A Case Report on Genital Tuberculosis

Female genital tuberculosis is a significant cause of female infertility. It has been noted that about 10% of females having infertility were due to genital tuberculosis (TB). It is an accidental finding while one is investigating infertility. Laparoscopy is the investigation of choice. A histopathologic examination is done to confirm the diagnosis. A 34-year-old primigravida with 35 weeks + four days gestation with IVF conception and decreased fetal movements with ultrasonography suggestive of a double loop of cord around the neck came for safe confinement. She was operated on July 6, 2022, as an emergency lower segment cesarean section procedure with bilateral fimbriectomy. The indication was that this was an IVF baby, and the mother noticed diminished fetal movements. She was discharged on July 11, 2022. A color doppler was done on the day of discharge which showed normal findings. The patient was asked to come for a follow-up after 15 days in the outpatient department or so in case of an emergency. A high protein and iron diet, plenty of fluids, and adequate rest were recommended. Symptoms differ depending on the severity and spread of the disease. Typical symptoms of TB include fever, night sweats, and weight loss. Other presentations include menstrual dysfunction, and chronic abdominal pain, with or without general symptoms like weight loss. Genital TB can cause abdominal adhesions and tubal blockage. It even causes infertility and menstrual abnormalities like amenorrhea and menorrhagia in females. The investigations to be done are the Mantoux test, chest X-ray, and cartridge-based nucleic acid amplification test (CBNAAT) to detect the presence of tubercle bacilli. Hysterosalpingography is done to check for infertility. A laparoscopy is to be performed. Symptomatic management of the patient can lead to a successful pregnancy.