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(Chest. 1994;106:1466-1470.)
© 1994 American College of Chest Physicians

Tuberculosis During Pregnancy

The Rhode Island Experience, 1987 to 1991

E. Jane Carter M.D., F.C.C.P.1 and Susan Mates M.D.2

1 From the Division of Pulmonary Medicine, Brown University School of Medicine, Roger Williams Medical Center, and the Rhode Island Tuberculosis Clinic, Providence
2 From the Division of Infectious Diseases, Brown University School of Medicine, and the Rhode Island Department of Health, Providence

Although recent studies have reported otherwise, previous conventional wisdom has held that one-half to two-thirds of pregnant women with tuberculosis are asymptomatic. If true, this has important implications for screening programs. Charts of all patients with culture-proven Mycobacterium tuberculosis in Rhode Island between 1987 and 1991 were reviewed. One-third of women aged 21 to 32 years with culture-proven tuberculosis were pregnant at time of diagnosis (7 pregnant; 15 nonpregnant). Pregnant patients with pulmonary conditions were more likely to be found through routine screening (p=0.008) and to be asymptomatic (p=0.008). In addition, pregnant women with pulmonary conditions were more likely to present with unilateral non-cavitary, smear-negative disease (p=0.02). If routine screening is not performed prenatally with radiographic follow-up of all infected individuals, most pregnant women will not have their conditions diagnosed and, therefore, will not be treated in time to prevent risk to the fetus, the newborn, and the obstetric ward.

Key Words: pregnancy • screening • tuberculosis

Submitted on October 28, 1993
Accepted on February 25, 1994




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