Disseminated Hematogenous Tuberculosis Following in vitro Fertilization-Embryo Transfer: A Case Report

Ma, Hongye; Sun, Jing; Zhang, Lei; Yu, Lu; Liu, Hongjuan; Wu, Xuedan; Guo, Liang

doi:10.2147/idr.s332992

Cited by 8 publications

(6 citation statements)

References 29 publications

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“…Although all patients in our study survived and had a good response to antituberculous treatment combined with respiratory support including mask oxygen inhalation or mechanical ventilation, there were still some patients that died due to TB dissemination ( Ma et al., 2021 ). Perhaps, women who survived from miliary TB can no longer conceive again.…”

Section: Discussionmentioning

confidence: 92%

“…After establishing a primary focus of infection in the lung, miliary TB affects multiple organs and systems, such as the liver, spleen, bone marrow, and brain. Miliary TB is associated with poor prognosis, which may induce not only fetal death but also life-threatening complications to patients such as respiratory failure and acute respiratory distress syndrome (ARDS) ( Ma et al., 2021 ). Several case reports and case series referring to miliary TB after IVF-ET have been reported previously ( Jacquemyn et al., 2012 ; Li and Zhao, 2015 ; Ye et al., 2019 ; Gai et al., 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Clinical Features and Risk Factors in Pregnant Women With Miliary Pulmonary Tuberculosis After In Vitro Fertilization Embryo Transfer

Dong

Zhou

Peng

et al. 2022

Front. Cell. Infect. Microbiol.

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PurposeMiliary pulmonary tuberculosis (TB) among pregnant women after in vitro fertilization embryo transfer (IVF-ET) causes poor outcomes but is rarely reported. This study analyzed the clinical characteristics and risk factors of these patients to provide hints for further studies.MethodThe demographic characteristics, clinical manifestations, radiologic features, treatment, and outcomes of six patients diagnosed from May 2012 to August 2021 in Xiangya Hospital and 69 patients that were reported in English or Chinese literature from January 1980 to August 2021 were retrospectively analyzed. Continuous variables were compared between groups by t-test or Mann–Whitney U test, and categorical variables were compared between groups by chi-square test or Fisher exact test. Univariate and multiple logistic regression analyses were used to determine the predictors of respiratory failure.ResultsA total of 75 patients were included. The average age of patients was about 30 years. All patients had tubal obstruction; 5 of them were diagnosed with pelvic TB before. Thirteen cases had a history of pulmonary or extrapulmonary TB, six out of them without any antituberculosis treatment history. All patients were in their first or second trimester during the onset of symptoms. The average interval between onset of symptoms and radiologic examination was about 21 days. The most common abnormalities on chest computed tomography scan were multiple nodules, pulmonary infiltrate, and consolidation. Merely 10 patients obtained bacteriological diagnosis by Mycobacterium tuberculosis culture or polymerase chain reaction test. The other patients were clinically diagnosed. All the patients received antituberculosis treatment. Although 44% of patients had fatal complications, all cases were cured or improved after antituberculosis treatment. Unfortunately, only eight fetuses survived (10.6%). The most frequent and severe complication was type I respiratory failure (20%). Patients with expectoration, dyspnea, coarse breath sounds, ground-glass opacity, and pulmonary infiltrate or consolidation were more likely to have respiratory failure (P < 0.05). Ground-glass opacity (OR = 48.545, 95% CI = 2.366–995.974, P = 0.012) and pulmonary infiltrate or consolidation (OR = 19.943, 95% CI = 2.159–184.213, P = 0.008) were independent predictors for respiratory failure.ConclusionTube infertility with underscreened or untreated TB is a risk factor for miliary TB during pregnancy after IVF-ET. Ground-glass opacity and pulmonary infiltrate or consolidation are predictors of respiratory failure. We demonstrate risk factors for incidence and complications to supply clues for future intervention and improve patient prognosis.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Analysis of Clinical Features and Risk Factors in Pregnant Women With Miliary Pulmonary Tuberculosis After In Vitro Fertilization Embryo Transfer

Dong

Zhou

Peng

et al. 2022

Front. Cell. Infect. Microbiol.

