Maternal and perinatal outcomes of pregnancies complicated by multidrug resistant tuberculosis and hiv-1-co infection in Durban, KwaZulu-Natal, South Africa
Setting: King Edward VIII and King George V Hospitals, Durban, KwaZulu-Natal. Objective: To identify the impact of co-infection with multi drug resistant tuberculosis (MDR TB) and Human Immunodeficiency Virus syndrome (HIV-1) during pregnancy, on maternal and perinatal outcomes. Design: Prospective study between 1996 and 2001 at the antenatal and obstetric wards. Symptomatic women were investigated for tuberculosis and those with confirmed MDR TB were followed up prospectively. Maternal and perinatal outcomes were recorded.Results: Five women hadMDR TB, 3 of who were HIV-1 co- infected.All women had received TB treatment in the past. Second line TB therapy was commenced based on sputum susceptibility results. One woman decided on termination of pregnancy and another delivered preterm. No overt teratogenic features were noted in the newborns but 2 had clinical and neurological features of intrauterine growth restriction.Conclusion: These cases highlight the clinical issues associated with the management of pregnant women with MDR TB in a setting of high rates of HIV infection.
Obstetrics & Gynaecology Forum Vol. 17 (3) 2007: pp. 85-89