Petrović Slobodanka, Pribić Radmila Ljustina, Rodić Branislavka Bjelica, Dautović Gordana Vilotijević, Cegar Svetlana
Institut za zdravstvenu zastitu dece i omladine Vojvodine, Novi Sad, Klinika za decje bolesti, Sluzba za plućne bolesti, Medicinski fakultet Novi Sad.
Med Pregl. 2012 Nov-Dec;65(11-12):496-501. doi: 10.2298/mpns1212496p.
The number of people suffering from tuberculosis has increased rapidly in the whole world over the past three decades. The classical age distribution of disease has also changed. According to the epidemiological data the number of pregnant women having tuberculosis has also risen with the resulting increase in the incidence of perinatal tuberculosis.
The presentation of tuberculosis in pregnancy varies. The effects of tuberculosis on pregnancy depend upon various factors: site and extent of the disease. nutritional status and immune status of mother, concomitant diseases, stage of pregnancy when the treatment started and others. A delay between the onset and diagnosis occurs regularly. Treatment response, time to clearance of bacilli from sputum. and prognosis are similar to non pregnant women.
Perinatal tuberculosis is extremely rare if the mother is effectively treated in pregnancy. but disease is usually fatal if untreated. Diagnosis of perinatal tuberculosis is very often problematic and difficult. The reason of this is the fact that the initial manifestations of disease are nonspecific and may be delayed. In practice, congenital and early neonatal infections have almost the same mode of presentations, treatment and prognosis. Epidemiological data on the active tuberculosis in mother or some other family member are of the utmost importance in diagnoing tuberculosis. Differences in immune responses in the fetus and neonate add to the diagnostic difficulties already recognised in young children. Tuberculin tests are negative in at least 75% of cases.
If the condition is recognised and treated according to existing tuberculosis protocols, the outcome is favourable.
在过去三十年中，全球结核病患者数量迅速增加。疾病的经典年龄分布也发生了变化。根据流行病学数据，患结核病的孕妇数量也有所上升，围产期结核病的发病率随之增加。
妊娠期结核病的表现各不相同。结核病对妊娠的影响取决于多种因素：疾病的部位和范围、母亲的营养状况和免疫状态、伴随疾病、开始治疗时的妊娠阶段等。发病与诊断之间经常会出现延迟。治疗反应、痰菌清除时间和预后与非孕妇相似。
如果母亲在孕期得到有效治疗，围产期结核病极为罕见，但如果不治疗，疾病通常会致命。围产期结核病的诊断往往存在问题且困难重重。原因在于疾病的初始表现不具特异性，且可能延迟出现。实际上，先天性和早期新生儿感染在表现形式、治疗和预后方面几乎相同。母亲或其他家庭成员的活动性结核病流行病学数据对诊断结核病至关重要。胎儿和新生儿免疫反应的差异增加了已在幼儿中认识到的诊断难度。结核菌素试验在至少75%的病例中呈阴性。
如果根据现有的结核病治疗方案对病情进行识别和治疗，结果将是良好的。