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“…In our case, all three patients underwent abortion during the second pregnancy trimester. Most spontaneous abortions occur at 13-16 weeks after embryo transfer, which mainly result from severe TB toxemia and chorioamnionitis due to the spread of M. tuberculosis through the blood to infect the placenta, resulting in abortion and fetal death [33]. Untimely TB treatment during pregnancy increases the risk of perinatal complications, including preeclampsia, intrauterine growth delay, prenatal bleeding, low birth weight, low Apgar score at birth, and early fetal death [25].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in Pregnancy after in Vitro Fertilization and Embryo Transfer: Case Series and Literature Review

Zou

Chen

et al. 2023

Preprint

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Background Worldwide, tuberculosis (TB) remains an important cause of maternal mortality and morbidity, accounting for approximately one-third of annual deaths. Moreover, untimely TB treatment during pregnancy increases the risk of perinatal complications and poor fetal prognosis. Recently, there has been widespread use of in vitro fertilization and embryo transfer (IVF-ET). However, its clinical characteristics and possible mechanisms of TB infection in pregnant women who conceive by IVF-ET remain unclear. Therefore, we report three cases of young pregnant women diagnosed with TB after IVF-ET and describe their diagnosis and treatment. Case presentation Three young women (age: 26–31 years) diagnosed with primary infertility underwent IVF-ET treatment. They lacked a history of TB or manifestations of activated TB before transplantation. After presenting with fever, cough, and headache at 5–12 weeks of pregnancy, they were diagnosed with miliary TB, disseminated TB, and tuberculous meningitis, respectively. Initially, the patients were on a daily fixed-dose combination of first-line anti-TB treatment (ATT), which comprised rifampicin, isoniazid, pyrazinamide, and ethambutol, followed by medication adjustment during treatment for 6–12 months. Although all fetuses were lost, the patients achieved optimal outcomes after timely ATT. Conclusions This report demonstrates the increased risk of TB in pregnant women who conceive by IVF-ET. Therefore, it is important to carefully monitor these women even if they lack a history of or exposure to TB. Accordingly, prompt diagnosis and treatment of TB in these patients is necessary to optimize patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Tuberculosis in Pregnancy after in Vitro Fertilization and Embryo Transfer

Zou

Chen

et al. 2023

Preprint

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Background: Worldwide, tuberculosis (TB) remains an important cause of maternal mortality and morbidity, accounting for approximately one-third of annual deaths. Moreover, untimely TB treatment during pregnancy increases the risk of perinatal complications and poor fetal prognosis. Recently, there has been widespread use of in vitro fertilization and embryo transfer (IVF-ET). However, its clinical characteristics and possible mechanisms of TB infection in pregnant women who conceive by IVF-ET remain unclear. Therefore, we report three cases of young pregnant women diagnosed with TB after IVF-ET and describe their diagnosis and treatment. Case presentation: Three young women (age: 26–31 years) diagnosed with primary infertility underwent IVF-ET treatment. They lacked a history of TB or manifestations of activated TB before transplantation. After presenting with fever, cough, and headache at 5–12 weeks of pregnancy, they were diagnosed with miliary TB, disseminated TB, and tuberculous meningitis, respectively. Initially, the patients were on a daily fixed-dose combination of first-line anti-TB treatment (ATT), which comprised rifampicin, isoniazid, pyrazinamide, and ethambutol, followed by medication adjustment during treatment for 6–12 months. Although all fetuses were lost, the patients achieved optimal outcomes after timely ATT. Conclusions: This report demonstrates the increased risk of TB in pregnant women who conceive by IVF-ET. Therefore, it is important to carefully monitor these women even if they lack a history of or exposure to TB. Accordingly, prompt diagnosis and treatment of TB in these patients is necessary to optimize patient outcomes.

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Disseminated Hematogenous Tuberculosis Following in vitro Fertilization-Embryo Transfer: A Case Report

Cited by 8 publications

References 29 publications

Analysis of Clinical Features and Risk Factors in Pregnant Women With Miliary Pulmonary Tuberculosis After In Vitro Fertilization Embryo Transfer

Analysis of Clinical Features and Risk Factors in Pregnant Women With Miliary Pulmonary Tuberculosis After In Vitro Fertilization Embryo Transfer

Tuberculosis in Pregnancy after in Vitro Fertilization and Embryo Transfer: Case Series and Literature Review

Tuberculosis in Pregnancy after in Vitro Fertilization and Embryo Transfer

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