TB diagnosis in pregnant women being 'delayed'

GPs should be alert to nonspecific presentation of TB in pregnant women, UK researchers have warned.

A team from Oxford University examined cases of TB during pregnancy using the UK Obstetric Surveillance System. They found 33 women diagnosed with TB while pregnant.

The cases occurred exclusively in minority ethnic women and almost exclusively in those not born in the UK.

The researchers found that, although screening for TB during pregnancy is recommended, it is not routine. This may mean that diagnoses of TB in pregnancy are delayed, they said.

The number of women dying from TB is increasing. This may be due to a lack of awareness of TB in pregnancy among healthcare workers, the researchers suggest.

Dr Knight and her team found that presentation of TB during pregnancy is often atypical. For instance, extrapulmonary disease was as common as pulmonary disease.

'Women and their doctors and midwives should be aware that symptoms of TB in pregnancy may be different and consider the diagnosis, especially in recently arrived immigrant women, presenting with non-specific symptoms,' they say.

TB cases were not limited to areas with high minority ethnic populations. However, regions with higher incidence in pregnancy are those with higher TB incidence in the general population.

'It may be beneficial to raise awareness and introduce specific referral pathways in maternity units in these areas in view of the unusual presentations of TB in pregnancy,' the researchers suggest.

tom.moberly@haymarket.com

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