İbrahim KALE, Rahime BAYIK, Gizem Berfin ULUUTKU, Başak ERGİN

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Gebelikte rutin TORCH taraması gerekli midir?

AMAÇ: Ümraniye Eğitim ve Araştırma Hastanesi’nin gebe polikliniğine başvuran gebelerde Toksoplasma Gondii, Rubella ve Sitomegalovirus’a karşı olan bağışıklık durumunu tespit etmek ve Türkiye’nin diğer bölgelerindeki seroprevalans oranları ile karşılaştırmaktır. GEREÇ VE YÖNTEM: 01/01/2017- 30/10/2019 tarihleri arasında hastanemizin gebe polikliniğine başvuran tüm gebelerin Toksoplasma Gondii, Rubella ve Sitomegalovirus’e karşı olan antikor düzeyleri retrospektif olarak hastane kayıtlarından çıkarıldı. Çalışmaya sadece her üç virus için IgM ve IgG antikorlarının birlikte bakıldığı gebeler dahil edildi. IgM ve IgG birlikte pozitif olduğu gebelerin varsa IgG avidite sonuclarına ulaşıldı. Bu serolojik testler Elisa yöntemi ile Abbott Architect i2000 SR cihazında üretici firmanın önerileri doğrultusunda çalışılmıştır. BULGULAR: Hastane kayıtlarından Toxoplasma gondii için 7535, Rubella için 9093 ve CMV için 2652 gebenin test sonuçlarına ulaşıldı. Toxoplasma gondii IgM pozitifliği %0.6, Rubella IgM pozitifliği %0.3 ve Cytomegalovirus IgM pozitifliği %2.3, Toxoplasma gondii IgG pozitifliği %24, Rubella IgG pozitifliği %86.4 ve Cytomegalovirus IgG pozitifliği %99 olarak saptandı. Toxoplasma gondii IgG Avidite test sonuçları %5.3 düşük, %10.5 sınır ve % 84.2 yüksek değer olarak saptandı. Rubella IgG ve CMV IgG avidite sonuçlarının hepsi yüksek avidite olarak tespit edildi. SONUÇ: Toxoplasma IgG seroprevalansı yüksek olmadığı için ve gebelikte geçirilen akut Toxoplasmozis enfeksiyonun tedavisi olduğu için gebelere Toxoplasma taraması önerilmelidir. Ülkemizde Rubella virusüne karşı bağışıklığın halen istenilen düzeyde olmamasından dolayı gebelikte Rubella virusüne karşı taramanın önemli olduğunu düşünmekteyiz. Ülkemizde CMV IgG seroprevalansının yüksek olmasından dolayı gebelerde rutin CMV taramasının gereksiz olduğunu düşünmekteyiz.
Anahtar Kelimeler:

antenatal tarama, toxoplasma, rubella, cytomegalovirus

Is routine TORCH screening necessary for pregnancy follow-up?

Aim: This study aimed to determine the seroprevalence rates of Toxoplasma gondii, Rubella and Cytomegalovirus (CMV) among the pregnant women who presented to the Ümraniye Training and Research Hospital and to compare the seroprevalence rates with the other studies fromTurkey. Material and method: The antibody levels of all pregnant women presented to the prenatal outpatient clinic between January 1, 2017 and October 30, 2019, for Toxoplasma gondii, Rubella, CMV were obtained retrospectively. Only pregnant women with immunoglobulin M (IgM) and immunoglobulin G (IgG) antibody results of the three viruses were included in the study. If IgM and IgG were both found to be positive, the IgG avidity results were obtained using the Abbott Architect i2000 SR device with enzyme-linked immunosorbent assay (ELISA), following the manufacturer's recommendations. Results: Serological results of pregnant women for Toxoplasma gondii (n = 7535), Rubella (n = 9093), and CMV (n = 2652) were obtained from the hospital records. IgM positivity was found to be 0.6% for Toxoplasma gondii, 0.3% for Rubella, and 2.3% for CMV. IgG positivity was found to be 24% for Toxoplasma gondii, 86.4% for Rubella, and 99% for CMV. IgG avidity test results for Toxoplasma gondii were 5.3% low, 10.5% borderline, and 84.2% high. Rubella IgG and CMV IgG avidity results were all determined following high avidity. Conclusion: Because Toxoplasma IgG seroprevalence is not high, and the treatment of acute toxoplasmosis infection during pregnancy is possible, Toxoplasma screening should be recommended to all pregnant women. Because the immunity to the Rubella virus is still not at the desired level in our country, we believe screening against Rubella is vital during pregnancy. We also believe that routine CMV screening is unnecessary in pregnant women owing to the high seroprevalence of CMV IgG in our country.
Keywords:

antenatal screening, toxoplasma, rubella, cytomegalovirus,

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Türk Kadın Sağlığı ve Neonatoloji Dergisi-Cover
  • Başlangıç: 2019
  • Yayıncı: Sağlık Bilimleri Üniversitesi Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi
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