Mehmet KEÇECİOĞLU, Begüm NALÇA ERDİN, Tuğba KULA ATİK, Alev ÇETİN DURAN

Gebelikte Toxoplasma Gondii, Rubella virus ve Cytomegalovirus Enfeksiyonlarının Araştırılması, Avidite Testlerinin Perinatal Takip Sonuçlarının Retrospektif Değerlendirilmesi

Amaç: Bu çalışmada Toxoplasma Gondii, Rubella virus ve Cytomegolovirus (CMV) IgM ve IgG sonuçları, avidite testleri ve perinatal takip sonuçlarının retrospektif olarak araştırılması amaçlandı. Gereç ve Yöntem: 2017-2018 yıllarında Kadın Hastalıkları ve Doğum Polikliniğine başvuran gebelerin Toxoplasma Gondii, Rubella virus, CMV IgG ve IgM test sonuçları ve IgG avidite indeksleri retrospektif olarak incelendi. Bu enfeksiyonlardan herhangi biri için IgM sonucu pozitif olduğunda, IgG avidite indeksleri, ultrason (USG) bulguları, doğum öncesi sonuçları, amniyosentez sonuçları, IgM pozitifliği görülen gebelik haftası ve bu enfeksiyonlara yönelik uygulanan tedaviler geriye dönük olarak araştırıldı. Bu gebelerin bebeklerinin doğum şekli ve ağırlığı, APGAR skoru ve yoğun bakım ihtiyacı gibi bilgiler incelendi. Bulgular: 6719 hastanın %24,1'inin Toxoplasma IgG, %98,9'unun Rubella virus IgG ve %98,7'sinin CMV IgG pozitif olduğu görüldü. IgM pozitifliği incelendiğinde bu oranın Toksoplazma için %0,46 (n=31), Rubella virus için %0,16 (n=11) ve CMV için %0,7 (n=47) olduğu görüldü. Sadece Toxoplasma Gondii için 9 düşük avidite testi sonucu saptandı ancak TORCH ile ilişkili perinatal enfeksiyon kanıtı bulunamadı. Sonuç: Sonuç olarak, gebelikte Toksoplazma, Rubella virus ve CMV enfeksiyonlarının taranması halen tartışmalı bir konu olup, ülkeler arasında farklı öneriler ve uygulamalar mevcuttur ve Türkiye'de ulusal bir tarama programı bulunmamaktadır. Seroprevalansın bilinmesi ulusal tarama stratejilerinin oluşturulmasında ve gebelere bu enfeksiyonlardan korunma konusunda danışmanlık verilmesinde büyük önem taşımaktadır. Bu açıdan bakıldığında çalışmamız bu konuda Balıkesir bölgesinde yapılmış ilk çalışma olması açısından bu verilere katkı sağlaması açısından değerlidir.

Anahtar Kelimeler:

TORCH, konjenital infeksiyon, avidite

Investigation of Toxoplasma Gondii, Rubella virus and Cytomegalovirus Infections in Pregnancy, Retrospective Evaluation of Avidity Tests and Perinatal Follow-up Results

Aim: In this study, it was aimed to investigate Toxoplasma Gondii, Rubella virus and Cytomegalovirus (CMV) IgM and IgG results, the avidity tests and perinatal follow-up results retrospectively. Material and Method: Test results of pregnant women who applied to Gynecology and Obstetrics Polyclinics in 2017-2018 were analyzed retrospectively.When IgM result was positive for any of these infections, IgG avidity indices, ultrasound (USG) findings, prenatal screening results, amniocentesis results, week of gestation that IgM positivity was observed, and if any treatments applied for these infections, were examined from the file records of pregnant women. Results: It was observed that 24.1% of 6719 patients were Toxoplasma IgG, 98.9% were Rubella IgG and 98.7% were CMV IgG positive. When the IgM positivity was examined, it was seen that this rate was 0.46% (n=31) for Toxoplasma, 0.16% (n=11) for Rubella and 0.7% (n=47) for CMV. There was only 9 low avidity test results for Toxoplasma Gondii. But there was no evidence of perinatal infection associated with these infectious agents . Conclusion: In conclusion, screening for toxoplasma, rubella and CMV infections during pregnancy is still a controversial subject and there is no national screening programme in Turkey. Knowing the seroprevalence is of great importance in establishing national screening strategies and providing consultancy to pregnant women about protection from these infections. From this point of view our study is valuable in that it contributes to these data as the first study conducted in Balıkesir region on this subject

Keywords:

TORCH, congenital infection, avidity,

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