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A case report on tuberculosis in pregnancy revealing the need for an effective multidisciplinary approach and the importance of tailored therapy

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Case Report

Author Details : Nishitha Gandavaram*, Rajalekshmi M

Volume : 11, Issue : 3, Year : 2024

Article Page : 515-520

https://doi.org/10.18231/j.ijogr.2024.093

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Abstract

Background: Tuberculosis (TB) during pregnancy, especially with central nervous system (CNS) involvement, poses significant risks to maternal and fetal health. This case report explores the diagnostic and therapeutic challenges of managing new-onset seizures in a pregnant patient with CNS-TB.
Case Presentation: A 23-year-old primigravida presented at 36 weeks gestation with new-onset seizures. The diagnostic workup, complicated by the pregnancy, revealed a left frontal tuberculoma. The patient was started on a standard antitubercular therapy (ATT) regimen of 2HRZE followed by 4HR, taking into account the drugs’ teratogenic potential and fetal safety. Despite the development of mild atonic postpartum hemorrhage (PPH), the patient gave birth to a preterm but viable infant with satisfactory APGAR scores.
Management and Outcome: The interdisciplinary team provided comprehensive care, including seizure management with Levetiracetam and postpartum follow-up for both mother and child. The patient showed neurological improvement and, alongside the newborn, had a favorable outcome.
Conclusion: This case underlines the importance of a tailored, multidisciplinary approach to managing TB in pregnancy. It also emphasizes the need for vigilant monitoring and treatment adherence to navigate the complexities of TB with CNS involvement and concurrent pregnancy.
Future Recommendations: Enhanced prenatal screening for TB, interdisciplinary protocols, research on TB medications during pregnancy, and long-term follow-up studies are recommended to improve outcomes for similar future cases.
 

Keywords: Tuberculosis, Pregnancy, CNS tuberculosis, Seizures, Antitubercular therapy, Multidisciplinary management.

How to cite : Gandavaram N, Rajalekshmi M, A case report on tuberculosis in pregnancy revealing the need for an effective multidisciplinary approach and the importance of tailored therapy. Indian J Obstet Gynecol Res 2024;11(3):515-520

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