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TB Treatment & Pregnancy

Untreated tuberculosis (TB) disease represents a greater hazard to a pregnant woman and her fetus than does its treatment. Treatment should be initiated whenever the probability of TB is moderate to high.

  • • Infants born to women with untreated TB may be of lower birth weight than those born to women without TB and, in rare circumstances, the infant may be born with TB.
  • • Although the drugs used in the initial treatment regimen for TB cross the placenta, they do not appear to have harmful effects on the fetus.


TB Treatment Regimen for Pregnant Women

Treatment at per National Tuberculosis Elimination Programme (Previously RNTCP) includes Isoniazid (H), Rifampicin (R), Ethambutol(E), Pyrazinamide(Z) for 2 months and then H, R, E for next 4 months usually. Sometimes some modification is required from case to case basis.


Can pregnancy make asthma worse?

One third of asthmatic women improve, one third remains same and remaining third (33%) of asthmatic women usually have worsening of symptoms.


Contraindications

The following antituberculosis drugs are contraindicated in pregnant women:

  • • Streptomycin
  • • Kanamycin
  • • Amikacin
  • • Capreomycin
  • • Ethionamide
  • • Bedaquiline

Drug-Resistant TB

Pregnant women who are being treated for drug-resistant TB should receive counselling concerning the risk to the fetus because of the known and unknown risks of second-line antituberculosis drugs.
Consider termination of pregnancy if the mother’s life is compromised. When the condition of the mother is so poor that a pregnancy would carry a significant risk to her life, a medical abortion may be indicated.


Breastfeeding

Breastfeeding should not be discouraged for women being treated with the first-line antituberculosis drugs because the concentrations of these drugs in breast milk are too small to produce toxicity in the nursing new born. For the same reason, drugs in breast milk are not an effective treatment for TB disease or latent TB infection in a nursing infant. Breastfeeding women taking INH should also take pyridoxine (vitamin B6) supplementation.