Influence of TORCH infections in first trimester miscarriage in the Malabar region of Kerala

Abstract


Denoj Sebastian, K. F. Zuhara* and K. Sekaran2

To correlate the prevalence of TORCH (Toxoplasma gondii, Rubella, Cytomegalovirus and Herpes simplex) infections with incidence of abortion in pregnant women in the Malabar area of Kerala, in order to establish basic knowledge for future pregnancy care. Patients attending the Institute of Maternity and Child Health, Calicut Medical College, Kerala were subjected for the study. Seventy one miscarriage cases and thirty normal pregnant women were studied through their medical, clinical, and serological data. Results were analyzed using person’s chi-square test. This study showed that general population of Malabar area has an infection susceptibility of 32.3% to Toxoplasma gondii, 9.6% to Rubella, 3.2% to CMV (Cytomegalovirus) and 61.3% to HSV (Herpes simplex virus) infections. This was revealed through the estimation of TORCH specific IgG. IgM specific to TORCH agents was also studied in abortion cases and was observed as T. gondii- 50.7% (p<0.03), Rubella- 11.3% (p<0.597), CMV-28.2% (p<0.231) and HSV-59.2% (p<0.022) . When 40.8% of the miscarriage cases were showing IgM specific to one or the other TORCH agents, only 20% of the control cases possessed IgM to TORCH agents. Cross infections with more than one of the TORCH agents was observed and 5.6% of the aborted mothers were infected with all the four pathogens. The significant role of T. gondii and HSV infection on spontaneous abortion, compared to CMV and Rubella, is provided here. The increased susceptibility of the general population of Malabar to these two pathogens, substantiates this observation further. Various abortion categories are also influenced by these pathogens differently. We also observed cross infections with two or more of the pathogens in the TORCH group, with a statistical significance of p<0.003. 

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