Tuberculosis in pregnancy

Key contentTuberculosis (TB) is an important global cause of maternal and neonatal morbidity and mortality.With increasing migration, cases of tuberculosis in pregnancy or the puerperium are increasing in resource-rich nations with advanced health care systems.Diagnosis may be delayed given the overlap of some of the symptoms with that of pregnancy.Timely diagnosis is essential to initiate appropriate treatment and prevent maternal and neonatal morbidity and mortality. Learning objectivesTo understand the relevant global and UK epidemiology of the disease, including recent goals set by the World Health Organization and the UK.To review the pathophysiology of pulmonary and extrapulmonary TB, and of latent and active TB.To learn how to identify high-risk women for antenatal assessment and gain an awareness of the screening tests available for latent TB.To gain awareness of the clinical symptoms, diagnosis and therapeutic management of active tuberculosis, including management of any drug resistance.To understand management of the neonate within high-risk groups and where the mothers have diagnosed latent or active TB. Ethical issuesPregnant women with TB should be fully counselled about the benefits, risks, and alternate options of management.Should healthcare professionals with high risk of acquiring TB infection be exempt from managing TB infection?Management of TB in HIV-positive women provides additional challenges.Breastfeeding issues around seropositive mothers should be considered.

Automated summary

Tuberculosis is a significant cause of maternal and neonatal morbidity and mortality globally. The increasing migration has led to a rise in tuberculosis cases among pregnant women or during the postpartum period in resource-rich countries. Diagnosis may be delayed as the symptoms overlap with those of pregnancy. Timely diagnosis is crucial to initiate appropriate treatment and prevent adverse outcomes for both the mother and baby.