Characteristics of miliary tuberculosis in pregnant women after in vitro fertilisation and embryo transfer

2019 ◽  
Vol 23 (2) ◽  
pp. 136-139
Author(s):  
R. Ye ◽  
C. Wang ◽  
L. Zhao ◽  
X. Wu ◽  
Y. Gao ◽  
...  
2020 ◽  
Author(s):  
Xiaoyan Gai ◽  
Hongbin Chi ◽  
Wenli Cao ◽  
Lin Zeng ◽  
Lixue Chen ◽  
...  

Abstract 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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoyan Gai ◽  
Hongbin Chi ◽  
Wenli Cao ◽  
Lin Zeng ◽  
Lixue Chen ◽  
...  

Abstract 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 and December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. Results Out of 62,755 infertile women enrolled, 7137 (11.4 %) showed signs of prior pulmonary TB on chest X-ray (CXR). Among the 15,136 women (mean age: 33.2 ± 5.0 years) who successfully achieved clinical pregnancy, seven patients aged 28–35 years had miliary TB during pregnancy, with two patients having a complication of TB meningitis. All 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. Conclusions TB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. Signs of prior TB on CXR may be risk factors for TB reactivation during pregnancy.


2020 ◽  
Author(s):  
Xiaoyan Gai ◽  
Hongbin Chi ◽  
Wenli Cao ◽  
Lin Zeng ◽  
Lixue Chen ◽  
...  

Abstract 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.


GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 346-353
Author(s):  
Natalya I. Tapilskaya ◽  
Mikhail S. Nekrasov ◽  
Inna O. Krikheli ◽  
Ksenia V. Ob'edkova ◽  
Alexander M. Gzgzyan ◽  
...  

Aim. To study a stress-protective efficacy of micronized progesterone (MP) in pregnant women with anxiety disorders after in vitro fertilisation (IVF). Materials and methods. We conducted a prospective, comparative open-label randomized trial in two IVF-clinics. A total of 98 pregnant women after IVF with anxiety disorders were recruited at the 9th week of pregnancy. Progesterone supplementation after IVF for luteal phase support was administered out until 9 weeks gestation. Then, after randomization, group 1 (n=35) received 400 mg per day of MP vaginally, group 2 (n=33) received 400 mg of MP orally, group 3 (n=30) was comparative for the other groups. The duration of progesterone treatment was 12 weeks. The Spielberger State Trait Anxiety Inventory (STAI), the Montgomerysberg depression rating scale (MADRS), Hospital Anxiety and Depression Scale (HADS), and the Epworth Sleepiness Questionnaires (ESQ) were used to compare maternal mood at 9 weeks (day of randomization) after delivery and at 283, 565, 847 days after randomization. Results. The mean STAI sumscore in MP-groups was significantly lower than in group 3 starting from day 565 and continued until the end of the study. There were no significant differences between vaginal and oral administration of progesterone. There were no significant differences between the mean sumscores when questioning on the HADS, MADRS and ESQ. Conclusion. Prolonged use of MP in pregnant women with anxiety disorders led to the prevention of manifestations of an increase in anxiety and depression. The stress-protective and neuromodulating properties of MP can determine additional indications for its prolonged administration in women with anxiety disorders and/or premorbid history.


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