关键词: 胚胎移植, 血行播散性肺结核, 妊娠结局

Abstract: Objective To analyze the clinical characteristics and pregnant outcome of women with hematogenous pulmonary tuberculosis after in vitro fertilization and embryo transplant. Methods Clinical data of 5 women with hematogenous pulmonary tuberculosis after in vitro fertilization and embryo transplant in Third People Hospital of Shenzhen city from January 2012 to December 2015 were collected and analyzed. Results All patients were presented with fever, including one with headache and two with dyspnea. The onset of fever was at the average of 63.0 days after IVF-ET while the diagnosis was confirmed at the average of 82.4 days. One patient was compliant with tuberculous meningitis. Two patients were compliant with respiratory failure. Chest X-ray and CT showed typical miliary and infiltrate lesion. Pathogen study showed TB culture positive in sputum in a patient, positive in CSF in another patient. And one patient was found out TB-DNA positive in fetal membrane after abortion. TB specific INF-γElispot in blood showed 4 positive and 1 negative cases. Pregnant outcome: 1 case of spontaneous abortion, 1 case of inevitable abortion, 1 case of artificial abortion, 1 case of premature birth at 32th week, and 1 case of cesarean section at 39th week. All patients took anti-tuberculosis treatment and recovered. Two babies were healthy. Conclusions The main symptom of hematogenous pulmonary tuberculosis after IVF-ET is fever. Most patients are in critical conditions. Early diagnosis and anti-tuberculosis treatment may benefit the outcome of pregnancy and artificial abortion may be evitable.

Key words: Embryo transplant, Hematogenous pulmonary tuberculosis, Pregnancy outcome