Tuberculosis and pregnancy

Reikhrud T.A., Kulchavenya E.V., Myshkova E.P., Zhukova I.I., Zhukova E.M.

1 Novosibirsk Research Institute of Tuberculosis, Ministry of Health of Russia, Novosibirsk 630040, Okhotskaya str. 81A, Russia 2 Novosibirsk State Medical University, Novosibirsk 630091, Krasny Prospect 52, Russia 3 Novosibirsk Regional Tuberculosis Dispensary, Novosibirsk 630075, Alexander Nevsky str. 9/1, Russia
Background. Tuberculosis (TB) is difficult to diagnose in pregnant women; pregnancy management in patients with TB also poses certain challenges. The incidence of TB in pregnant women was 1.3 times higher than that
in the general population.
Description. The paper describes a case of recurrent multidrug-resistant pulmonary TB in a 24-year-old woman. The patient decided to maintain her current pregnancy, despite the use of anti-TB drugs and X-ray examination. The pregnancy was hard; the baby was born with birth defects.
The second case reflects a good maternal immunity because TB of the placenta was detected only after normal delivery and spontaneously cured TB of the uterine appendages was identified in three more months.
Conclusion. Pregnancy and TB are a negative concurrence for a woman; the patient should be oriented towards the prevention of an unplanned pregnancy.


pulmonary tuberculosis
extrapulmonary tuberculosis
urogenital tuberculosis
genital tuberculosis
tuberculosis of the placenta

Supplementary Materials

  1. Fig. 1. Disseminated pulmonary tuberculosis with signs of infiltration and destruction
  2. Fig. 2. Residual post-tuberculous changes: fibrosis in both lungs, a small number of high density zones
  3. Fig. 3. Caseous inflammation of placenta. Hematoxilin–eosin 100x
  4. Fig. 4. Mtb in tissue  of placenta. Colored by Zheel-Nelsen


1. WHO. Global tuberculosis report 2015. 20th ed. WHO; 2015. Available at:›tb/publications/global_report/en/

2. Кульчавеня Е.В., Краснов А.В., Мордык А.В. Альманах внелегочного туберкулеза. Новосибирск: Сибпринт; 2015. 247с. [Kulchavenya E.V., Krasnov A.V., Mordyk A.V. Almanac of extrapulmonary tuberculosis. Novosibirsk: Sibprint; 2015. 247c. (in Russian)]

3. Cain M.A., Whiteman V.E., Buhari M.A., Louis J.M. Positive interferon-γ release assay leading to a diagnosis of Mycobacterium tuberculosis pericarditis in pregnancy. Obstet. Gynecol. 2014;124(2, Pt 2, Suppl, 1):475-7.

4. Кульчавеня Е.В., Брижатюк Е.В., Хомяков В.Т. Туберкулез экстраторакальных локализаций в Сибири и на Дальнем Востоке. Туберкулез и болезни легких. 2005; 6: 23-5. [Kulchavenya E.V., Brizhatuk E.V., Khomyakov V.T. Tuberculosis extrathoracic localization in Siberia and the Far East. Tuberkulez i bolezni legkih. 2005; 6: 23-5. (in Russian)]

5. Осадчий А.В., Кульчавеня Е.В., Рейхруд Т.А., Нарышкина С.Л., Кожевникова Е.В., Хомяков В.Т. Социально-демографическая характеристика больных туберкулезом легких и внелегочных локализаций. Туберкулез и болезни легких. 2015; 2: 46-8. [Osadchy A.V., Kulchavenya E.V., Reikhrud T.A., Naryshkina S.L., Kozhevnikova E.V., Khomyakov V.T. Socio-demographic characteristics of patients with pulmonary tuberculosis and extrapulmonary localization. Tuberkulez i bolezni legkih. 2015; 2: 46-8. (in Russian)]

