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Conducting TORCH testing correctly to reduce the risk of birth defects
LIAN Yan, WANG Xie-tong
Chinese Journal of Practical Gynecology and Obstetrics ›› 2026, Vol. 42 ›› Issue (2) : 150-153.
PDF(996 KB)
PDF(996 KB)
Conducting TORCH testing correctly to reduce the risk of birth defects
TORCH infection is one of the causes of birth defects，and there is currently a lack of effective treatment options. Strengthening preconception and prenatal TORCH infection surveillance and making accurate diagnosis are crucial. Serological screening markers for TORCH infection include specific IgM，IgG，and IgG antibody affinity，which are used for infection screening and immune status assessment. Preconception TORCH serological screening is recommended. Routine TORCH serological screening is not recommended for low-risk pregnant women during pregnancy，but TORCH testing is advised when indicated. Clinical signs of suspected maternal infection and certain abnormal ultrasound findings provide clues for detecting intrauterine infection and guide the decision on invasive prenatal diagnosis. Clear intrauterine fetal infection and the presence of structural abnormalities are critical for assessing fetal prognosis. The ultrasound findings of fetal TORCH infection lack specificity and can involve multiple organs，with varying degrees of fetal involvement after maternal viral infection. Fetal blood analysis has additional value in identifying the risk of fetal infection and assessing fetal prognosis.
TORCH infection / serological screening / prenatal diagnosis / fetal prognosis / birth defects
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近年来，国内外均发表了与TORCH感染相关的临床实践指南，但仍有内容需要加以补充和明确。国内部分专家就TORCH感染筛查、诊断及干预的临床路径进行了专题研讨，达成共识如下：（1）不是所有的TORCH病原体都需要孕前或孕期筛查；对围孕期妇女不需要进行单纯疱疹病毒抗体分型检测，若无临床症状，不需要等待其IgM抗体转阴再妊娠。（2）检测TORCH-IgM、IgG抗体时应采用定量技术，保存检测过的剩余血清样本对可能的后续诊断有不可替代的参考价值。（3）不能依据血清学筛查阳性结果而做出终止妊娠的决定。（4）重视对巨细胞病毒再次感染的孕期监测。（5）慎重使用介入性产前诊断技术，在确认孕期TORCH感染的5~7周并可见胎儿影像学异常后，孕18周后采取羊水标本进行病原体DNA或RNA的检测，可以结合脐血样本的IgM抗体检测进行产前诊断；超声及MRI检查有助于评估宫内感染的胎儿预后。（6）注意孕妇和胎儿的弓形虫感染治疗方法不同。（7）胎儿非免疫性水肿或不明原因胎死宫内的孕妇需要检测微小病毒B19抗体状态，对确诊贫血的存活胎儿有微小病毒B19宫内感染时，可给予宫内输血治疗。
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