TORCH-screening –“ To do or not to do?” : Een retrospectieve cohortstudie

Zuidema, P. (Peter) (2016) TORCH-screening –“ To do or not to do?” : Een retrospectieve cohortstudie. thesis, Medicine.

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Abstract

This study seeks to investigate the expediency of the TORCH-screening performed at the University Medical Center Groningen (UMCG), which is a tertiary referral center for obstetrics and prenatal diagnostics. The study collects TORCH-screening results, and links them to both the indications on which they were requested and the pregnancy outcomes. The data comprises 799 TORCH-screenings, in a period of 6,5 years (January 2010 – June 2016). The most common indication found was ‘echogenic bowel’ (28,8%). The costs of TORCH-screenings have averaged at €32.962,14 per annum, with an upward trend throughout the period. As a result, a total of five cases of congenital CMV infections were found. These are linked to the following indications: echogenic bowel, intrauterine growth restriction, microcephaly with ventriculomegaly (twice), and one indication not resulting from ultrasound anomalies. In one case only did the discovery of the congenital CMV infection have implications for the pregnancy, resulting in abortion. In three other cases after-birth antiviral therapy was initiated. Of these three cases, one infant died six weeks after birth, one was left with mild to moderate hearing loss on one ear and one did not show, so far, any residual damage. Two cases of congenital Parvo B19 infection were identified. One had clear signs of hydrops foetalis on the ultrasound, for which it received intrauterine blood transfusion in a hospital elsewhere. In the second case, a primary infection with Parvo B19 was discovered in the first trimester. However, as no abnormalities were found on the consecutive ultrasound, no treatment was given. Both cases resulted in healthy infants with no residual damage. In all 799 TORCH-screenings comprised in this study, no cases of congenital Toxoplasmosis, Rubella or Lues were found. [Therefore, this study recommends making changes to the current process, aiming for a higher expediency]. It suggests abandoning the practice of standard screening for Rubella and HSV, totaling up to a cost reduction of €17.213,34 per annum. Screening for Toxoplasmosis, Parvo B19 and Lues need to be more specific, resulting in a lower ‘Number Needed To Screen’ and thus a higher expediency.

Item Type:	Thesis (Thesis)
Supervisor name:	1e begeleider: and Gordijn dr. S.J. Afdeling: Obstetrie & Gynaecologie – Obstet and 2e begeleider: and Vermont dr. C.L. Afdeling: Kindergeneeskunde – Infectiezieke
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:01
Last Modified:	25 Jun 2020 11:01
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2112

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