St. Hitrova-Nikolova, L. Vakrilova, D. Hristova, I. Ibryam
Abstract
Tuberculosis remains a serious global public health problem, despite immunization programs. We
present a clinical case of a pregnant woman infected with tuberculosis. Her newborn had negative tests
as a result of maternal treatment. Primary, infiltrative-pneumonic maternal tuberculosis of the lungs was
diagnosed and treated at 26 gestational weeks in the University Hospital of Obstetrician and Gynecology
“Maichin Dom” – Sofia. A cesarean section was carried out at 40 weeks’ of gestation. Mycobacterium
tuberculosis was not found in the amniotic fluid or the placental tissue. The newborn had negative
laboratory tests for congenital tuberculosis. We would like to remind the recommendations for pregnant
women and their newborns in cases of tuberculosis. Prenatal history, diagnosis, and treatment during
pregnancy are of great benefit for early diagnosis and the determination of neonatal outcomes.
Key words: maternal tuberculosis, term neonate, recommendations
Bibliography
- Велизарова, Св., Спасова, А., Габровска, Н. IGRA – тестове – съвременна имунологична диагноза на туберкулозното заболяване в детска възраст. GP news, 2017;2: 27-31 стр.
- Hui SYA, Lao TT. Tuberculosis in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2022 Dec;85(Pt A):34-44.
- Schaaf HS, Bekker A, Rabie H. Perinatal tuberculosis-An approach to an under-recognized diagnosis. Front Public Health. 2023 Nov 7;11:1239734.
- Mittal H, Das S, Faridi MM. Management of newborn infant born to mother suffering from tuberculosis: current recommendations & gaps in knowledge. Indian J Med Res. 2014 Jul;140(1):32-9
- Cantwell MF, Shehab ZM, Costello AM, et al. Brief report: congenital tuberculosis. N Engl J Med. 1994;330:1051
- Pop R, Kaelin MB, Kuster SP, et al. Low secondary attack rate after prolonged exposure to sputum smear positive miliary tuberculosis in a neonatal unit. Antimicrob Resist Infect Control. 2022 Dec 5;11(1):148.
- American Academy of Pediatrics. Tuberculosis. In: Pickering LK, editor. Red book: 2012 report of the committee on infectious diseases. 29th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2012. p. 736-56.
- World Health Organization. Treatment of tuberculosis guidelines, 4th ed. Geneva: who; 2009. WHO/HTB/ TB/2009.420.
- Kumari N, Khatri A.Congenital tuberculosis: a review article. Int J Contemp Pediatr 2019;6:2750-4.
- Simpson G, Philip M, Vogel JP, et al. The clinical presentation and detection of tuberculosis during pregnancy and in the postpartum period in low- and middle-income countries: A systematic review and meta-analysis. PLOS Glob Public Health. 2023 Aug 23;3(8):e0002222.
- Nguyen HT, Pandolfini C, Chiodini P, et al. Tuberculosis care for pregnant women: a systematic review. BMC Infect Dis. 2014 Nov 19;14:617.
- Hu Z, Zeng D, Yang Y, et al. Pathomorphological characteristics of tuberculous placenta and its clinical implication. Diagn Pathol. 2023 Nov 29;18(1):128.
Address for corespondence:
Clinic of neonatology, University Hospital of Оbstetrics and Gynecology “Maichin dom”
Department of Obstetrics and Gynecology
Medical University of Sofia
2, “Zdrave”, Str.,
1431, Sofia, Bulgaria
e-mail: stasia_doc@abv.bg

