Fetus

Virus

Polyhydramnios

Cytomegalovirus

Rubella virus

Rubella

Serology

Biology

Obstetrics

Antibody

Vaccination

Herpesviridae

Measles

Metallurgy

Materials science

Welding

Immunology

Toxoplasmosis

Seroconversion

Viral disease

Pregnancy

Torch

Genetics

Medicine

Prenatal Diagnosis

Background The acronym ‘TORCH’ refers to well‐recognised causes of perinatal infections: toxoplasmosis, rubella, cytomegalovirus (CMV) and herpes simplex virus (HSV). A TORCH serology panel is often used to test for maternal primary infection following detection of ultrasound abnormalities in pregnancy. Aim This review aims to estimate the diagnostic yield of maternal TORCH serology in pregnancy following fetal ultrasound abnormalities. Materials and Methods Primary studies published since 2000 that assessed maternal TORCH serology for suspected fetal infection and included information on indications for testing, definition of positive TORCH serology results, and perinatal outcomes were included. Results Eight studies with a total of 2538 pregnancies were included. The main indications for testing were polyhydramnios, fetal growth restriction and hyperechogenic bowel. There were 26 confirmed cases of congenital CMV, of which 15 had multiple ultrasound abnormalities. There were no cases of congenital toxoplasmosis, rubella or HSV confirmed in any of the eight studies. Conclusions The clinical utility of TORCH serology for non‐specific ultrasound abnormalities such as isolated fetal growth restriction or isolated polyhydramnios is low. It is time to retire the TORCH acronym and the reflex ordering of ‘TORCH’ panels, as their continued use obscures, rather than illuminates, appropriate investigation for fetal ultrasound abnormalities.

A systematic review of maternal TORCH serology as a screen for suspected fetal infection