Carter E J, Mates S
Division of Pulmonary Medicine, Brown University School of Medicine, Roger Williams Medical Center, Providence, RI.
Chest. 1994 Nov;106(5):1466-70. doi: 10.1378/chest.106.5.1466.
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.
尽管最近的研究报告得出了相反的结论，但以往的传统观点认为，患有结核病的孕妇中有二分之一至三分之二没有症状。如果这是真的，那么这对筛查项目具有重要意义。我们回顾了罗德岛州1987年至1991年间所有经培养证实患有结核分枝杆菌的患者病历。在年龄为21至32岁、经培养证实患有结核病的女性中，三分之一在诊断时已怀孕（7名孕妇；15名非孕妇）。患有肺部疾病的孕妇更有可能通过常规筛查被发现（p = 0.008），且更有可能没有症状（p = 0.008）。此外，患有肺部疾病的孕妇更有可能表现为单侧非空洞性、涂片阴性的疾病（p = 0.02）。如果在产前不进行常规筛查并对所有受感染个体进行影像学随访，大多数孕妇的病情将无法得到诊断，因此将无法及时接受治疗以预防对胎儿、新生儿和产科病房造成的风险。