6. Кульчавеня Е.В., Алексеева Т.В., Шевченко С.Ю. Особенности поло-возрастной характеристики больных туберкулезом легких и мочеполовой системы. Туберкулез и болезни легких. 2015; 5: 104-6. [Kulchavenya E.V., Alekseeva T.V., Shevchenko S.Yu. Features of the sex-age characteristics of patients with pulmonary tuberculosis and the genitourinary system. Tuberkulez i bolezni legkih. 2015; 5: 104-6. (in Russian)]

7. Rendell N.L., Batjargal N., Jadambaa N., Dobler C.C. Risk of tuberculosis during pregnancy in Mongolia, a high incidence setting with low HIV prevalence. Int. J. Tuberc. Lung Dis. 2016; 20(12): 1615-20.

8. Tripathy S.N., Tripathy S.N. Tuberculosis and pregnancy. Int. J. Gynaecol. Obstet. 2003; 80(3): 247-53.

9. Bishara H., Goldstein N., Hakim M., Vinitsky O., Shechter-Amram D., Weiler-Ravell D. Tuberculosis during pregnancy in Northern Israel, 2002-2012: epidemiology and clinical practices. Isr. Med. Assoc. J. 2015;17(6): 346-50.

10. Bishara H., Vinitsky O., Salim R., Keness Y., Chazan B., Miron D. Tuberculosis in pregnancy and puerperium. Harefuah. 2013; 152(7): 381-4, 435.

11. Sheriff F.G., Manji K.P., Manji M.P., Chagani M.M., Mpembeni R.M., Jusabani A.M. et al. Latent tuberculosis among pregnant mothers in a resource poor setting in Northern Tanzania: a cross-sectional study. BMC Infect. Dis. 2010; 10: 52. doi: 10.1186/1471-2334-10-52.

12. Sobhy S., Babiker Z., Zamora J., Khan K.S., Kunst H. Maternal and perinatal mortality and morbidity associated with tuberculosis during pregnancy and the postpartum period: a systematic review and meta-analysis. BJOG. 2017; 124(5): 727-33.

13. Bekker A., Schaaf H.S., Draper H.R., Kriel M., Hesseling A.C. Tuberculosis disease during pregnancy and treatment outcomes in HIV-infected and uninfected women at a referral hospital in CapeTown. PLoS One. 2016; 11(11): e0164249. doi: 10.1371/journal.pone.0164249. eCollection 2016.

14. Asuquo B., Vellore A.D., Walters G., Manney S., Mignini L., Kunst H. A case-control study of the risk of adverse perinatal outcomes due to tuberculosis during pregnancy. J. Obstet. Gynaecol. 2012; 32(7): 635-8. doi: 10.3109/01443615.2012.704436.

15. Zenner D., Kruijshaar M.E., Andrews N., Abubakar I. Risk of tuberculosis in pregnancy: a national, primary care-based cohort and self-controlled case series study. Am. J. Respir. Crit. Care Med. 2012; 185(7): 779-84. doi: 10.1164/rccm.201106-1083OC.

16. Jonnalagadda S., LaCourse S.M., Otieno P., Lohman-Payne B., Maleche-Obimbo E., Cranmer L.M. et al. Incidence and correlates of tuberculosis IGRA conversion among HIV-infected postpartum women. Int. J. Tuberc. Lung Dis. 2015; 19(7): 792-8. doi: 10.5588/ijtld.14.0878.

17. Bothamley G.H., Ehlers C., Salonka I., Skrahina A., Orcau A., Codecasa L.R. et al. Pregnancy in patients with tuberculosis: a TBNET cross-sectional survey. BMC Pregnancy Childbirth. 2016; 16(1): 304.

18. García-López S.J., Pérez-Martínez A., Chávez-Martínez S., Sereno-Coló J.A. Genital tuberculosis and pregnancy to term. Case report. Ginecol. Obstet. Mex. 2014; 82(4): 261-7.

