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Management of tuberculosis in pregnancy
1Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10461.
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.
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.