Features of pregnancy course in women with chemoresistant tuberculosis (a literature review)

Raznatovska, О. М.; Shalmin, O. S.

doi:10.14739/2310-1210.2019.5.179473

Cited by 3 publications

(2 citation statements)

References 15 publications

(24 reference statements)

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“…Initiation during third trimester had 100.0% live births. Similarly, a favourable birth outcome was also associated with DR-TB treatment initiation during the second trimester in a Ukraine study [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Retrospective record review of pregnant women treated for rifampicin-resistant tuberculosis in South Africa

et al. 2020

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Background Tuberculosis (TB) is amongst the top five causes of death in women of childbearing age (15-�44 years). Little is known about treatment of pregnant women with drug-resistant TB (DR-TB). Treatment for pregnant women remains challenging and more complex in DR-TB/HIV co-infection, where an evidence-based guide to clinical practice is limited. The study reviewed treatment and pregnancy outcomes and birth outcomes of their newborn in a cohort of pregnant women with DR-TB from three MDR-TB hospitals during 2010 and 2018. Design/Methods Data were extracted from: TB register and patient clinic notes using a standardized case record form. Information on DR-TB treatment, pregnancy and Adverse Drug Events (ADEs) of twenty-six pregnant women treated with individualized second-line TB medications were captured. The frequency of favourable and adverse outcomes regarding disease and pregnancy were evaluated. Results The mean age was 29 years (SD ±5.1), with the minimum and maximum age of 21 and 40 years, respectively. Eleven (42.3%) were previously treated with first-line TB drugs, 11 (42.3%) never treated before and 4 (15.4%) were previously treated for DR-TB. Of the 26 women, 15 (57.7%) had at least one ADE, but most had more than one ADE. Seventeen women were successfully treated, and 22 live births recorded. Live birth outcome was significantly associated with trimester of initiation of DR-TB treatment (p = 0.036). The proportion of live births for the pregnancy trimester when DR-TB treatment was initiated, were 60.0%, 90.9% and 100.0%, for first, second and third trimester, respectively.

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Section: Discussionmentioning

confidence: 99%

Retrospective record review of pregnant women treated for rifampicin-resistant tuberculosis in South Africa

et al. 2020

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“…Following a literature review [6], we concluded that pregnant women with tuberculosis (TB) infection have a significantly higher risk of developing complications such as premature birth, maternal and perinatal mortality and neonatal outcomes include intrauterine growth retardation, congenital anomalies, respiratory distress syndrome and other. Based on these facts, most researchers recommend the initiation of second-line drugs for MDR-TB according to drug susceptibility test (DST) results since the second trimester of pregnancy avoiding amikacin, streptomycin, prothionamide ключевые слОва: беременность, мультирезистентный туберкулез, ВИЧ-инфекция, бедаквилин.…”

Section: клінічний досвідmentioning

confidence: 99%

Clinical course of pregnancy and postpartum in a multidrug-resistant tuberculosis/HIV co-infected patient receiving bedaquiline-containing regimen as antimycobacterial therapy

Raznatovska

Tertishniy

Syusyuka

et al. 2019

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Background. According to World Health Organization (WHO), experimental studies performed in rats and rabbits have revealed no evidence of harmful side effects of bedaquiline to the fetus. WHO points out that, given the lack of adequate and controlled studies on the effects of bedaquiline on the fetus in pregnant women, and the fact that drug data regarding teratogenicity are limited to nonclinical animal data, this drug may be used when an effective treatment regimen cannot otherwise be provided. However, WHO recommends thorough registering treatment, pregnancy, and postpartum bedaquiline-related outcomes to provide data on appropriate dosing for multidrug-resistant tuberculosis (MDR-TB) treatment during pregnancy and postpartum. However, in the modern literature, there are no data about attributable to bedaquiline adverse events in MDR-TB/HIV co-infected pregnant women and their fetus as well as during the postpartum period. oBjective. To update the literature data with the clinical features of pregnancy and postpartum period in a MDR-TB/ HIV co-infected patient receiving a bedaquiline-containing regimen as antimycobacterial therapy in the third trimester based on an example from own clinical experience. Methods. We report the clinical case of pregnancy course in the MDR-TB/HIV co-infected woman treated with the bedaquiline-containing regimen as antimycobacterial therapy in the third trimester. results. In the clinical case presented, the patient demonstrated an initial poor adherence to treatment for both MDR-TB and HIV infection resulting in tuberculous process and HIV rapid progression. Since the patient refused the option of undergoing the therapeutic abortion prior to 22 gestational weeks as the pregnancy was intended, the antimycobacterial therapy regimen was modified by bedaquiline inclusion at 30 weeks' gestation (the third trimester) for the maternal and neonatal mortality prevention. However, there was no sputum smear conversion on the antimycobacterial therapy regimen including bedaquiline, the patient presented with the signs of endogenous intoxication and nephropathy. Relatedly, neonatal transabdominal ultrasound revealed intrauterine growth retardation, worsening fetoplacental insufficiency (reverse flow) and intrauterine dystrophy. There was abundant placental calcification. Taking into account breech presentation, II degree intrauterine growth retardation, III degree fetoplacental insufficiency (reverse flow), oligohydramnios, fetal distress syndrome and bilateral pyelectasis, the patient was transferred to the Perinatal Centre for planned caesarean section at the 32nd week of gestation. The premature female infant was declared dead some hours later. In the postpartum period, the patient continued the initiated bedaquilinebased antimycobacterial therapy and antiretroviral therapy. However, positive clinical-radiological dynamics and sputum smear conversion have not been achieved. conclusions. The clinical case presented confirms the literature data that the features of pregnancy and postpartum pe...

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ОСОБЕННОСТИ ТЕЧЕНИЯ И ИСХОДОВ БЕРЕМЕННОСТИ У ЖЕНЩИН С ТУБЕРКУЛЕЗОМ, "Вестник Центрального Научно-Исследовательского Института Туберкулеза"

Borodulina¹,

Кузьмина²

2021

Вестник ЦНИИТ

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Обзор посвящен наиболее актуальным вопросам эпидемиологии, диагностики и лечения туберкулеза (ТБ) на фоне беременности. Внедрение новых методов ранней диагностики ТБ, разработка регламентирующих документов и программы по снижению заболеваемости ТБ у беременных являются неизменно актуальными.

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Features of pregnancy course in women with chemoresistant tuberculosis (a literature review)

Cited by 3 publications

References 15 publications

Retrospective record review of pregnant women treated for rifampicin-resistant tuberculosis in South Africa

Retrospective record review of pregnant women treated for rifampicin-resistant tuberculosis in South Africa

Clinical course of pregnancy and postpartum in a multidrug-resistant tuberculosis/HIV co-infected patient receiving bedaquiline-containing regimen as antimycobacterial therapy

ОСОБЕННОСТИ ТЕЧЕНИЯ И ИСХОДОВ БЕРЕМЕННОСТИ У ЖЕНЩИН С ТУБЕРКУЛЕЗОМ, "Вестник Центрального Научно-Исследовательского Института Туберкулеза"

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