Received: 05.09.2025
Accepted: 26.12.2025
Published online: 20.03.2026
UDC: 616.24-002.5+ 618.5-08
DOI: 10.26212/2227-1937.2026.26.21.010
DIAGNOSTIC FEATURES AND INTENSIVE THERAPY OF PULMONARY HEMORRHAGE IN A PREGNANT WOMAN AT 35 WEEKS OF GESTATION (clinical case)
A.B. Arymbayeva, B.D. Baymukhambetov, A.T. Ibraimov, Zh.A. Ibrayev, B.U. Bektursynov
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 (fibrotic scars, cavities, bron chiectasis) often persist and may be complicated by pulmonary hemorrhage. Such complications are particularly dan gerous during pregnancy, when the respiratory system is under increased load.
Objective. To present the diagnostic and therapeutic features of a pregnant woman in late gestation with pulmonary hemorrhage, emphasizing the role of instrumental diagnostic methods and the effectiveness of a comprehensive treat ment 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. Examination was performed according to the approved algo rithm. To identify the source of bleeding, fiberoptic bronchoscopy (FBS) with endobronchial valve blockade was car ried out. To control hemorrhage, lung resection was performed, and the surgical specimen was sent for histological ex amination at the Pathomorphological Laboratory of the National Scientific Center of Phthisiopulmonology of the Republic of Kazakhstan.
Results. Despite the combination of severe conditions—pulmonary hemorrhage and late-term pregnancy—timely FBS with biopsy, histological verification, and comprehensive surgical management allowed preservation of both maternal and fetal lives.
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. A 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 decision making.
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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