Fetal Infections / TORCH in Pregnancy
Some infections during pregnancy can affect the baby’s growth, brain, heart, liver, placenta, amniotic fluid or overall wellbeing. At Mayflower Fetal Medicine & High-Risk Pregnancy Centre, Nagpur, Dr. Kunda Shahane provides detailed ultrasound evaluation, counselling and follow-up planning when fetal infection or TORCH-related concern is suspected.
When infection is suspected, timing and detail matter.
Ultrasound does not diagnose every infection, but it can detect important fetal effects and guide the next step.
What are fetal infections in pregnancy?
Fetal infections are infections that may pass from the mother to the baby during pregnancy. Some infections are mild or have no visible fetal effect, while others may need close fetal medicine surveillance, blood tests, repeat scans or specialist counselling.
TORCH and beyond
TORCH commonly refers to toxoplasmosis, other infections, rubella, cytomegalovirus and herpes-related infections. In modern pregnancy care, evaluation may also include parvovirus B19, varicella, syphilis and other infections depending on the clinical situation.
Ultrasound clues
Infection may be suspected when ultrasound shows growth restriction, ventriculomegaly, calcifications, echogenic bowel, ascites, hydrops, placental thickening or abnormal amniotic fluid.
Integrated care
Fetal medicine evaluation is combined with maternal blood tests, obstetric history, infection timing, possible amniotic fluid testing and counselling. The goal is clarity, not panic.
Reviewed by Dr. Kunda Shahane
Dr. Kunda Shahane, MBBS, MS (Obs & Gynae), FIFM, FMF (London), is Central India’s first dedicated fetal medicine specialist and Founder-Director of the Indian Institute of Fetal Medicine.
With nearly two decades of fetal medicine experience and 20,000+ fetuses evaluated, she provides advanced fetal ultrasound, genetic counselling coordination and high-risk pregnancy surveillance at Mayflower Clinic, Nagpur.
Who may need fetal infection / TORCH evaluation?
Your obstetrician may refer you to a fetal medicine specialist when there is a maternal infection history, abnormal blood test, suspicious ultrasound finding, or a need to understand fetal risk more clearly.
Maternal history or test concern
- Positive or unclear TORCH blood report
- Fever, rash, viral illness or exposure during pregnancy
- Previous pregnancy affected by infection-related concern
- Referral after CMV, toxoplasmosis, rubella, varicella, parvovirus B19 or syphilis concern
Ultrasound concern
- Fetal growth restriction or small baby
- Ventriculomegaly or brain findings
- Echogenic bowel or abdominal findings
- Ascites, hydrops, placental thickening or fluid abnormality
Important reassurance
A positive infection blood test does not always mean the baby is affected. Similarly, a normal ultrasound does not always exclude infection. Correct interpretation depends on the type of infection, timing, IgG/IgM pattern, avidity testing, fetal findings and gestational age.
What Dr. Kunda evaluates during the scan
The scan is customised depending on gestational age, infection type and referral reason. The aim is to look systematically for fetal effects and plan safe follow-up.
| Area assessed | What is checked | Why it matters |
|---|---|---|
| Fetal growth | Biometry, estimated fetal weight, growth pattern | Growth restriction may be one clue of fetal stress or placental involvement. |
| Fetal brain | Ventricles, brain structure, head size, calcification suspicion | Neurosonography may be advised when infection can affect the fetal brain. |
| Heart and circulation | Cardiac size, rhythm, function, Doppler when needed | Some infections can cause fetal anaemia, hydrops, heart strain or rhythm changes. |
| Abdomen and liver | Liver size, ascites, bowel echogenicity, abdominal fluid | Echogenic bowel or ascites may need correlation with infection and genetic reports. |
| Placenta | Placental thickness, texture and associated findings | Placental changes may support the need for close follow-up and obstetric coordination. |
| Amniotic fluid | Liquor volume, polyhydramnios or oligohydramnios | Fluid change can be a sign of fetal swallowing, placental or fetal wellbeing issues. |
| Hydrops check | Skin edema, pleural effusion, pericardial effusion, ascites | Hydrops needs urgent specialist evaluation and close monitoring. |
| Doppler when required | Umbilical artery, MCA, ductus venosus depending on indication | Doppler helps assess fetal wellbeing, placental circulation and possible anaemia-related concerns. |
How evaluation usually proceeds
Every case is individual. The plan depends on the infection suspected, gestational age, lab reports and fetal ultrasound findings.
