Skip to main content
I need a test

Ways to test

Plan it

Privacy

Your situation

I have symptoms

Check

Down there

Elsewhere

Is it an STI at all?

I was exposed

Act now

Timing

Your risk

I tested positive

Next steps

Partners

Living with it

Prevention

Daily defenses

Vaccines

Smarter sex

Conditions

Health areas

Bacterial

Viral

Hepatitis

Parasitic & skin

Related & look-alikes

Infections Call your provider

TORCH infections

Also known as Congenital infections, TORCH complex, TORCH panel. Any time; first-trimester infections often carry the highest risk.

TORCH is a memory aid, not a single illness. It names a group of infections that, caught during pregnancy, can cross the placenta and harm a developing baby: Toxoplasmosis, Other (including syphilis, chickenpox, parvovirus, Zika, HIV, and hepatitis B), Rubella, Cytomegalovirus (CMV), and Herpes. They are usually mild or silent in the mother yet can cause serious birth defects, so much of prenatal care is built around preventing, screening for, and treating them. Many are preventable through vaccination, food safety, hygiene, and routine testing.

Know the warning signs When to call a provider
How common
Varies by infection
CMV is the most common, affecting about 1 in 200 babies; others range from rare to rising.
When
First trimester riskiest
Early infection usually causes the most harm, except herpes, which is riskiest near delivery.
Urgency
Screen and prevent
Managed through prenatal screening, prevention, and treatment; new fever or rash warrants a call.
Outlook
Many preventable
Vaccination, hygiene, food safety, and screening prevent much of the harm.

Understanding it

What is TORCH infections?

TORCH groups infections that share one feature: acquired during pregnancy, they can pass to the baby and cause birth defects, growth problems, or lasting disability. The letters, Toxoplasmosis, Other, Rubella, Cytomegalovirus (CMV), and Herpes simplex, span unrelated organisms, tied together only by that shared pattern of harm.

The common thread frustrates detection: these infections are usually mild or silent in the mother. You might have a brief fever, a rash, swollen glands, or nothing at all while the infection quietly affects the baby. That is why prenatal care leans on screening and prevention instead of waiting for symptoms. The baby, not the mother, is the one at risk.

Timing matters. For most, first-trimester exposure, when the baby's organs are forming, does the most severe harm, and rubella is especially damaging in the first 12 weeks. Herpes is the exception: its greatest danger is near delivery, when active genital sores can infect the baby during birth. Toxoplasmosis tends to reach the baby later but does less damage then.

The most hopeful part is how much is preventable. Vaccination before pregnancy heads off rubella and chickenpox; hygiene and food safety head off much of CMV and toxoplasmosis. Syphilis, the most tragic because so treatable, is caught by routine blood tests and cured with penicillin, which is why most congenital syphilis reflects missed testing, not untreatable disease. Understanding the group helps you take the steps that protect your baby.

Symptoms

What are the symptoms?

In the mother, these are usually mild or silent, and the concern is the effect on the baby. Certain exposures and symptoms still warrant a prompt call.

Early signs

  • Often no symptoms at all in the mother
  • Nonspecific illness: fever, a rash, swollen glands, or a flu-like feeling
  • Joint aches (parvovirus), or a genital sore or ulcer (syphilis or herpes)
  • Signs in the baby are usually found on ultrasound or after birth, not felt during pregnancy

Emergency signs — call 911

  • A new fever or rash during pregnancy, which should be evaluated
  • Known exposure to rubella, chickenpox, or fifth disease (the slapped-cheek rash of parvovirus)
  • A new genital sore, ulcer, or blister, especially near your due date
  • Reduced or absent fetal movement, which can signal fetal anemia or distress
  • Recent travel, by you or a partner, to an area with Zika transmission

Why it matters

Risks to you and baby

Birth defects and disability

The core concern. Depending on the infection and timing, they can cause hearing loss, vision problems, heart defects, small head size (microcephaly), and neurodevelopmental disability. Congenital infections, CMV above all, are the leading infectious cause of hearing loss present from birth.

Pregnancy loss and stillbirth

Several, including toxoplasmosis, syphilis, and parvovirus, can cause miscarriage or stillbirth, particularly when the baby is infected early or severely.

