关键词: 妊娠, 结核,抗多种药物性, 婴儿, 治疗结果

Abstract:

Objective: To investigate the clinical feature, treatment and outcome of rifampicin-resistant and multidrug-resistant tuberculosis (RR/MDR-TB) pregnant women. Methods: The clinical data of 13 pregnant women with drug-resistant tuberculosis (DR-TB) admitted to Public Health Clinical Center of Chengdu from January 2017 to April 2022 were retrospectively analyzed, and the clinical characteristics, treatment and outcome of the maternal and infant patients were descriptively analyzed. Results: A total of 13 pregnant women with RR/MDR-TB were enrolled in this study. Fever (53.8%, 7/13), cough (84.6%, 11/13) and expectoration (53.8%, 7/13) were the main clinical symptoms. Until November 2022, 11 patients survived (84.6%) and 2 patients died (15.4%), 9 patients (69.2%, 9/13) cured, 2 patients (15.4%, 2/13) were still in treatment (1 relapse after 1 year drug withdrawal). Severn patients (53.8%) had 9 adverse effects during the treatment, including liver dysfunction (30.8%, 4/13), myelosuppression (15.4%, 2/13), nausea and vomiting (7.7%, 1/13), blurred vision (7.7%, 1/13) and rash (7.7%, 1/13). Eight cases (61.5%, 8/13) had abortion or induced labor. Five cases (38.5%, 5/13) delivered, including 1 case of natural labor, 4 cases of cesarean section. Among the 5 newborns, 3 premature delivery, 2 low birth weight, all of whom with no birth defects or congenital tuberculosis. During the 5 to 66 months follow-up, all the infants survived, with one’s height and weight two standards lower than contemporary, 1 had language retardation, and the other 3 were normal. Conclusion: The pregnant women with RR/MDR-TB had no specific clinical manifestation. Most of them had favourable outcomes after effective anti-tuberculosis treatment. Most induced labor in early and middle pregnancy. There was no serious adverse outcomes in infants except partial growth restriction.

Key words: Pregnancy, Tuberculosis, multidrug-resistant, Infant, Treatment outcome