Occurrence of female genital tuberculosis among infertile women: a study from a tertiary maternal health care research centre in South India

Bhanothu, Venkanna; Theophilus, Jane; Reddy, P. K.; Rozati, Roya

doi:10.1007/s10096-014-2164-1

Cited by 25 publications

(29 citation statements)

References 43 publications

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“…Liu et al reported a similar case in which untreated prior pulmonary TB developed into miliary TB during pregnancy [11]. Genital TB (GTB) is a form of extrapulmonary TB and a major cause of primary infertility among women in TB-endemic countries [24], with a prevalence rate of 28.4% in our hospital, as observed in previous studies [25,26]. GTB may cause fallopian tube obstruction, reduced endometrial receptivity, and ovarian dysfunction, leading to infertility.…”

Section: Discussionmentioning

confidence: 99%

Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

Gai

Chi

Cao

et al. 2020

Preprint

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BackgroundWhile miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET.MethodsData of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 to December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. The keywords “infertility,” “in vitro fertilization and embryo transfer,” and “tuberculosis” were used to search for articles published from 1980 to 2019 in PubMed, Medline, and EMBASE databases.ResultsOf 62,755 enrolled women, 7137 (11.4%) showed signs of prior pulmonary TB on chest X-ray (CXR). Seven patients aged 28–35 years had miliary TB during pregnancy, with two patients complicated by TB meningitis. All of these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Previous literature indicates that signs of prior TB on CXR and oviduct obstruction on laparoscopy are risk factors for TB reactivation during pregnancy, which displayed a trend for hematogenous dissemination.ConclusionsTB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. The coexistence of primary infertility, untreated prior pulmonary TB, and fallopian tube obstruction is a risk factor for TB dissemination.

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Section: Discussionmentioning

confidence: 99%

Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

Gai

Chi

Cao

et al. 2020

Preprint

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“…Liu et al reported a similar case in which untreated prior pulmonary TB developed into miliary TB during pregnancy [18]. Genital TB (GTB) is a form of extrapulmonary TB and a major cause of primary infertility among women in TB-endemic countries [32], with a prevalence rate of 28.4% in our hospital, as observed in previous studies [33,34]. GTB may cause fallopian tube obstruction, reduced endometrial receptivity, and ovarian dysfunction, leading to infertility.…”

Section: Discussionmentioning

confidence: 99%

Acute miliary tuberculosis in pregnancy after in vitro fertilization and embryo transfer: A report of seven cases and systematic review

Gai

Chi

Cao

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: While miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET.Methods: Data of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 to December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. The keywords “infertility,” “in vitro fertilization and embryo transfer,” and “tuberculosis” were used to search for articles published from 1980 to 2019 in PubMed, MEDLINE, EMBASE, and Chinese Wanfang databases.Results: Of 62,755 enrolled women, 7,137 (11.4%) showed signs of prior pulmonary TB on chest X-ray (CXR). Seven patients aged 28–35 years had miliary TB during pregnancy, with two patients having a complication of TB meningitis. All of these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Previous literature indicates that signs of prior TB on CXR and oviduct obstruction on laparoscopy are risk factors for TB reactivation during pregnancy, which displayed a trend for hematogenous dissemination.Conclusions: TB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. Physicians should not only enhance awareness about miliary TB, but also consider the occurrence of this form of TB, particularly in patients presenting with unknown fever as well as those in whom risk factors for TB reactivation such as primary infertility, untreated prior pulmonary TB, and fallopian tube obstruction coexist.

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“…Dans une étude indienne récemment publiée colligeant plus de 30000 femmes stériles, l'étiologie tuberculeuse a été retrouvée dans 15% des cas [ 12 ], ce qui justifie la recherche systématique d'une TG chez toute femme stérile. Les troubles du cycle à type d'aménorrhée primaire ou secondaire sont un autre motif de consultation, retrouvés dans 5 à 20% des cas [ 13 ].…”

Section: Discussionunclassified

“…Les techniques d'amplification nucléique ont considérablement facilité le diagnostic de certaines formes de tuberculose extrapulmonaire. La détermination rapide de la présence du génome bactérien par polymerase chain reaction (PCR) constitue actuellement un progrès récent dans le diagnostic de la TG [ 12 , 20 ], avec une spécificité et une sensibilité dépassant les 60% dans certaines études [ 21 ]. L'examen histologique d'une biopsie de l'endomètre, de lésion péritonéale ou de masse tubo-ovarienne reste l'examen clé pour confirmer le diagnostic, tout en sachant que la nécrose caséeuse peut manquer dans d'authentiques tuberculoses.…”

Section: Discussionunclassified

Caractéristiques épidémio-cliniques de la tuberculose génitale chez la femme tunisienne: une série de 47 cas

Zayet¹,

Berriche²,

Ammari³

et al. 2018

Pan Afr Med J

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L'objet est de relever les caractéristiques épidémio-cliniques, diagnostiques, thérapeutiques et évolutives de la tuberculose génitale (TG) chez la femme en Tunisie. Nous avons mené une étude rétrospective, descriptive au service des maladies infectieuses de l'hôpital la Rabta de Tunis, sur une période de 15 ans et demi (janvier 2000-juin 2014). Nous avons inclus toutes les patientes hospitalisées pour une tuberculose génitale. 47 cas ont été colligés. L'âge moyen était de 42,2 ans. Dix-huit femmes étaient d'origine rurale. Un comptage tuberculeux a été retrouvé dans cinq cas. Pour tous les cas, le début était insidieux. Un ou plusieurs signes d'imprégnation tuberculeuse ont été rapportés dans 23 cas. L'intradermoréaction (IDR) à la tuberculine réalisée chez 35 femmes (74,8%), était positive dans 26 cas (74%). Trente-neuf patientes (83%) avaient eu une exploration radiologique par une échographie et / ou une tomodensitométrie (TDM) abdomino-pelvienne. Une cœlioscopie diagnostique a été réalisée dans 37 cas (75,5%). L'examen Anatomopathologique a permis de confirmer le diagnostic de TG dans 42 cas (89,3%) en retrouvant un granulome épithéloïde et giganto-cellulaire. Nous avons relevé 21 cas de TG isolée, alors que les 26 autres avaient une atteinte péritonéale associée. Toutes les patientes ont reçu une antibiothérapie spécifique associant l'Isoniazide, la Rifampicine, le Pyrazinamide et l'Ethamubutol pour une durée moyenne de 12 mois. Aucune patiente n'a reçu de corticothérapie et aucune chirurgie secondaire n'a été indiquée. L'évolution était favorable dans 39 cas, 8 patientes ont été perdues de vue. La TG est une pathologie rare qui ne représente que 0,5% de la tuberculose extra-pulmonaire, mais d'un grand polymorphisme clinique. La confirmation diagnostique est difficile et repose sur l'étude bactériologique et/ou histologique. Le diagnostic doit être évoqué devant toute symptomatologie abdomino-pelvienne trainante, devant une stérilité chez la femme, associé à un contexte épidémio-clinique évocateur.

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Occurrence of female genital tuberculosis among infertile women: a study from a tertiary maternal health care research centre in South India

Cited by 25 publications

References 43 publications

Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

Acute miliary tuberculosis in pregnancy after in vitro fertilization and embryo transfer: A report of seven cases and systematic review

Caractéristiques épidémio-cliniques de la tuberculose génitale chez la femme tunisienne: une série de 47 cas

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