Management of tuberculosis in pregnancy

In the United States, escalating rates of homelessness and human immunodeficiency virus infection have provided a background for the resurgence of Mycobacterium tuberculosis. This scourge of tuberculosis has disproportionately affected groups of reproductive-age women who have limited access to health care. Despite wide reporting of an increased incidence of tuberculosis, a low index of suspicion continues to delay diagnosis of the disease in pregnant women. As a result, a newborn diagnosed with congenital infection often becomes the index case for maternal infection. To become proficient in the prenatal diagnosis of tuberculosis, clinicians must make an in-depth review of the clinical signs and symptoms consistent with tuberculosis a routine part of obstetrical screening. Once diagnosed, tuberculosis is treated as aggressively in pregnancy as it is in the nonpregnant patient.