Infections during pregnancy that may cause congenital abnormalities have been recognized for decades, but their diagnosis is challenging. This was again illustrated with the emergence of Zika virus (ZIKV), highlighting the inherent difficulties in estimating the extent of pre- and postnatal ZIKV complications because of the difficulties in establishing definitive diagnoses. We reviewed the epidemiology, infection kinetics, and diagnostic methods used for Toxoplasma gondii, parvovirus B19, rubella virus, and cytomegalovirus (TORCH) infections and compared the results with current knowledge of ZIKV diagnostic assays to provide a basis for the inclusion of ZIKV in the TORCH complex evaluations. Similarities between TORCH pathogens and ZIKV support inclusion of ZIKV as an emerging TORCH infection. Our review evaluates the diagnostic performance of various TORCH diagnostic assays for maternal screening, fetal screening, and neonatal screening. We show that the sensitivity, specificity, and positive and negative predictive value of TORCH complex pathogens are widely variable, stressing the importance of confirmatory testing and the need for novel techniques for earlier and accurate diagnosis of maternal and congenital infections. In this context it is also important to acknowledge different needs and access to care for different geographic and resource settings.

中文翻译：

---

在刚体弓形虫，细小病毒B19，风疹病毒和巨细胞病毒（TORCH）诊断测定的背景下进行寨卡测定的性能。

怀孕期间可能导致先天性异常的感染已被识别数十年，但其诊断具有挑战性。Zika病毒（ZIKV）的出现再次说明了这一点，突显了由于难以确定的诊断而难以估计产前和产后ZIKV并发症的程度。我们回顾了弓形虫，细小病毒B19，风疹病毒和巨细胞病毒（TORCH）感染的流行病学，感染动力学和诊断方法，并将结果与​​ZIKV诊断测定的当前知识进行了比较，从而为将ZIKV包括在炬综合评估。TORCH病原体与ZIKV之间的相似性支持将ZIKV纳入新兴的TORCH感染。我们的评估评估了各种TORCH诊断测定对孕产妇筛查，胎儿筛查和新生儿筛查的诊断性能。我们表明，TORCH复杂病原体的敏感性，特异性以及阳性和阴性预测值变化很大，从而强调了验证性测试的重要性以及对早期和准确诊断母体和先天性感染的新技术的需求。在这种情况下，同样重要的是要认识到不同的需求，并能够获得针对不同地理和资源设置的护理。强调确认性测试的重要性以及对早期和准确诊断产妇和先天性感染的新技术的需求。在这种情况下，同样重要的是要认识到不同的需求，并能够获得针对不同地理和资源设置的护理。强调确认性测试的重要性以及对早期和准确诊断产妇和先天性感染的新技术的需求。在这种情况下，同样重要的是要认识到不同的需求并获得针对不同地理和资源设置的护理。