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Chapter 36 - Tuberculosis in Pregnancy

from Section 6 - Cardiopulmonary Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Amira El-Messidi  and
Alan D. Cameron
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A patient is referred by her primary care provider for consultation and transfer of care to your high-risk obstetric unit at a tertiary center. She is a 32-year-old primigravida at 15+3 weeks’ gestation with new abnormalities on chest X-ray and a positive sputum smear for acid-fast bacilli, performed as part of investigations for a four-week history of cough and night sweats. You have arranged to see her at the end of your clinic, with appropriate infection precautions. Referral to an infectious disease expert has also been instigated. A copy of the routine maternal prenatal investigations is unavailable at this time. First-trimester sonogram and aneuploidy screen were unremarkable. She has no obstetric complaints.

Keywords

Active, latent tuberculosisPregnancyComorbiditiesInvestigations, diagnostic evaluationFirst-line treatment, drug-susceptible infectionVitamin supplementationPerinatal risksAntenatal, intrapartum, postpartum managementBreastfeedingContraception
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 468 - 478
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

Canadian Tuberculosis Standards, 7th ed; 2014. Available at www.canada.ca/en/public-health/services/infectious-diseases/canadian-tuberculosis-standards-7th-edition.html. Accessed January 20, 2021.Google Scholar
Centers for Disease Control and Prevention (CDC). TB in specific populations: pregnancy. Available at www.cdc.gov/tb/topic/populations/pregnancy/default.htm. Accessed January 17, 2021.Google Scholar
El-Messidi, A, Czuzoj-Shulman, N, Spence, AR, et al. Medical and obstetric outcomes among pregnant women with tuberculosis: a population-based study of 7.8 million births. Am J Obstet Gynecol. 2016;215(6): 797.e1–797.e6.Google Scholar
International Union against Tuberculosis and Lung Disease. Management of tuberculosis – a guide to essential practice. 7th ed., 2019. Available at https://theunion.org/technical-publications/management-of-tuberculosis-a-guide-to-essential-practice. Accessed January 17, 2021.Google Scholar
Public Health England. Pregnancy and tuberculosis – information for clinicians. Available at www.gov.uk/government/publications/tuberculosis-and-pregnant-women. Accessed January 17, 2021.Google Scholar
Miele, K, Bamrah Morris, S, Tepper, NK. Tuberculosis in pregnancy. Obstet Gynecol. 2020;135(6):1444–1453.Google Scholar
Sobhy, S, Babiker, Z, Zamora, J, et al. Maternal and perinatal mortality and morbidity associated with tuberculosis during pregnancy and the postpartum period: a systematic review and meta-analysis. BJOG. 2017;124(5):727–733.CrossRefGoogle ScholarPubMed
Queensland guidelines for the treatment of tuberculosis in pregnant women and newborn infants, version 3.1. September 2016. Available at www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/diseases/tuberculosis/guidance/guidelines. Accessed January 17, 2021.Google Scholar
World Health Organization (WHO). Guidelines on TB. Available at www.who.int/tb/publications/9789241547833/en/. Accessed January 17, 2021.Google Scholar
Zha, BS, Nahid, P. Treatment of drug-susceptible tuberculosis. Clin Chest Med. 2019;40(4):763–774.CrossRefGoogle ScholarPubMed

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