19. Якимова А.В., Шкурупий В.А. Беременность и роды у больных туберкулезом органов дыхания женщин: особенности развития и исход. Журнал акушерства и женских болезней. 2009; 58(4): 70-8. [Yakimova A.V., Shkurupiy V.A. Pregnancy and childbirth in patients with tuberculosis of the respiratory system of women: developmental features and outcome. Zhurnal akusherstva i zhenskih bolezney. 2009; 58(4): 70-8. (in Russian)]

20. Черданцева Л.А., Якимова А.В., Надеев А.П., Шкурупий В.А. Особенности структурной организации плаценты при туберкулезе легких. Архив патологии. 2009; 71(2): 7-9. [Cherdantseva L.A., Yakimova A.V., Nadeyev A.P., Shkurupiy V.A. The placental structural organization in pulmonary tuberculosis. Arkhiv patologii. 2009; 71(2): 7-9. (in Russian)]

21. Ветушенко С.А., Захарова Т.Г. Частота и тяжесть осложнений беременности и родов у женщин с туберкулезом различной локализации в Красноярском крае. Журнал акушерства и женских болезней. 2014; 58(3): 58-65. [Vetushenko S.A., Zakharova T.G. The frequency and severity of complications of pregnancy and childbirth in women with tuberculosis of various locations in the Krasnoyarsk Territory. Zhurnal akusherstva i zhenskih bolezney. 2014; 58 (3): 58-65. (in Russian)]

22. Gounder C.R., Wada N.I., Kensler C., Violari A., McIntyre J., Chaisson R.E. et al. Active tuberculosis case-finding among pregnant women presenting to antenatal clinics in Soweto, South Africa. J. Acquir. Immune Defic. Syndr. 2011; 57(4): e77-84. doi: 10.1097/QAI.0b013e31821ac9c1.

23. Keskin N., Yilmaz S. Pregnancy and tuberculosis: to assess tuberculosis cases in pregnancy in a developing region retrospectively and two case reports. Arch. Gynecol. Obstet. 2008; 278(5): 451-5. doi: 10.1007/s00404-008-0594-7.

24. Oliveira H.B., Mateus S.H. Characterization of multidrug-resistant tuberculosis during pregnancy in Campinas, State of São Paulo, Brazil, from 1995 to 2007. Rev. Soc. Bras. Med. Trop. 2011; 44(5): 627-30.

25. Nakbanpot S., Rattanawong P. Congenital tuberculosis because of misdiagnosed maternal pulmonary tuberculosis during pregnancy. Jpn. J. Infect. Dis. 2013; 66(4): 327-30.

26. Taweevisit M., Nisagornsen C., Thorner P.S. Intrauterine tuberculosis manifesting as acute chorioamnionitis: a case report and review of the literature. Pediatr. Dev. Pathol. 2015; 18(4): 335-8. doi: 10.2350/15-02-1607-CR.1.

27. Abramowsky C.R., Gutman J., Hilinski J.A. Mycobacterium tuberculosis infection of the placenta: a study of the early (innate) inflammatory response in two cases. Pediatr. Dev. Pathol. 2012; 15(2): 132-6. doi: 10.2350/11-05-1039-CC.1.

28. Kulchavenya E., Dubrovina S. Typical and unusual cases of female genital tuberculosis. IDCases. 2014; 1(4): 92-4. doi: 10.1016/j.idcr.2014.10.001. eCollection 2014.

29. Gupta N., Sharma J.B., Mittal S., Singh N., Misra R., Kukreja M. Genital tuberculosis in Indian infertility patients. Int. J. Gynaecol. Obstet. 2007; 97(2): 135-8.

30. Sharma J.B., Roy K.K., Pushparaj M., Kumar S., Malhotra N., Mittal S. Laparoscopic findings in female genital tuberculosis. Arch. Gynecol. Obstet. 2008; 278(4): 359-64.

