Assessment of Utility of Serological Test Against TORCH Group of Agents for Bad Obstetric Outcome in Tertiary Care Hospital

摘要

Introduction: Poor pregnancy outcome is multi factorial. Maternal infections have been considered as one of the significant factors in causation of poor pregnancy outcome elsewhere but it has not assumed much significance in India, as data is scanty because of the technical difficulties in isolating the organisms and the requirement for use of commercial diagnostic kits which are expensive. This study is a case control study to study the utility of testing for TORCH IgM antibodies in patients having a bad obstetric history.Aim: Present study was conducted among pregnant women with bad obstetric history, coming to ANC clinic of our hospital to shed some light on association between seroprevalence & recent infection with Toxoplasma, Rubella virus, Human Cytomegalovirus (HCMV), and Herpes Simplex virus (HSV), by the detection of IgM Antibodies.Materials and Methods: Thirty seven women in the age range from 18-35 years with bad obstetric outcome were included in this study after clearance from Institutional Ethical Committee. Thirty five healthy women with previous normal obstetric outcome were also included as age match control group. Serum samples from aseptically collected blood from the enrolled cases after informed consent was preserved in 0.5 ml aliquots at -20oC till tested. All sera were tested for the identification of class specific IgM antibodies by ELISA for Toxoplasma, Rubella virus, HSV I and II and CMV using IgM capture ELISA kit according to manufacturer’s instructions. Data was maintained in Microsoft Excel and tests of proportions and Pearson’s chi test for significance were employed using Epi info.Results: In the study group (group I), 10 (27.02%) women were positive for IgM antibodies against Toxoplasma, Rubella, Cytomegalovirus, Herpes I and II either alone or in combination. In the Control group (group II), IgM antibodies were detected in 5(14.28%) cases against Cytomegalovirus and Herpes I and II each. One case had antibodies against Rubella. When compared with the control group only Toxoplasma infection amongst TORCH agent with p value at one degree of freedom is statistically significant for bad obstetric outcome.Conclusion: In Present study detection of IgM Antibodies has been performed by capture ELISA which reflects recent infection whereas most of the other studies have relied on IgG antibodies. Serological diagnosis may not be reliable indicator of maternal infection, hence it can be used as screening test in cases were there is strong suspicion of maternal infection and should be confirmed by tests with higher specificity.