Abstract
Tuberculosis (TB) is a common infectious pathology especially in low-income countries,
which may complicate pregnancy. Although pulmonary TB is more common in pregnancy
than extra pulmonary TB (EPTB), EPTB is becoming more common especially in those living
with human deficiency virus (HIV) co infection or have other comorbidities. The diagnosis
of TB may be delayed in pregnancy due to the masking of its symptoms by those of pregnancy.
If diagnosed and treated on time both pulmonary TB and EPTB are associated with excellent
maternal and perinatal outcome. If, however, there is delay in diagnosis and treatment
then there could be adverse maternal and fetal consequences like preterm labour, fetal
growth restriction and even stillbirths. Similarly severe forms of TB like disseminated
disease (miliary TB) or multi drug resistant TB (MDR TB) are associated with poor
outcome. Diagnosis and management is same as in non-pregnant patients. Both drug sensitive
pulmonary TB and EPTB are treated with four drugs (isoniazid, rifampicin, pyrazinamide
and ethambutol) orally daily for 2 months followed by three drugs (isoniazid, rifampicin
and ethambutol) orally daily for 4 months. Drug resistant TB is treated with second
line drugs with caution, as some of these drugs are teratogenic. Optimum antenatal
care and nutrition therapy along with anti-tuberculosis drugs provide for optimum
maternal and perinatal outcome. This review discusses maternal and perinatal outcomes,
diagnosis and management of pulmonary TB and extrapulmonary TB as well as perinatal
tuberculosis.
Keywords
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Article info
Publication history
Published online: February 19, 2021
Accepted:
February 16,
2021
Received in revised form:
February 14,
2021
Received:
October 31,
2020
Identification
Copyright
© 2021 Published by Elsevier B.V.
