Gynäkologie und Geburtshilfe
Offener Zugang

Abstrakt

Pregnant Woman with Fulminant Disseminated TB to the Omentum and Placenta

Baraa K Nabulsi, Mai Kadi, Hateem AlAbadi, Rawaa K Alnabulsi, Ahmad Badeghiesh and Sarah Aldhaheri

This is a case report of a young 24 year old Somali woman in her 27^th week of gestation who was given Rifampicin, Ethambutol, INH, Pyridoxine and Pyrazinamide as a treatment for systemic TB. She did not respond to the treatment. She died because of brainstem infarction (brain death). According to MRI results, multiple brain tuberculomas were seen suggesting brain TB. Brain biopsy was not done and the treatment was initiated at her 27^th week of gestation. Patient arrested and was transferred to ICU with GCS of 3-4/15. Cesarean section was done at the 29^th week of gestation and the infant was not infected. There were query tuberculosis seeding scattered all over the patient’s omentum and placenta.

A specimen was taken for histopathology, which demonstrated that the placenta and omentum contained focal areas of microinfarctions and necrotizing granulomas consistent with tuberculosis. We emphasize that screening should be done during pregnancy to discover dormant infection, asymptomatic disease and to lower the incidence of congenital TB. The aggressive early treatment for dissemination of the disease, especially when associated with pregnancy, and the importance of early diagnosis and therapy will result in regression of the lesions.