Pregnant woman infected with Tuberculosis
In
2005.WHO was declared a public health emergency for Tuberculosis. TB become
more complicated in case of maternal mortality & is among the three leading
causes of death among of women aged
13-45 years.
If
you infected by TB during pregnancy & you don’s treated it early, there is
an increased risk of:
·
A
chance of Miscarriage.
·
Premature
Baby.
·
Baby
burn with low birth weight.
·
Baby
born with TB.
So proper treatment is vary necessary for TB infected pregnant woman.
Diagnosis:
If
pregnant women are coughing up sputum( Phlegm) for more than three weeks, it
must be go for sputum test which pick up most form of TB. This may be followed
by a chest X-ray. Skin test or a blood test.If
you have no specific symptom of TB,you will be given the tuberculosis test,
also called Mantoux Test.
Treatment for TB during
pregnancy
TB can be
fully cured by using full course of medication (antibiotics) without interruption of
medication. The course can go for between six and nine months. Occasionally the treatment might go on for longer, depending on the
severity of the case. Your doctor will tell you when it is safe to stop your
medication.
You may feel better within a few weeks of treatment, but the bacteria will still be alive. So it is very important to complete the full course of medication. If you don't take the drugs as exactly prescribed, there is a very strong chance of a relapse. And you could pass the infection on to your family members. You may also end up with drug-resistant forms of the disease which are more difficult to treat.
You may feel better within a few weeks of treatment, but the bacteria will still be alive. So it is very important to complete the full course of medication. If you don't take the drugs as exactly prescribed, there is a very strong chance of a relapse. And you could pass the infection on to your family members. You may also end up with drug-resistant forms of the disease which are more difficult to treat.
Using of Directly
Observed Therapy, Short Course (DOTS) is better option for treatment of TB with
Pregnancy. This therapy entails the use of combination therapy for at least 6
months, depending on the combination of antituberculous agents that are
available. This combination includes isoniazide and rifampicin compulsorily,
supported by ethambutol and pyrazinamide .For patients with drug-susceptible TB
and, these regimens will cure around 90% of TB cases. The use of these
first-line antituberculosis drugs in pregnancy is considered safe for the
mother and the baby by The British Thoracic Society, International Union against
Tuberculosis and Lung Disease, and the World Health Organization.
Isoniazide
INH is safe during
pregnancy even in the first trimester, though it can cross the placenta and may
be cause of INH-induced hepatotoxicity. Pyridoxine supplementation is
recommended for all pregnant women taking INH at a dose of 50 mg daily.
Rifampicin
This is also believed to be safe in pregnancy,
though there may be an increased risk of haemorrhagic disorders in the newborn
(some authorities prescribe supplemental vitamin K (10 mg/day) for the last four to eight weeks of pregnancy.)
Ethambutol
It may cause retro
bulbar neuritis (optic neuritis) in adults because it may interfere with
ophthalmological development when used in pregnancy but this has not been
demonstrated when the standard dose is used. This was also confirmed in experimental
studies on some abort uses.
Pyrazinamide
The use of pyrazinamide
in pregnancy was avoided by many physicians for a long time due to
unavailability of adequate data on its teratogenicity. Presently, many
international organizations now recommend its use. There are no reports of
significant adverse events from the use of this drug in the treatment of TB in
pregnant women despite its use as part of the standard regimen in many
countries.
Its use is particularly
indicated in women with tuberculosis meningitis in pregnancy, HIV infection,
and suspected INH resistance.
Streptomycin
The drug has been proven
to be potentially teratogenic throughout pregnancy. It causes fetal
malformations and eighth-nerve paralysis, with deficits ranging from mild hearing
loss to bilateral deafness. Many centres are against the use of this drug in pregnancy.
Multidrug-Resistant
Tuberculosis in Pregnancy
Pregnant women with
MDR-TB have much difficult to treatment. They may sometimes require treatment
with second-line drugs, including cycloserine, ofloxacin, amikacin, kanamycin,
capreomycin, and ethionamide. The safety of these drugs is unfortunately not
well-established in pregnancy.
Ethionamide is
associated with growth retardation, central nervous system and skeletal
abnormalities in early pregnancy. Its use is, therefore, not recommended in
pregnancy.
Therapeutic abortion has
been proposed as an option of management for these women, as MDR-TB poses more
risk to the woman and the society at large. Another option is to delay
initiating treatment to the second trimester where possible. Individualized
Treatment Regimen (ITR) using various combinations of the 2nd line
antituberculosis agents based on their
susceptibility profile had, however, been tried in some pregnant women with no
adverse obstetric outcome
The outlook for those patients is expected to
improve as experience and knowledge in the management of the condition
increases.
In
addition to your antibiotics, it is important to take good care of yourself so
that you strengthen your immune system:
- Eat a well balanced diet.
- Get plenty of fresh air.
- Don't miss antenatal visits of doctor.
- Report any side effects, such as vision changes, headaches or increased nausea to your doctor immediately.
As long as you are infectious, maintain good personal hygiene. Ensure that you wash your hands regularly and
cover your mouth and nose with a tissue when you cough or sneeze so that you do
not spread the germs around. Make sure you dispose of your soiled tissues in a
covered bin or sealed plastic bag.
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