Although recent studies have reported otherwise, previous conventional
wisdom has held that one-half to two-thirds of pregnant women with tu
berculosis are asymptomatic. If true, this has important implications
for screening programs. Charts of all patients with culture-proven Myc
obacterium tuberculosis in Rhode Island between 1987 and 1991 were rev
iewed. One-third of women aged 21 to 32 years with culture-proven tube
rculosis were pregnant at time of diagnosis (7 pregnant; 15 nonpregnan
t). Pregnant patients with pulmonary conditions were more likely to be
found through routine screening (p=0.008) and to be asymptomatic (p=0
.008). In addition, pregnant women with pulmonary conditions were more
likely to present with unilateral noncavitary, smear-negative disease
(p=0.02). If routine screening is not performed prenatally with radio
graphic follow-up of all infected individuals, most pregnant women wil
l not have their conditions diagnosed and, therefore, will not be trea
ted in time to prevent risk to the fetus, the newborn, and the obstetr
ic ward.-