Received:05.09.2025
Accepted:26.12.2025
Published online: 20.03.2026
UDC: 616.24-002.5+618.5-08
DOI: 10.26212/2227-1937.2026.46.79.007
Clinical case report DIAGNOSTIC FEATURES AND INTENSIVE THERAPY OF PULMONARY HEMORRHAGE IN A PREGNANT WOMAN AT 35–36 WEEKS OF GESTATION
Arymbayeva A.B., Baymukhambetov B.D., Ibraimov A.T., Ibrayev Zh.A., Bektursynov B.U.
National Scientific Center of Phthisiopulmonology of the Republic of Kazakhstan, Almaty, Kazakhstan
Introduction. Pulmonary tuberculosis remains one of the most significant infectious diseases, posing a serious threat to public health and life in many countries. Even after successful treatment, residual changes such as fibrotic scars, cavities, and bronchiectasis often persist and may be complicated by pulmonary hemorrhage. Such complications are particularly dangerous during pregnancy, when the respiratory system is under increased stress.
Objective. To present the diagnostic and therapeutic features of pulmonary hemorrhage in a pregnant woman in late gestation, with special emphasis on the role of instrumental diagnostic methods and the effectiveness of a comprehensive treatment approach.
Materials and Methods. Informed voluntary consent was obtained from the patient for the description and publication of this clinical case without disclosure of personal data. The examination was performed according to the approved clinical algorithm. To identify the source of bleeding, fiberoptic bronchoscopy (FBS) with endobronchial valve blockade was performed. To control the hemorrhage, lung resection was carried out, and the surgical specimen was submitted for histological examination at the Pathomorphological Laboratory of the National Scientific Center of Phthisiopulmonology of the Republic of Kazakhstan.
Results. Despite the combination of two severe conditions – pulmonary hemorrhage and late-term pregnancy – timely FBS with biopsy, histological verification, and comprehensive surgical management made it possible to preserve the lives of both mother and child.
Discussion. This clinical case illustrates the concurrence of two life-threatening complications: pulmonary and obstetric hemorrhage. A distinctive feature was the absence of bacterial excretion despite morphologically confirmed tuberculoma. The combination of surgical interventions (lobectomy and hysterectomy) with intensive therapy resulted in a favorable outcome. This case highlights the importance of a multidisciplinary approach and readiness for urgent clinical decisionmaking.
Conclusion. Pregnant women with a history of tuberculosis require special attention and multidisciplinary management. Timely surgical interventions and adequate intensive therapy are key factors in saving the lives of both mother and child.
Keywords: pulmonary hemorrhage, tuberculosis, pregnancy.
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