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PULMONARY DISEASE : TUBERCULOSIS(TB) IN PREGNANCY, CAUSES, Screening &…
PULMONARY DISEASE : TUBERCULOSIS(TB) IN PREGNANCY
DEFINITION
TB is an infectious disease caused by Mycobacterium tuberculosis. In pregnancy, two forms are relevant:
Latent TB infection:
Bacteria present without symptoms; cannot spread.
Active TB disease:
Symptoms present; potentially transmissible and harmful.
Pregnancy does not cause TB—but immune changes and repeated pregnancies may promote reactivation of latent infection
COMPLICATIONS
Obstetric & fetal: Preterm labor, low birth weight, increased neonatal mortality, and rare congenital TB if untreated
Diagnosis challenges: Pregnancy symptoms can mask TB—weight gain, fatigue, and respiratory changes may delay detection
Maternal: Untreated active TB greatly increases risks—maternal morbidity, miscarriage, anemia, and mortality
MANAGEMENT
Confirm active disease:
If tests positive or symptoms present, proceed with chest X-ray (with shielding) and sputum tests
Test if at risk:
Use TB skin test (TST) or blood test (IGRA)—both safe in pregnancy
TREATMENT
Active TB Disease
Start treatment immediately. Use standard first-line drugs: isoniazid, rifampin, ethambutol, and often pyrazinamide, supplement pyridoxine; monitor liver function.
Drug-Resistant TB
Manage only in consultation with TB experts; weigh risks/benefits carefully
Latent TB
Generally, defer treatment until 2–3 months postpartum unless high risk—in which case start earlier. Include isoniazid + pyridoxine.
MONITORING & SUPPORT
• Coordinate care across TB and maternal health teams for comprehensive follow-up
• For rifampin use late in pregnancy, consider vitamin K prophylaxis to avoid bleeding complications
• Provide birth control counseling if on interactions-affecting TB drugs (e.g., rifampin reduces oral contraceptive efficacy)
• Monitor liver function, particularly with isoniazid or rifampin; schedule regular symptom checks
CAUSES
Screening & Diagnosis