TORCH Infections in Pregnancy

TORCH infections are a group of infections that pass from a pregnant patient to the fetus and can cause miscarriage, stillbirth or birth defects: toxoplasmosis, other infections such as syphilis, varicella, parvovirus B19 and HIV, rubella, cytomegalovirus, and herpes simplex. Nursing care is mostly prevention, screening and timing. For toxoplasmosis, someone else changes the cat litter, or the patient wears gloves and washes hands, and meat is cooked thoroughly. Rubella immunity is checked with a titer at the first prenatal visit. The MMR vaccine is live, so it is never given in pregnancy; a non-immune patient is vaccinated after birth and avoids pregnancy for four weeks. Congenital rubella causes deafness, cataracts and heart defects. Cytomegalovirus is the most common congenital infection, and hearing loss is its hallmark, so teach handwashing after diapers and contact with a young child's saliva. Herpes lesions or prodromal symptoms at the start of labor mean a cesarean birth, with suppressive acyclovir from 36 weeks. Syphilis is treated with benzathine penicillin G, and parvovirus B19 can cause severe fetal anemia.