Robinson C A, Rose N C
Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philaldephia 19104, USA.
Obstet Gynecol Surv. 1996 Feb;51(2):115-24. doi: 10.1097/00006254-199602000-00021.
After years of decline, tuberculosis has again emerged as a serious public health issue. Following the introduction of effective chemotherapy at mid-century, cases of tuberculosis decreased until 1986. Since that time, the number of cases of tuberculosis have dramatically increased, particularly among young persons. The reemergence of tuberculosis is localized to urban areas and is linked to the increase in the incidence of human immunodeficiency virus infection and drug resistance. Since pregnant women are at risk for tubercular infection, an effective method exists to identify women who are asymptomatically infected, provide them with treatment to prevent progression of disease, and investigate their contacts. This review will discuss the issues of diagnosis and treatment of asymptomatic infection and active tuberculosis in pregnant women. Additionally, the need for universal screening of all prenatal patients and the benefit and potential perinatal toxicity of chemotherapy in both immunocompetent patients and those infected with human immunodeficiency virus will be addressed.
经过多年的下降后，结核病再次成为一个严重的公共卫生问题。在本世纪中叶引入有效的化疗方法后，结核病病例数一直下降到1986年。从那时起，结核病病例数急剧增加，尤其是在年轻人中。结核病的再度出现局限于城市地区，并且与人类免疫缺陷病毒感染率和耐药性的增加有关。由于孕妇有感染结核的风险，因此存在一种有效的方法来识别无症状感染的妇女，为她们提供治疗以预防疾病进展，并对其接触者进行调查。本综述将讨论孕妇无症状感染和活动性结核病的诊断和治疗问题。此外，还将探讨对所有产前患者进行普遍筛查的必要性，以及化疗在免疫功能正常患者和感染人类免疫缺陷病毒患者中的益处和潜在的围产期毒性。
