Tuberculosis in Term Pregnancy

A 28-year-old term-pregnancy Tibetan woman presented to the hospital with a premature rupture of membranes and breech presentation. A cesarean delivery was performed and a healthy girl was delivered. After suturing the uterine incision, several round nodules were observed on the posterior uterine wall, ovarian surface, and mesentery (Figure A, B, and C, arrows), which pathology confirmed as granulomatous loci. A pipe-like rigid caseous fimbriae on the right fallopian tube was observed (Figure A and B, arrowhead). A cheesy substance extruded from the right fallopian tube. The placenta’s maternal surface was distributed with yellow cheese-like plaques (Figure D), which microscopically proved to be necrosis. Postoperative computer tomography revealed a 3 cm tuberculosis lesion in the upper lobe of the left lung (Figure E, arrowhead). Nucleic acid analysis for Mycobacterium tuberculosis was positive in both the ascites and intrauterine secretion. Antituberculosis treatment was initiated following the operation.