Bruceloza u trudnoći: prikazi slučaja s različitim ishodima u endemskom području

Different outcomes of brucellosis in pregnancy regarding the fetus/neonate and the mother are described. Medical records of five pregnant women with brucellosis were retrospectively analyzed. Patients were treated in several departments of infectious diseases in the Republic of Macedonia between 1995 and 2009. The diagnosis of brucellosis was based on clinical findings compatible with the disease supported by detection of specific antibodies. Pregnancy outcomes in patients were as follows: spontaneous abortion, intrauterine fetal death, premature delivery in two cases (one with twin pregnancy) and term delivery. One of the women experienced relapse. Follow-up results of neonates showed no infection and their normal growth and development. Brucellosis, especially if acquired in early pregnancy, can have an impact on pregnancy outcome. In endemic regions, in pregnant women with persisting fever and unspecific manifestations one should always have in mind brucellosis. In these areas, cases with unexplained spontaneous abortion, intrauterine fetal death and premature delivery should also be investigated for brucellosis.Opisuju se različiti ishodi bruceloze u trudnoći u odnosu na fetus/novorođenče i majku. Retrospektivno su analizirani medicinski zapisi za pet trudnica s brucelozom. Bolesnice su liječene u nekoliko klinika za zarazne bolesti u Republici Makedoniji u razdoblju od 1995. do 2009. godine. Dijagnoza bruceloze temeljena je na kliničkim nalazima sukladnima s bolešću i potkrijepljena otkrivanjem specifičnih protutijela. Ishodi trudnoće u ovih bolesnica bili su sljedeći: spontani pobačaj, intrauterina smrt fetusa, prijevremeni porođaj u dva slučaja (jedan s blizanačkom trudnoćom) i terminski porođaj. Recidiv je nastupio kod jedne od ovih žena. Rezultati praćenja novorođenčadi pokazali su odsutnost infekcije te normalan rast i razvoj. Bruceloza, osobito ako je stečena u ranoj trudnoći, može utjecati na ishod trudnoće. U endemskim područjima brucelozu treba uvijek imati na umu kod trudnica s ustrajnom groznicom i nespecifičnim manifestacijama. U ovim područjima testiranje na brucelozu treba provoditi i u slučaju neobjašnjenog spontanog pobačaja, intrauterine smrti fetusa i prijevremenog porođaja