Missed Early Signs of Tuberculosis in Pregnancy: Insights From a Case Series of Disseminated Life-Threatening Maternal Disease and Adverse Fetal Outcomes.

Tuberculosis (TB) continues to be a global public health issue. The management of tuberculosis in pregnancy is even more challenging in developing countries. Delays in seeking or providing appropriate care and subtle initial presentation in pregnancy lead to delays in diagnosis and treatment. We present case details of five women who reflect the real-world scenario, where women and their primary antenatal care providers are still ignorant and negligent about tuberculosis. All of the women had life-threatening manifestations of the disease. Three out of five patients had extensive pulmonary tuberculosis and required ventilatory support. One had hydrocephalus secondary to tubercular meningitis, and one had tubercular peritonitis with pyoperitoneum. These women also faced adverse pregnancy outcomes manifesting as fetal growth restriction, prematurity, fetal demise, and congenital tuberculosis. Since pregnancy is the opportune time for many women in low- and middle-income countries to come into contact with the health care system, it is important for the antenatal care provider not to miss the diagnosis.