Pregnancy Management

Perinatal infections account for 2% to 3% of all congenital anomalies. TORCH, which includes Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes infections, are some of the most common infections associated with congenital anomalies. Most of the TORCH infections cause mild maternal morbidity, but have serious fetal consequences, and treatment of maternal infection frequently has no impact on fetal outcome. Therefore, recognition of maternal disease and fetal monitoring once disease is recognized are important for all clinicians. Knowledge of these diseases will help the clinician appropriately counsel mothers on preventive measures to avoid these infections, and will aid in counseling parents on the potential for adverse fetal outcomes when these infections are present.

Several other pathogens can also be vertically transmitted during pregnancy and have detrimental effects on the fetus and/or newborn. These include HIV in pregnancy, perinatal hepatitis B, group B streptococci, E. coli, gonococcal infections and chlamydial infections, West Nile virus, Zika virus, measles virus, enterovirus, and adenovirus.