Pulmonary tuberculosis in pregnancy

Tuberculosis (TB) was once a formidable public health hazard but is now less feared because of the development of an armamentarium of effective drugs. The incidence of TB had been declining for decades until recently when the number of cases of TB began to rise. The most obvious reasons for this trend were the rising rate of human immunodeficiency virus infection and the development of multiple drug-resistant TB. The largest percentage increase in TB cases occurred among persons 25 to 44 years of age; many of them are women. A number of these women will first be diagnosed with TB infection during pregnancy. It is important for the clinician to be aware of the impact of TB on this population. Patients must be screened as recommended by the Centers for Disease Control and Prevention because it is important to quickly diagnose TB. Prompt and effective therapy will benefit the mother and the neonate. This article reviews the diagnosis, prevention, and treatment regimens of TB in pregnancy, as well as the effects on the HIV patient, the neonate, and breastfeeding. Prompt recognition and treatment of TB infection will ensure that the rates of TB cases decline.