Obstetrics - TORCHES Infections

Question 1

TORCHES Infections?

Toxoplasmosis?

Cause?

Symptoms?

Answer 1

Cause:

• Infection caused by Toxoplasma gondii , a protozoan
• More common in immunosuppressed individuals

Transmission:

• Infected meat
• Cat faeces

Symptoms:

• Often asymptomatic
• Flu like, fatigue, sore throat, headache, fever lymphadonopathy

Question 2

TORCHES Infections?

Toxoplasmosis?

Investigations?

Treatments?

Answer 2

Investigations:

• Blood test: Maternal IgM
• Radiology: USS scan for fetal hydrocephalus
• Amniocentesis
• HIV - co-infection

Treatment:

• Education
• Medical:
  
  • Fetal - Pyrimethamine/Sulphonamide
  • Maternal - Spiramycin

Question 3

TORCHES Infections?

Toxoplasmosis?

Complications?

Answer 3

Fetal - 3Cs:

• C - Cerebral manifestations
• C - Convulsions
• C- Chorioretinitis

Maternal - ABCDE:

• A - Abscess formation
• B - Blurred vision
• C - Confusion
• D - Difficulty in breathing (pneumonitis)
• E - Encephalomyelitis

Question 4

TORCHES Infections?

Rubella?

What is it?

Answer 4

What is it?

• Single strand RNA virus
• German measles
• Greatest risk of infection 1st trimester

Question 5

TORCHES Infections?

Rubella?

Symptoms/Investigations?

Answer 5

Symptoms:

• Arthralgia
• Sore throat
• Fever
• Macular rash, face then torso
• Occipital lymphadonopathy

Investigations:

• Blood test: maternal antibodies
• Urinalysis: for virus in neonate

Question 6

TORCHES Infections?

Rubella?

Treatment/Complications?

Answer 6

Treatment:

• Education
• Avoid contact
• MMR vbaccine

Complications Fetal Congenital Rubella syndrome ABCDE:

• A - A Small head (microcephally) low birth weight
• B - Blueberry muffin rash
• C - Congenital heart malformations
• D - Deafness
• E - Eye abnormalities