Fetal growth and anemia

Some, like CMV, restrict the baby's growth, and parvovirus can cause severe fetal anemia that, in a minority of cases, needs a blood transfusion to the baby before birth.

Usually mild for the mother

For the pregnant person, most are mild or unnoticed; the seriousness lies almost entirely with the baby. That is why a minor-seeming illness or exposure is taken seriously in pregnancy.

How it's found

How is it diagnosed?

TORCH infections are found through prenatal screening blood tests, evaluation of symptoms or exposures, and ultrasound of the baby. Confirming fetal infection sometimes needs more specific tests.

Prenatal screening blood tests

Routine early-pregnancy tests check immunity and infection status for syphilis, rubella, HIV, and hepatitis B. Antibody tests distinguish past immunity (IgG) from recent or active infection (IgM).

Targeted testing after symptoms or exposure

After a fever, rash, or known exposure, specific tests for CMV, toxoplasmosis, or parvovirus check for a recent infection.

Ultrasound and fetal testing

Ultrasound looks for signs of fetal infection, such as growth restriction, brain calcifications, or fluid buildup. Amniocentesis can confirm fetal infection, and Doppler ultrasound tracks for parvovirus-related anemia.

Standard screening is done at the first prenatal visit, with syphilis often repeated later. Targeted testing happens whenever symptoms or an exposure raise concern.

Treatment

How is it managed?

Treatment depends entirely on which infection is involved. Some are cured with antibiotics, some managed with antivirals, and some, having no specific treatment, are prevented instead.

Treatment paths

Syphilis is cured with penicillin, which also protects the baby. Toxoplasmosis is treated with antibiotics (spiramycin, or pyrimethamine and sulfadiazine if the baby is infected) to cut transmission and harm. Herpes is managed with antivirals late in pregnancy, plus a cesarean if active genital sores are present at delivery. Parvovirus-related severe fetal anemia can be treated with a transfusion to the baby in the womb.

Medication

By pathogen: penicillin for syphilis, spiramycin or pyrimethamine-sulfadiazine for toxoplasmosis, antivirals for herpes and symptomatic CMV. Rubella and Zika have no specific treatment, so prevention is the strategy.

Monitoring

When an infection is suspected or confirmed, the baby is watched closely with ultrasound and, after birth, evaluated and treated as needed. Babies with congenital CMV, for example, may get antiviral medicine to reduce hearing loss.

Can it recur?

For most of these, a first (primary) infection leaves you immune, so the goal is preventing a new infection rather than a recurrence. The main exceptions are CMV, which can reactivate, and herpes, which recurs episodically. Rubella and chickenpox immunity, once established by infection or vaccine, protects future pregnancies.

What you can do

Can it be prevented?

  • Get immune before pregnancy

    Make sure you are vaccinated against rubella and chickenpox before conceiving. These are live vaccines, not given during pregnancy, so confirm immunity beforehand. If you are not immune, you can be vaccinated after delivery.

  • Practice CMV hygiene

    CMV, the most common congenital infection, often comes from young children's saliva and urine. Wash your hands after diaper changes, avoid sharing food, cups, or utensils with toddlers, and avoid kissing them on the mouth.

  • Handle food and cats safely

    To prevent toxoplasmosis, cook meat thoroughly, wash produce, wear gloves when gardening, and have someone else change the cat litter, or wear gloves and wash your hands if you must.

  • Keep your prenatal screening

    Routine blood tests for syphilis, HIV, hepatitis B, and rubella immunity catch treatable and preventable infections early. Most congenital syphilis, which is entirely preventable, traces to missed testing, so do not skip it.

Who is more at risk

Risk factors

Contact with young children
Parents of toddlers and childcare workers meet more CMV through saliva and urine, the main source of that infection.
Not being immune to rubella or chickenpox
Being unvaccinated or non-immune leaves you vulnerable to these vaccine-preventable infections, which are most damaging early in pregnancy.
Food and cat exposures
Eating undercooked meat or unwashed produce, and handling cat litter or contaminated soil, raise the risk of toxoplasmosis.
Limited prenatal care
Missing prenatal screening is the leading reason congenital syphilis occurs, since testing and penicillin prevent it.
Missed testing or treatment contributes to about 88% of congenital syphilis cases.
Travel and exposures
Travel to areas with Zika, or exposure to someone with fifth disease (parvovirus), raises the risk of those specific infections.

