TORCH Infection during Pregnancy: A Comprehensive Review from Diagnosis to Treatment
DOI:
https://doi.org/10.32792/utq/utjsci/v12i2.1509Keywords:
Toxoplasma gondii, Syphilis, CytomegalovirusAbstract
TORCH is a group of pathogens that can infect a pregnant woman and subsequently transmit the infection to the fetus. These include the parasite Toxoplasma gondii, and other pathogens such as Treponema pallidum, parvovirus B19, rubella, Human cytomegalovirus, and herpes simplex virus. TORCH infections are among the most significant risks to fetal development, leading to congenital malformations and other complications transmitted from the mother and causes congenital malformations. Therefore, this review aims to provide a comprehensive overview of TORCH infection, including diagnostic methods, such as serological tests, PCR, and ultrasound imaging, to detect fetal malformations such as cerebral calcifications, hydrocephalus, and organ enlargement. The review also explained the treatment used for this infection, If a mixture of pyrimethamine and sulfadiazine is used with folic acid to treat, while the vaccine is used before pregnancy for the purpose of preventing German infection, as for CMV infection, acyclovir or ganciclovir is usually used, while penicillin is the treatment for Treponema pallidum. This review focuses on the clinical manifestations on the clinical manifestations of TORCH infection as a cause of congenital malformations in fetuses, presents the most important methods that can be used for accurate diagnosis, compares the protocols used for treating each infection in this group, and evaluates methods of prevention.
Received: 2025-10-25
Revised: 2025-12-01
Accepted: 2025-12-13
References
[1] A. M. Tenter, A. R. Heckeroth, and L. M. Weiss, “Toxoplasma gondii: from animals to humans,” International Journal for Parasitology, vol. 30, no. 12–13, pp. 1217–1258, 2000.
[2] M. Attias, D. E. Teixeira, M. Benchimol, et al., "The life-cycle of Toxoplasma gondii reviewed using animations," Parasites & Vectors, vol. 13, p. 588, 2020, doi: 10.1186/s13071-020-04445-z
[3] U. C. Ghoshal et al., “Role of intestinal parasites in irritable bowel syndrome,” World Journal of Gastroenterology, vol. 19, no. 3, pp. 390–398, 2013.
[4] Z. Shafiei, F. Esfandiari, B. Sarkari, Z. Rezaei, M. R. Fatahi, and S. M. K. Hosseini Asl, “Parasitic infections in irritable bowel syndrome patients: evidence to propose a possible link, based on a case-control study in the south of Iran,” BMC Research Notes, vol. 13, no. 1, p. 264, 2020, doi: 10.1186/s13104-020-05118-x
[6] A. Smyrli, V. Raveendran, S. Walter, W. Pagarkar, N. Field, S. Kadambari, H. Lyall, and H. Bailey, “What are the neurodevelopmental outcomes of children with asymptomatic congenital cytomegalovirus infection at birth? A systematic literature review,” Reviews in Medical Virology, vol. 34, no. 4, p. e2555, 2024, doi: 10.1002/rmv.2555
[7] D. W. Kimberlin, “Neonatal Herpes Simplex Infection,” Clinical Microbiology Reviews, vol. 17, no. 1, pp. 1–13, 2004, doi: 10.1128/cmr.17.1.1-13.2004
[8] R. Gopalakrishnan and R. T. Kandikuppa, “Shining a light on TORCH infections in pregnancy,” Journal of Clinical Infectious Diseases Society, vol. 1, no. 4, pp. 302–308, 2023, doi: 10.4103/CIDS.CIDS_4_24
[9] R. Patil and S. Mehendale, “Prenatal diagnosis of congenital infections: A review,” Journal of Fetal Medicine, vol. 7, no. 3, pp. 179–190, 2020, doi: 10.1007/s40556-020-00259-2
[10] S. Leech, “Prenatal diagnosis of TORCH pathogens,” Clinical Lab Products, 2022. [Online]. Available: https://www.clinicallab.com/prenatal-diagnosis-of-torch-pathogens-21819.
