母体 TORCH 筛查在胎儿生长受限中的临床实用性:一项双中心回顾性研究。

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Christine A. Wade, Naomi Atkinson, Natasha E. Holmes, Lisa Hui
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引用次数: 0

摘要

研究目的本研究旨在评估孕产妇 TORCH(弓形虫、风疹、巨细胞病毒(CMV)和单纯疱疹病毒(HSV))血清学检测的适应症,重点关注分离胎儿生长受限(FGR)的检测率:澳大利亚墨尔本两家医院对 2014 年 1 月至 2018 年 12 月间的产前 TORCH 检测进行了回顾性审查。不包括因妊娠失败和死胎而进行的 TORCH 检测:回顾了 718 例妊娠的医疗记录,代表 760 个胎儿。在 71.2% 的妊娠中,孤立性 FGR 是 TORCH 筛查的指征。7.4%(95% CI 5.5-10.0%)的孕妇因孤立性 FGR 而接受筛查,结果呈阳性。母体免疫球蛋白 M 阳性的有 49 例(CMV = 34 例,弓形虫 = 15 例)。诊断出 2 例孕期急性母体感染(CMV = 1 例,弓形虫 = 1 例),两次筛查都是为了评估无症状的母体疾病。有一名新生儿感染了 CMV,是由一名患有无症状原发性 CMV 的妇女所生。未发现孕产妇或新生儿风疹或 HSV 感染。我们发现,TORCH筛查对孤立性FGR的诊断率为0.0%(95% CI 0.00-0.8%)。在这项研究中,用于孕产妇 TORCH 筛查的费用估计为 64 269.75 澳元:结论:针对孤立性 FGR 的母体 TORCH 检测没有诊断价值,应予以放弃。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical utility of maternal TORCH screening in fetal growth restriction: A retrospective two-centre study

Clinical utility of maternal TORCH screening in fetal growth restriction: A retrospective two-centre study

Objective

The aim of this study was to evaluate the indications for maternal TORCH (Toxoplasma gondii, rubella, cytomegalovirus (CMV), and herpes simplex virus (HSV)) serology, with a focus on the yield in isolated fetal growth restriction (FGR).

Materials and Methods

A retrospective review of antenatal TORCH testing between January 2014 and December 2018 was carried out at two hospitals in Melbourne, Australia. TORCH testing ordered for pregnancy losses and stillbirth was excluded.

Results

Medical records of 718 pregnancies were reviewed, representing 760 fetuses. Isolated FGR was the indication for TORCH screening in 71.2% of pregnancies. Screens ordered for isolated FGR were positive in 7.4% (95% CI 5.5–10.0%). There were 49 positive maternal immunoglobulin M (CMV = 34, Toxoplasma = 15). Two acute maternal infections during pregnancy were diagnosed (CMV = 1, Toxoplasma = 1), with both screens ordered to assess symptomatic maternal illness. There was one neonatal CMV infection, born to a woman with symptomatic primary CMV. No maternal or neonatal rubella or HSV infections were identified. We found a diagnostic yield of TORCH screening for isolated FGR of 0.0% (95% CI 0.00–0.8%). An estimated AUD$64 269.75 was expended on maternal TORCH screens in this study.

Conclusion

Maternal TORCH testing for isolated FGR is of no diagnostic yield and should be abandoned.

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来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
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