Abstract:
Introduction/Background. The problem of tuberculosis in pregnant women deserves special
attention during increasing incidence of this disease in Moldova. Risk of maternal and perinatal
pathology significantly increased in women with active tuberculosis of the respiratory organs. In
this study we analyzed features of the course of pregnancy in 84 patients with active tuberculosis.
Direct proportionality was found between the active form of lung specific process and frequency
of obstetric complications. Patients, Methods. To achieve this study observational retrospective
analysis of obstetrical records of pregnant women with active tuberculosis of the respiratory
organs was conducted of PHCF ICSOSMC and SCM N1 (Moldova) during the years 2005-2010.
Results. The most common clinical form of tuberculosis of the respiratory organs, found in
patients in the study group was found to be infiltrative pulmonary tuberculosis - 52 (61.9%) cases.
Second after impact was exudative pleurisy - 16 (19.0%) cases. Disseminated (miliary) form was
detected in 6 (7.1%) patients, fibro-cavitary form - 5 (6.0%) patients, nodular form - 5 (6.0%)
patients. A woman was diagnosed with generalized tuberculosis affecting the lungs (miliary
tuberculosis), pleura (pleural exudative - fibrinous), liver, kidney, intrathoracic lymph nodes. The
case resulted in maternal death and intranatal mortality. At 3/4 of patients pregnancy developed
on the background of iron deficiency anemia - 69 (82.1%) cases. During pregnancy they were treated anemic. Other complications of pregnancy in patients with active tuberculosis of the
respiratory organs were imminent abortion in different terms - 38 (45.2%) cases; placental
pathology was found in 22 (26.2%) cases, pregnant swelling - in 4 (4.8%) cases; pregnancy was
complicated by gestosis and preeclampsia - in 5 (6.0%) cases. Analyzing the peculiarities of
placental pathology there was identified intrauterine fetal chronic hypoxia in 9 (10.7%) cases,
placental chronic insufficiency - in 6 (7.1%) cases, fetal growth symmetric form retardation - in 15
(17.9%) cases and asymmetric form - in 3 (3.6%) cases; amniotic fluid pathology was noted in 7
(8.3%) cases. Only 6 (7.1%) pregnancies were uncomplicated. Conclusion. The obtained data are
confronted with data from the literature. The increased incidence of pregnancy complications in
women with active tuberculosis of the respiratory organs was found. According to foreign studies
the complicated evolution of pregnancy occurs in 40.0 to 43.1% of cases, and according to data
from this study - up to 70% of cases. Frequently the pregnancy was complicated by iron deficiency
anemia (about 80%), much higher than the population average (15-20%). The obstetric
complications were significant: gestosis and preeclampsia - 5 (6.0%) cases, placental pathology 22
(26.2%) cases, being accompanied 18 (21.4%) cases of fetal growth retardation. These obstetric
complications observed in this study coincided with their incidence in the literature.