体外受精和胚胎移植后妊娠合并急性粟粒性肺结核的临床特点

目的总结体外受精和胚胎移植（IVF-ET）后妊娠发生急性粟粒性肺结核的临床特点。方法回顾性分析2001年1月至2005年12月在浙江大学医学院附属妇产科医院生殖中心接受IVF-ET后妊娠并发粟粒性肺结核的6例临床资料。结果IVF-ET后妊娠并发粟粒性肺结核患者的临床表现多不典型，以发热为主要表现，呼吸道症状隐匿。胸部影像学表现以粟粒性结节和浸润性改变为主。平均于移植后53．2d发病，1例人工流产终止妊娠，其余5例均在发病后2～4周内发生自然流产。结论发热为急性粟粒性肺结核的主要临床表现，IVF-ET后妊娠发生粟粒性肺结核的妊娠结局差，对抗炎治疗无效的发热患者应警惕肺结核，尽早行结核病的相关检查。

Retrospective analysis of 6 cases of miliary tuberculosis in pregnant women after in vitro fertilization and embryo transfer

OBJECTIVE: To analyze the clinical characteristics of haematogenous disseminated tuberculosis in pregnant women after in vitro fertilization and embryo transfer (IVF-ET). METHODS: Six cases of haematogenous disseminated tuberculosis after in vitro fertilization pregnancy from January 2001 to December 2005 were retrospectively analyzed. RESULTS: The clinical manifestations of pulmonary miliary tuberculosis were non-specific. All cases presented with fever for several weeks, but typical respiratory manifestations were lacking. Chest X-ray showed typical miliary and infiltrate lesions. The onset of fever was at an average of 53.2 days after embryo transfer. Miscarriage occurred in 5 patients within 2 to 4 weeks after the onset of fever. CONCLUSION: The main symptom of miliary tuberculosis in pregnant women after IVF-ET was fever, and the prognosis of the pregnancy was poor. Physician should be alert to the occurrence of haematogenous disseminated tuberculosis, especially in pregnant women with long-term fever.