Serological Screening of TORCH Agents as an Etiology of Spontaneous Abortion in Dhulikhel Hospital, Nepal

Abstract

The role of TORCH infections as a cause of spontaneous abortions is still debatable with conflicting results where geographical variation may play a significant role. This study was undertaken to discover the association of TORCH infections in women with spontaneous abortions by serological testing. The descriptive case control study was conducted from January to December, 2012. A serological evaluation was carried out to determine the presence of Toxoplasma gondii, Rubella, Cytomegalovirus (CMV) and Herpes Simplex Virus (HSV) specific immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies, using commercial diagnostic kits by enzyme-linked immunosorbent assay (ELISA) technique. Mean age of the study and control subjects were 24.8+/-6.4 and 23.8+/-3.8 years respectively where 72.8% of the study subjects were of the age between 20 to 35 years and 23% of the women with spontaneous abortion were below 20 years. Most of the cases were of incomplete abortions (43%) followed by complete abortions (26%). Only 1.3% of both IgG and IgM seropositivity against TORCH agents were noted among the study subjects whereas highest IgG seropositivity was detected with Rubella (86.8%) followed by HSV-I (72.8%). An infection susceptibility rate of 77.9% to Toxoplasma gondii, 11.7% to Rubella, 51.9% to CMV, 36.4% to HSV-I and 84.4% to HSV-II was noted. No significant difference in relation to age and type of abortion was found in seropositivity between the study and the control subjects. This study, probably the first of its kind from Nepal, suggests that current infection with TORCH agents might not be the possible etiology of spontaneous abortion. Serological TORCH screening may not be conclusive.