THE IMPORTANCE OF EARLY DETECTION OF TORCH INFECTIONS

Abstract

Early detection of TORCH infections—encompassing Toxoplasma gondii, Other agents (e.g., syphilis, varicella-zoster, parvovirus B19), Rubella virus, Cytomegalovirus (CMV), and Herpes simplex virus (HSV)—is critical to reducing adverse fetal and neonatal outcomes. This narrative review synthesizes evidence on the importance and impact of early detection strategies for TORCH pathogens during pregnancy and in neonates. A comprehensive search was conducted in PubMed/MEDLINE, Google Scholar, Embase, and key organizational websites (WHO, CDC, professional society guidelines) for literature published from January 2010 to May 2025, using combinations of “TORCH,” “early detection,” “prenatal screening,” “diagnosis,” and related terms. Inclusion criteria comprised studies addressing diagnostic modalities, timing of detection, management implications, and outcome data; exclusion criteria included case reports without focus on diagnostic timing or outcomes. Findings indicate that early detection via maternal serology, targeted ultrasound, PCR of amniotic fluid, and neonatal screening can substantially mitigate morbidity: for example, timely identification of congenital toxoplasmosis with prompt therapy reduces sequelae; syphilis screening in the first trimester nearly eliminates congenital syphilis; early CMV detection informs monitoring though specific interventions remain limited; antenatal identification of primary HSV infection aids delivery planning to reduce neonatal transmission. However, universal TORCH panel screening in low-risk asymptomatic women is not uniformly recommended due to cost-effectiveness concerns and variable prevalence; targeted screening based on risk factors or ultrasound findings is often advised. Barriers include resource limitations, asymptomatic maternal infections, and gaps in awareness. Integration of early detection into routine antenatal care, with algorithmic approaches combining serology, imaging, and molecular diagnostics, is essential to optimize maternal–fetal health. Continued research should refine cost-effectiveness of universal versus targeted approaches, enhance diagnostic accuracy (e.g., novel biomarkers, improved PCR assays), and evaluate interventions following early detection to further reduce the burden of TORCH-related morbidity.