[11] L. Bollani, C. Auriti, C. Achille, F. Garofoli, D. U. De Rose, V. Meroni, G. Salvatori, and C. Tzialla, "Congenital toxoplasmosis: The state of the art," Frontiers in Pediatrics, vol. 10, p. 894573, 2022, doi: 10.3389/fped.2022.894573
[12] T. M. Lanzieri, P. Haber, J. Icenogle, and M. Patel, “Chapter 20: Rubella,” in Pink Book: Epidemiology and Prevention of Vaccine-Preventable Diseases, 13th ed., Centers for Disease Control and Prevention (CDC), 2024
[13] S. B. Boppana et al., “Congenital cytomegalovirus infection in the era of maternal serology screening,” Pediatric Infectious Disease Journal, vol. 20, no. 4, pp. 276–279, 2001
[14] J. Amir, D. G. Wolf, and I. Levy, "Treatment of symptomatic congenital cytomegalovirus infection with intravenous ganciclovir followed by long-term oral valganciclovir," European Journal of Pediatrics, vol. 169, no. 9, pp. 1061–1067, 2010, doi: 10.1007/s00431-010-1176-9
[15] E. Terracciano, F. Amadori, V. Pettinicchio, L. Zaratti, and E. Franco, “Strategies for elimination of rubella in pregnancy and of congenital rubella syndrome in high and upper-middle income countries,” Journal of Preventive Medicine and Hygiene, vol. 61, no. 1, pp. E98–E108, 2020, doi: 10.15167/2421-4248/jpmh2020.61.1.1310
[16] J. L. Jones, F. Ogunmodede, J. Scheftel, E. Kirkland, A. Lopez, J. Schulkin, and R. Lynfield, “Toxoplasmosis-related knowledge and practices among pregnant women in the United States,” Infectious Diseases in Obstetrics and Gynecology, vol. 11, no. 3, pp. 139–145, 2003, doi: 10.1080/10647440300025512
[17] Baker, Jonathan MPAS, PA-C, DFAAPA. A paradigm shift away from condoms: Focusing STI prevention on evidence-based interventions. JAAPA 36(7):p 6-7, July 2023. | DOI: 10.1097/01.JAA.0000937276.51342.74
[18]J. Baker, "A paradigm shift away from condoms: Focusing STI prevention on evidence-based interventions," JAAPA, vol. 36, no. 7, pp. 6–7, Jul. 2023, doi: 10.1097/01.JAA.0000937276.51342.74.
[19] M. A. Gouda, A. M. E. Katawy, W. M. O. Ashry et al.,“Current status of TORCH infection seroprevalence in pregnant women: a cross-sectional study in Al Sharqia Governorate, Egypt,” Bulletin of the National Research Centre, vol. 47, p. 123, 2023, doi: 10.1186/s42269-023-01099-6
[20] E. Hunsperger, E. Osoro, P. Munyua et al., “Seroconversion and seroprevalence of TORCH infections in a pregnant women cohort study, Mombasa, Kenya, 2017–2019,” Epidemiology and Infection, vol. 152, p. e68, 2024, doi: 10.1017/S0950268824000165
[21] Centers for Disease Control and Prevention, “Rubella: Signs and symptoms.” Accessed: Sep. 13, 2025. [Online]. Available: https://www.cdc.gov/rubella/signs-symptoms/index.html
[22] P. Tushabe, J. Bwogi, E. Abernathy, M. Birungi, J. P. Eliku, R. Seguya, H. Bukenya, P. Namuwulya, P. Kakooza, S. Suppiah, T. Kabaliisa, M. Tibanagwa, I. Ampaire, A. Kisakye, A. Bakainaga, C. R. Byabamazima, J. P. Icenogle, and B. Bakamutumaho, “Descriptive epidemiology of rubella disease and associated virus strains in Uganda,” Journal of Medical Virology, vol. 92, no. 3, pp. 279–287, 2020, doi: 10.1002/jmv.25604
[23] A. S. Jasem and N. J. Alrikaby, “Serological assessment of Toxoplasma gondii infection in marriage applicants and blood donors,” Laboratory Diagnosis in Eastern Europe, vol. 14, no. 1, pp. 23–28, 2025, doi: 10.34883/PI.2025.14.1.016.
[24] H. Kang, L. Wang, Y. Chen et al., “Screening and prenatal diagnosis of fetal cytomegalovirus infection: experience in a western Chinese city,” BMC Infectious Diseases, vol. 25, p. 542, 2025, doi: 10.1186/s12879-025-10910-w
[25] A. Khairullah, S. Kurniawan, A. Widodo, M. Effendi, A. Hasib, O. Silaen, S. Ramandinianto, I. Moses, K. Riwu, S. Yanestria, M. Samodra, and D. Afnani, “A Comprehensive Review of Toxoplasmosis: Serious Threat to Human Health,” Open Public Health Journal, vol. 17, p. e18749445281387, 2024, doi: 10.2174/0118749445281387240202094637
Downloads
Published
License
Copyright (c) 2025 University of Thi-Qar Journal of Science
This work is licensed under a Creative Commons Attribution 4.0 International License.