Do not wait

When to call your provider or 911

  • Call your provider for a new fever or rash during pregnancy, so it can be evaluated.
  • Report known exposure to rubella, chickenpox, or fifth disease (a slapped-cheek rash), especially if you are unsure of your immunity.
  • Seek care for a new genital sore, ulcer, or blister, particularly near your due date.
  • Contact your provider for reduced or absent fetal movement.
  • Tell your provider about recent travel, by you or a partner, to an area with Zika transmission.

Talking to your team

Questions to ask your provider

  • Am I immune to rubella and chickenpox, and should I be vaccinated before or after pregnancy?
  • What TORCH infections am I screened for, and when?
  • How can I lower my risk of CMV and toxoplasmosis?
  • I was exposed to a rash (or fifth disease); do I need testing?
  • If an infection is found, how would it be treated and how is my baby monitored?
  • Have my syphilis and other prenatal screens been done and reviewed?

Keep reading

More on TORCH infections

All pregnancy guides articles

Good to Know

TORCH infections FAQs

Common questions about TORCH infections, answered.

What does TORCH stand for?

It is an acronym for a group of infections that can harm a developing baby: Toxoplasmosis, Other (syphilis, chickenpox, parvovirus, Zika, HIV, and hepatitis B), Rubella, Cytomegalovirus (CMV), and Herpes simplex. Though they are different organisms, they are grouped because they cause a similar pattern of harm when passed to a baby during pregnancy.

Which is the most common?

CMV, cytomegalovirus, is the most common congenital infection and the leading infectious cause of birth defects, affecting about 1 in 200 babies. It often comes from young children's saliva and urine, which is why hand hygiene around toddlers is a simple, important step.

If I feel fine, could my baby still be affected?

Unfortunately, yes, which is the whole reason for screening. Most are mild or silent in the mother while still reaching the baby, so prenatal care relies on blood tests and prevention rather than waiting for you to feel unwell. The risk to the baby often comes without warning signs in you.

Can these infections be prevented?

Many can. Vaccination before pregnancy prevents rubella and chickenpox. Hand hygiene, food safety, and cat-litter precautions largely prevent CMV and toxoplasmosis. Routine prenatal blood tests catch and treat syphilis, HIV, and hepatitis B. Together, prevention, screening, and early treatment head off most of the harm.

Why can't I get the rubella or chickenpox vaccine while pregnant?

Because they are live vaccines, not given during pregnancy out of caution, which is why immunity is ideally confirmed before you conceive. If your bloodwork shows you are not immune to rubella, you can be vaccinated safely right after delivery, protecting future pregnancies.

I have a cat. Do I have to give it up?

No. Keep your cat; you just need sensible precautions against toxoplasmosis. Have someone else change the litter box daily, or wear gloves and wash your hands well afterward. Keep the cat indoors, avoid strays, and wear gloves when gardening. Cooking meat thoroughly and washing produce matter at least as much as the litter box.

Is congenital syphilis really preventable?

Yes, almost entirely, which is what makes its rise so tragic. A routine blood test detects it, and penicillin cures it and protects the baby. Most congenital syphilis traces to missed or late testing, not untreatable disease, which is why the screen is so important and often repeated.

I was around a child with fifth disease. What should I do?

Let your provider know. Fifth disease is parvovirus B19, and infection in the first half of pregnancy can occasionally cause severe fetal anemia. Your provider may check your immunity and, if you were recently infected, monitor the baby with Doppler ultrasound. Most exposures cause no harm, but have it checked, especially before 20 weeks.

Medically Reviewed · Updated

Reviewed by Dr. Grace Lin, MD, FACOG · OB-GYN

Obstetrician-gynecologist focused on reproductive and sexual health for women: pregnancy, BV, yeast, trichomoniasis and HPV/cervical screening. Our editorial guidelines →

6 Sources

Data & references

Have a different question? Browse the full STD & STI FAQ library, every question we answer, in one place.