Review reports
Obstetric history, fever or rash history, TORCH/viral reports, IgG/IgM, avidity and previous scans are reviewed.
Detailed scan
Targeted fetal assessment is performed, including growth, brain, heart, abdomen, placenta and fluid.
Counselling
The findings are explained in simple language, including what is clear, what is uncertain and what needs follow-up.
Follow-up plan
Repeat scans, Doppler, neurosonography, fetal echo or amniotic fluid testing may be discussed when clinically indicated.
Advanced ultrasound on GE Voluson Signature Expert
Fetal infection evaluation needs careful imaging, especially for the fetal brain, heart, growth and subtle structural signs. Mayflower Clinic uses the GE Voluson Signature Expert to support detailed fetal assessment.
SonoLyst AI
Supports systematic acquisition of standard fetal anatomy views and improves workflow consistency during detailed fetal assessment.
fetalHS & STIC
Helps structured fetal heart assessment when infection-related cardiac effect, rhythm concern or fetal hydrops is suspected.
Colour Doppler
Helps evaluate fetal circulation, placental blood flow and fetal wellbeing where Doppler surveillance is clinically required.
Technology helps, but interpretation matters most.
AI-enabled ultrasound improves visualisation and workflow, but final diagnosis and counselling depend on the fetal medicine specialist’s experience, correlation with reports and careful clinical judgement.
Before your appointment
Bringing the right documents helps Dr. Kunda interpret the infection risk more accurately and avoid unnecessary confusion.
Please bring
- All previous pregnancy ultrasound reports
- TORCH / CMV / toxoplasmosis / rubella / viral blood reports
- IgG, IgM and avidity reports if available
- NIPT, dual marker, quadruple marker or amniocentesis reports if done
- Obstetrician referral note and current medicines
During counselling
- Ask which infection is suspected and what the timing means
- Understand whether the baby shows any ultrasound effect
- Clarify whether repeat scan, fetal echo or neurosonography is needed
- Discuss what warning signs or follow-up schedule your obstetrician recommends
Common questions about fetal infections and TORCH
Does a positive TORCH report mean the baby is definitely infected?
No. A positive report needs careful interpretation. IgG may indicate past infection, while IgM can sometimes be false-positive or need further testing. Timing, avidity, repeat titres, ultrasound findings and specialist counselling are important.
Can ultrasound completely rule out fetal infection?
No. Ultrasound can identify fetal effects when they are visible, but not all infections show ultrasound changes. A normal scan is reassuring but does not always exclude infection. Follow-up depends on the type and timing of infection.
Which infections are commonly considered in TORCH evaluation?
Commonly considered infections include toxoplasmosis, rubella, cytomegalovirus, herpes-related infections and other infections. Depending on history, doctors may also evaluate parvovirus B19, varicella, syphilis and other maternal infections.
When is fetal neurosonography needed?
Fetal neurosonography may be advised if infection can affect the fetal brain, or if routine ultrasound shows ventriculomegaly, small head size, calcification suspicion, abnormal brain anatomy or other neurological concerns.
Will I need amniocentesis?
Not always. Amniocentesis may be discussed in selected cases when amniotic fluid PCR or genetic testing is clinically useful. The decision depends on infection type, gestational age, maternal reports, ultrasound findings and counselling.
How often will scans be repeated?
Follow-up frequency is individual. Some pregnancies need one detailed scan and routine follow-up, while others may need serial growth scans, Doppler, fetal echo or neurosonography at planned intervals.
Doctor’s note
“When parents hear the word infection in pregnancy, they often become very anxious. The first step is not to panic. We need to understand which infection is suspected, when it happened, what the blood reports mean, and whether the baby is showing any effect on ultrasound. With a systematic fetal medicine approach, many families get much clearer guidance.”
— Dr. Kunda Shahane
Useful internal links
Need a fetal infection or TORCH-related scan opinion?
Book a consultation at Mayflower Fetal Medicine & High-Risk Pregnancy Centre, Nagpur. Please carry all infection blood reports and previous scan reports for accurate counselling.
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