Hindawi Publishing Corporation Journal of Pregnancy Volume 2012, Article ID 379271, 7 pages doi:10.1155/2012/379271 Review Article Tuberculosis in Pregnancy: A Review Olabisi M. Loto and Ibraheem Awowole Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospital, P.M.B. 5538, Ile-Ife, Osun State, Nigeria Correspondence should be addressed to Olabisi M. Loto, bisiloto@yahoo.co.uk and Ibraheem Awowole, drawo2001@yahoo.com Received 9 May 2011; Accepted 1 September 2011 Academic Editor: Oliver Ezechi Copyright © 2012 O. M. Loto and I. Awowole. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Tuberculosis (TB) was declared a public health emergency by WHO in 2005. The disease is a signiﬁcant contributor to maternal mortality and is among the three leading causes of death among women aged 15–45 years in high burden areas. The exact incidence of tuberculosis in pregnancy, though not readily available, is expected to be as high as in the general population. Diagnosis of tuberculosis in pregnancy may be challenging, as the symptoms may initially be ascribed to the pregnancy, and the normal weight gain in pregnancy may temporarily mask the associated weight loss. Obstetric complications of TB include spontaneous abortion, small for date uterus, preterm labour, low birth weight, and increased neonatal mortality. Congenital TB though rare, is associated with high perinatal mortality. Rifampicin, INH and Ethambutol are the ﬁrst line drugs while Pyrazinamide use in pregnancy is gaining popularity. Isoniazid preventive therapy is a WHO innovation aimed at reducing the infection in HIV positive pregnant women. Babies born to this mother should be commenced on INH prophylaxis for six months, after which they are vaccinated with BCG if they test negative. Successful control of TB demands improved living conditions, public enlightenment, primary prevention of HIV/AIDS and BCG vaccination. 1. Introduction Tuberculosis (TB) is believed to be nearly as old as human history. Traces of it in Egyptian mummies date back to about 7000 years ago, when it was described as phthisis by Hippo- crates [1]. It was declared a public health emergency in the African Region in 2005 [1] and has since continued to be a major cause of disability and death. About 9.4 million new cases of tuberculosis were diagnosed in 2009 alone and 1.7 million people reportedly died from the disease in the same year, translating to about 4700 deaths per day [2]. About one-third of the world’s population (estimated to be about 1.75 billion) is infected with the tubercule bacillus [3]. As much as 75% of individuals with TB are within the economically productive age group of 15 to 54 years. This sig- niﬁcantly impairs socioeconomic development, thereby per- petuating the poverty cycle [4]. Tuberculosis has been on the rise in tandem with HIV/ AIDS. This is because people with HIV/AIDS, whose im- mune systems are weakened have with a 20–37 times the risk of developing a progressive disease compared with HIV- negative individuals [4]. 2. Microbiology of Tuberculosis Mycobacterium tuberculosis, an aerobic, non-spore-forming, nonmotile bacillus, is one of ﬁve members of the Mycobac- terium tuberculosis complex, others being M. bovis, M. ulcer- ans, M. Africanum, and M. microti, though M. tuberculosis is the major human pathogen. It belongs to the family Myco- bacteriaceae. Other Mycobacterium species that may infect humans include Mycobacterium leprae, M. avium, M. Intra- cellulare, and M. scrofulaceum. 3. Pathophysiology Tuberculosis aﬀects almost every organ in the body, but the usual site of the disease is the lungs, accounting for more than 80 percent of tuberculosis cases [5]. The pattern of the infec- tion in HIV positive patients may, however, be diﬀerent, with increasing trends towards extrapulmonary spread [6]. Almost all tuberculosis infections are caused by inhala- tion of infectious particles aerosolized by coughing, sneezing, talking, or manipulation of infected tissues. Other modalities