Change of emphasis in the structure of prenatal infections, or what is SCORTCH? Literature review

Authors

DOI:

https://doi.org/10.18370/2309-4117.2020.54.101-109

Keywords:

prenatal infections, serological screening, syphilis, cytomegalovirus, toxoplasmosis, treponemal tests, nontreponemal tests, Western blotting, avidity

Abstract

Prenatal infections (PI) remain an actual problem. Taking into account the epidemiological data on the increase in the incidence of syphilis in many countries, a review of modern algorithms for diagnosing this disease in pregnant women and newborns has been carried out. Universal screening for syphilis at the first prenatal examination is recommended by WHO and CDC, and is practiced in most countries. The article also presents the characteristics of modern laboratory methods of serological screening of pregnant women for syphilis and their combinations, one of which is primary screening using the treponemal test “total antibodies to syphilis” with confirmation of a positive result by immunoblotting.

Given the controversial nature of approaches to the prevention of other PI and their consequences, this review provides current recommendations for countries that screen and actively manage infections such as cytomegalovirus (CMV) and toxoplasmosis (T). Despite the proven significance of CMV as a factor in PI, universal prenatal screening, similar to screening for syphilis is not practiced in any of the countries due to the absence of prenatal treatment with proven efficacy. According to the national protocol of Germany, serostatus (titers IgG, IgM) to CMV are determined in early pregnancy. Confirmation of congenital CMV infection (HCMVI) is a positive PCR result in the amniotic fluid after 20–21 weeks of gestation. The main method of laboratory diagnostics of HCMVI in a newborn is PCR for CMV in urine. The article also presents the main approaches to the prevention of congenital toxoplasmosis, which have been practiced in France since the 90s and demonstrate effectiveness.

Thus, despite the fact that the use of effective prenatal treatment is not possible for all PI, their diagnosis using a complex of modern laboratory and instrumental methods is critical for the child’s health, since it allows the application of an appropriate algorithm for specific treatment and observation from birth

Author Biographies

Т. М. Тутченко, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”, SSI “CIMT of the NAS of Ukraine» DILA medical laboratory, Kyiv

PhD, researcher at the Department of Endocrine Gynecology

Department of Reproductive Health

Scientific consultant

О. А. Бурка, A.A. Bogomolets National Medical University DILA medical laboratory, Kyiv

PhD, associate professor, Department of Obstetrics and Gynecology No. 1

Scientific consultant

О. В. Коломієць, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”, Kyiv

PhD, senior researcher, Department of Prevention and Treatment of Pus-inflammatory Diseases in Obstetrics

Г. І. Іщенко, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”, Kyiv

PhD, researcher, Department of Prevention and Treatment of Pus-inflammatory Diseases in Obstetrics

В. М. Харченко, CNE “Center of diagnostics and consultations”, Sviatoshyno district, Kyiv

Obstetrician gynecologist

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2020-10-20

How to Cite

Тутченко, Т. М., Бурка, О. А., Коломієць, О. В., Іщенко, Г. І., & Харченко, В. М. (2020). Change of emphasis in the structure of prenatal infections, or what is SCORTCH? Literature review. REPRODUCTIVE ENDOCRINOLOGY, (54), 101–109. https://doi.org/10.18370/2309-4117.2020.54.101-109

Issue

No. 54 (2020)

Section

Gynecology

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Copyright (c) 2020 Т. М. Тутченко, О. А. Бурка, О. В. Коломієць, Г. І. Іщенко, В. М. Харченко

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