RESUMO
Background: Infections caused by Toxoplasma gondii, Rubella virus and Cytomegalovirus are major causes of Bad Obstetric History (BOH). Cause of BOH may be genetic, hormonal, abnormal maternal immune response, and maternal infection. Women affected with any of these diseases during pregnancy are at high risk for miscarriage, stillbirth, or for a child with serious birth defects and/or illness and also a hazard to attending staff nurses. Methods: A total 96 serum samples were collected from antenatal women with BOH attending the out-patient services of department of gynaecology at NRI general hospital, Chinakakani, Guntur district, Andhra Pradesh. Serum samples were obtained and were subjected to screening for Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies of Toxopalsma gondii, Rubella Virus and CMV infections by VIDAS (bioMerieux, France) and Nanoplex ToRCH Screen kit [Lilac Medicare (P) Ltd, Maharastra, India]. Results: Majority of cases with BOH were found in females aged 18-23 years (25, 52.08%) followed by 24-29 years (18, 37.5%). Congenital anomalies and other complications were found to be more in age group 18-23 years followed by 24-29 years. The disease prevalence as studied with respect to IgM antibodies was found to be 31.25% for Cytomegalovirus Infections, 23.96% for Toxoplasma gondii, 21.88% for Rubella virus infections. The overall agreement in the Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) between VIDAS and Nanoplex ToRCH Screen kit for the detection of specific IgM and IgG antibodies in our study was excellent with sensitivity ranging from 90.91%-96.00% and specificity ranging from 89.47%-95.59% for the detection of IgM& IgG antibodies. The discrepancies were relatively less with 8.3% for CMV IgM, 6.2% for CMV IgG, 5.20% for Rubella IgM, 6.25% for Rubella IgG, 6.25% for Toxo IgM and 5.20% for Toxo IgG. Conclusion: Nanoplex ToRCH Screen Kit is a cheap, cost effective, efficient and innovative alternate for the diagnosis of ToRCH infections. As the technology is new, it needs to be further explored bring out various multiplex kits for diagnosing other infectious diseases.
RESUMO
Background : Bad obstetric history (BOH) implies previous unfavorable fetal outcome. Causes of BOH may be genetic, hormonal, abnormal maternal immune response and maternal infection. C.trachomatis is the most common bacterial sexually transmitted infection worldwide. Also it has been associated with adverse outcomes of pregnancy. The identification of C. trachomatis during pregnancy and its early treatment prior to delivery would therefore be an important strategy to prevent multiple complications in mother. Serology might act as a convenient tool for diagnosis. Methods:139 pregnant patients having history of BOH as study group and 30 normal pregnant as control group were tested by Indirect ELISA for detection of anti C.trachomatis IgM and IgG. Results: Anti C.trachomatis IgM was detected in 21 (15.11%) patients and anti C.trachomatis IgG was detected in 33 (23.74%) patients. Interpretation and Conclusion: Higher numbers of positive patients were found among younger age group. Statistical analysis shows that serological detection of anti C.trachomatis IgM and IgG antibodies for detection of current and past infection by C.trachomatis is significant in BOH patients.
RESUMO
The present study was conducted to find out the prevalence of IgM antibodies to Toxoplasma, Rubella and Cytomegalovirus in women with Bad Obstetric History (BOH) in and around Amritsar. Over a period of one year, 200 serum samples were collected from pregnant women having BOH and 100 serum samples were collected from pregnant women without BOH. Out of 200 sera, from women with BOH 137 (68.5%) were positive for Toxoplasma, Rubella and CMV alone or in combination. IgM seropositivity to Toxoplasma was 42.5%, Rubella was 17.5% and CMV was 29.5%. The highest percentage of these antibodies to Toxoplasma, Rubella and CMV was in cases of abortions i.e. 71.8%, 59.9% and 61% respectively. The study shows that there is a strong association of these agents with BOH. Thus, screening and early diagnosis for these agents in women can help in proper management of these cases.