, IgM) immunity

What do the results mean?

Depending on the presence or absence of the antibodies of a virus in the body, the finding may be positive or negative for each pathogen.

If IgM antibodies are positive, there is an acute infection, the patient has recently become infected with that virus or parasite. In this case, further tests should be performed to confirm the infection.

The presence (positivity) of an IgG antibody indicates an earlier infection, caused by that pathogen. If the test was performed in pregnancy, it is recommended to repeat the test two weeks later to find out if the infection was recent or earlier. If the test gives this result before pregnancy, the pathogen may show a very low risk of infection to the fetus, as the mother’s body is already able to produce antibodies against it.

If a specific antibody cannot be detected to a particular pathogen, it indicates susceptibility to its infection. In such cases, it is advised to monitor and re-test for that pathogen during pregnancy.