EC Gynaecology

Pulmonary tuberculosis (TB) during pregnancy poses a considerable risk of morbidity for both the pregnant woman and the product of conception if not diagnosed and treated promptly. The coexistence of TB and pregnancy increases the risk of miscarriage, low birth weight, preterm birth, preeclampsia, and perinatal mortality. Active pulmonary TB during pregnancy is associated with greater clinical severity and worse obstetric outcomes. Likewise, women who develop TB during gestation are at higher risk of more severe forms of the disease and a higher frequency of multiorgan involvement. Early detection and timely treatment provide these patients with a better perinatal prognosis; therefore, screening for TB is recommended in pregnant women from high-burden settings. We present the clinical case of a young patient diagnosed with TB who became pregnant three months into anti-tuberculosis treatment, presenting two serious obstetric complications that resulted in perinatal loss. The mother showed favorable clinical progress until discharge from the Health Unit. It is concluded that women of reproductive age affected by TB should also receive comprehensive gynecological-obstetric care so that pregnancies are not overlooked, thereby reducing complications in the mother- child dyad while ensuring the success of anti-tuberculosis treatment.

Keywords: Pulmonary Tuberculosis; Pregnancy; Primary Health Care

1. Forsyth KS., et al. “The X-quisite X-ception: Sex differences with immune responses”. Nature Reviews Immunology 7 (2024): 487-502.
2. Miele K., et al. “Tuberculosis in pregnancy”. Obstetrics and Gynecology 6 (2020): 1444-1453.
3. Mathad JS., et al. “Tuberculosis infection in pregnant people: current practices and research priorities”. Pathogens 12 (2022): 1481.
4. Morton AJ., et al. “Mycobacterium tuberculosis infection in pregnancy: A systematic review”. PLOS Global Public Health 11 (2024): e0003578.
5. Miele K., et al. “Tuberculosis in pregnancy”. Obstetrics and Gynecology 6 (2020): 1444-1453.
6. Sobhy S., et al. “Maternal and perinatal mortality and morbidity associated with tuberculosis during pregnancy and the postpartum period: a systematic review and meta-analysis”. BJOG: An International Journal of Obstetrics and Gynaecology 124 (2017): 727-733.
7. Nguyen HT., et al. “Tuberculosis care for pregnant women: a systematic review”. BMC Infectious Diseases 14 (2014): 617.
8. Van Schalkwyk M., et al. “Pharmacokinetics of first-line tuberculosis drugs rifampin, isoniazid, ethambutol, and pyrazinamide during pregnancy and postpartum with and without efavirenz-based antiretroviral treatment: IMPAACT P1026s study”. Antimicrobial Agents and Chemotherapy 9 (2025): e0005225.
9. Loto OM and Awowole I. “Tuberculosis in pregnancy: A review”. Journal of Pregnancy (2012): 379271.
10. Meehan SA., et al. “Association between tuberculosis and pregnancy outcomes: a retrospective cohort study of women in Cape Town, South Africa”. BMJ Open 14 (2024): e081209.
11. Starshinova A., et al. “Tuberculosis in pregnant women after COVID-19: Features of prevention, diagnosis, and treatment (Narrative Review)”. Journal of Clinical Medicine 16 (2025): 5681.
12. van de Water BJ., et al. “Tuberculosis clinical presentation and treatment outcomes in pregnancy: a prospective cohort study”. BMC Infectious Diseases 1 (2020): 595.
13. Nyangahu DD., et al. “Antibiotic treatment during gestation enhances susceptibility to Mycobacterium tuberculosis in offspring”. Microbiology Spectrum 6 (2022): e02491-22.
14. Hui SYA and Lao TT. “Tuberculosis in pregnancy”. Best Practice and Research Clinical Obstetrics and Gynaecology 85A (2022): 34-44.
15. Hughes J. “Pharmacokinetics and safety of Group A and B anti-tuberculosis drugs used in treatment of rifampicin-resistant tuberculosis during pregnancy and post-partum: A narrative review”. Pathogens12 (2023): 1385.
16. Wu D., et al. “Analysis of prevalence of adverse events connected with anti-tuberculosis drugs during pregnancy: A meta-analysis”. Heliyon11 (2023): e22786.
17. Hughes JA., et al. “Pharmacokinetics and safety of levofloxacin for treatment of rifampicin-resistant tuberculosis during pregnancy and the postpartum period: Results from IMPAACT P1026s”. Clinical Pharmacokinetics 4 (2025): 619-630.
18. Su Y., et al. “Adverse pregnancy outcomes and complications of tuberculosis in pregnant women”. Frontiers in Cellular and Infection Microbiology 15 (2025): 1550430.
19. Zenner D., et al. “Risk of tuberculosis in pregnancy: A national, primary care-based cohort and self-controlled case series study”. American Journal of Respiratory and Critical Care Medicine 7 (2012): 779-784.
20. Sugarman J., et al. “Tuberculosis in pregnancy: An estimate of the global burden of disease”. The Lancet Global Health12 (2014): e710-e716.
21. Crocker-Buque T., et al. “An update on the clinical management of HIV and tuberculosis co-infection in pregnancy: TB preventative therapy, long-acting ARVs, and bedaquiline-based regimens”. Current HIV/AIDS Reports 1 (2025): 37.
22. Maurice A., et al. “Perinatal tuberculosis”. Merck Manual Professional Version.