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Risk Assessment for Torch Complex Infection Agents During Pregnancy - Preliminary Study
1 Department of Obstetrics and Gynaecology, Victor Babes University of Medicine and Pharmacy Timisoara,
2 Maternal-Fetal Medicine Laboratory, Clinical Emergency Municipal Hospital Timisoara,
3 Department of Laboratory Medicine, Clinical Emergency County Hospital Timisoara
* The authors contributed equally to this work and should both be regarded as the first author

Correspondence to:
Dan Bogdan Navolan, MD, Department of Obstetrics and Gynaecology - Maternal-Fetal Medicine,
1-3 Odobescu Str., 300202 Timisoara,
Tel./Fax: +40-256491751
Email: navolan@yahoo.com
REZUMAT
Obiectiv: De a prezenta procentul de gravide din regiunea noastra cu risc de a contacta infectia primara cu agentii infectiosi TORCH in sarcina. Material si metode: Au fost testate 660 de gravide in primul trimestru de sarcina pentru detectarea anticorpilor IgG si IgM anti-Toxoplasma Gondii, anti-Citomegalovirus (CMV) si anti-virus rubeolic. Gravidele au fost impartite pe grupe de varsta (in intervale de 1 an). Procentul de gravide imunizate a fost calculat pentru fiecare grup. Rezultate: Din cele 660 de gravide testate pentru IgG-anti-Toxoplasma Gondii, 308 au avut un titru pozitiv si 352 un titru negativ, pentru IgG-anti-CMV 618 un titru pozitiv si 42 un titru negativ in timp ce pentru IgG-anti-virus rubeolic, 599 au avut un titru pozitiv si 45 un titru negativ (16 gravide nu au fost testate, datorita faptului ca au fost vaccinate recent). Dintre pacientele testate, 12 gravide au fost pozitive pentru IgM-anti-Toxoplasma Gondii, 6 pozitive pentru IgM-anti-CMV si o gravida pozitiva pentru IgM-anti-virus Rubeolic. Varsta gravidelor s-a incadrat intre 15 si 40 ani; 308 gravide au provenit din mediul urban, 190 din mediul rural iar 162 au schimbat resedinta. Concluzii: Aproximativ 54% dintre gravide nu sunt imunizate inainte de sarcina pentru Toxoplasma Gondii, 7% nu sunt imunizate pentru CMV si virusul rubeolic. Aceste gravide sunt susceptibile pentru primoinfectie in sarcina. Datorita riscului de malformatii determinat de primoinfectia cu agentii TORCH in sarcina recomandam efectuarea screeningului fata de acesti agenti indiferent de mediul de provenienta sau de varsta gravidei.

ABSTRACT
Objective: To present the percentage of gravidas in our area with the risk of contracting primary infections with TORCH-agents during pregnancy. Material and methods: There were 660 gravidas tested during the first trimester of pregnancy in order to detect anti-Toxoplasma Gondii, anti-cytomegalovirus (CMV) and anti-rubella IgG/IgM-antibodies. The pregnant women were divided according to age (one-year intervals). The percentage of immunized gravidas was calculated for each group. Results: Out of 660 tested gravidas for IgG-anti-Toxoplasma Gondii, 308 were positive and 352 negative, for IgG-anti-CMV 618 were positive and 42 negative and for IgG-anti-rubella, 599 were positive and 45 negative (16 gravidas were not tested, because they have recently been vaccinated). Among the tested patients, 12 were positive for IgM-anti-Toxoplasma Gondii, 6 for IgM-anti-CMV and 1 for IgM-anti- Rubella. The age of the gravidas varies between 15 and 40; 308 live in urban areas, 190 in rural areas and 162 changed their residency. Conclusions: About 54% of the gravidas were not immunized before pregnancy for Toxoplasma Gondii, 7% were not immunized for CMV or rubella virus and they could potentially be infected during the first trimester of pregnancy. Due to the fetal malformation risks caused primarily by the infection with TORCH agents during pregnancy, it is strongly recommended to perform TORCH screening tests for all pregnant women, no matter what area they come from (urban/rural) or their age.


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