31. Афонин А.В., Перецманас Е.О., Топоркова Е.Е., Ходаковский Е.П. Туберкулезная инфекция, как инфекция, передаваемая половым путем. Вестник последипломного медицинского образования. 2006; 3-4: 69-71. [Afonin A.V., Peretsmanas E.O., Toporkova E.E., Khodakovskiy E.P. Tuberculosis infection is a sexually transmitted infection. Vestnik poslediplomnogo meditsinskogo obrazovaniya. 2006; 3-4: 69-71. (in Russian)]

32. Кульчавеня Е.В., Бреусов А.А. Эффективность уро-ваксома при рецидивирующих инфекционно-воспалительных заболеваниях мочеполовой системы. Урология. 2011; 4: 7-11. [Kulchavenya E.V., Breusov A.A. Efficiency of uro-vaccoma in recurrent infectious and inflammatory diseases of the genitourinary system. Urologiya. 2011; 4: 7-11. (in Russian)]

33. Жукова И.И., Кульчавеня Е.В., Холтобин Д.П., Брижатюк Е.В., Хомяков В.Т., Осадчий А.В. Туберкулез мочеполовой системы сегодня. Урология. 2013; 1: 13-6. [Zhukova I.I., Kulchavenya E.V., Kholtobin D.P., Brizhatyuk E.V., Khomyakov V.T., Osadchy A.V. Tuberculosis of the genitourinary system today. Urologiya. 2013; 1: 13-6. (in Russian]

34. Кульчавеня Е.В., Брижатюк Е.В., Хомяков В.Т., Бреусов А.А. Частота возникновения цистита в зависимости от вида контрацепции. Урология. 2013; 1: 41-2. [Kulchavenya E.V., Brizhatuk E.V., Khomyakov V.T., Breusov A.A. The incidence of cystitis, depending on the type of contraception. Urologiya. 2013; 1: 41-2. (in Russian)]

35. Маисеенко Д.А., Егорова А.Т. Активный туберкулез легких и беременность: клинический случай прерывания по медицинским показаниям. РМЖ. 2013; 21(14): 766-7. [Maiseenko DA, Egorova A.T. Active pulmonary tuberculosis and pregnancy: a clinical case of interruption for medical reasons. RMJ. 2013; 21 (14): 766-7. (in Russian)]

Received 01.02.2017

Accepted 17.02.2017

About the Authors

Reykhrud Tatyana Anatolyevna, head of the therapeutic department, Novosibirsk Research Institute of Tuberculosis, Ministry of Health of Russia.
630040, Russia, Novosibirsk, Okhotskaya str. 81A. Tel.: +73832037989. E-mail:
Kulchavena Ekaterina Valerievna, MD, chief researcher of Novosibirsk Research Institute of Tuberculosis, Ministry of Health of Russia, professor of the tuberculosis department at Novosibirsk State Medical University. 630040, Russia, Novosibirsk, Okhotskaya str. 81A. Tel.: +73832037989. E-mail:
Myshkova Elena Pavlovna, doctor of the Novosibirsk Research Institute of Tuberculosis, Ministry of Health of Russia.
630040, Russia, Novosibirsk, Okhotskaya str. 81A. Tel.: +73832037989. E-mail:
Zhukova Irina Ivanovna, head of the extrapulmonary department of the Novosibirsk Regional Tuberculosis Dispensary.
630075, Russia, Novosibirsk, Alexander Nevsky str. 9/1
Zhukova Elena Mikhailovna, MD, leading research assistant of the Novosibirsk Research Institute of Tuberculosis, Ministry of Health of Russia.
630040, Russia, Novosibirsk, Okhotskaya str. 81A. Tel.: +73832037989. E-mail:

For citations: Reikhrud T.A., Kulchavenya E.V., Myshkova E.P., Zhukova I.I., Zhukova E.M. Tuberculosis and pregnancyy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (10): 124-9. (in Russian)

Similar Articles