BRUCELLOSIS IN PREGNANCY: CASE REPORTS WITH DIFFERENT OUTCOMES IN AN ENDEMIC REGION/BRUCELOZA U TRUDNOCI: PRIKAZI SLUCAJA S RAZLICITIM ISHODIMA U ENDEMSKOM PODRUCJU

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 premamre delivery should also be investigated for brucellosis. Key words: Abortion; Brucellosis; Intrauterine fetal death; Pregnancy; Preterm labor; Term labor Opisuju se razliciti ishodi bruceloze u trudnoci u odnosu na fetus/novorodence i majku. Retrospektivno su analizirani medicinski zapisi za pet trudnica s brucelozom. Bolesnice su lijecene u nekoliko klinika za zarazne bolesti u Republici Makedoniji u razdoblju od 1995. do 2009.godine. Dijagnoza bruceloze temeljena je na klinickim nalazima sukladnima s bolešcu i potkrijepljena otkrivanjem specificnih protutijela. Ishodi trudnoce u ovih bolesnica bili su sljedeci: spontani pobacaj, intra-uterina smrt fetusa, prijevremeni porodaj u dva slucaja (jedan s blizanackom trudnocom) i terminski porodaj. Recidiv je nastupio kod jedne od ovih žena. Rezultati pracenja novorodencadi pokazali su odsutnost infekcije te normalan rast i razvoj. Bruceloza, osobito ako je stecena u ranoj trudnoci, može utjecati na ishod trudnoce. U endemskim podrucjima brucelozu treba uvijek imati na umu kod trudnica s ustrajnom groznicom i nespecificnim manifestacijama. U ovim podrucjima testiranje na brucelozu treba provoditi i u slucaju neobjašnjenog spontanog pobacaja, intrauterine smrti fetusa i prijevremenog porodaja. Kljucne rijeci: Pobacaj; Bruceloza; Intrauterina smrt fetusa; Trudnoca; Prijevremeni porodaj; Terminski porodaj