TB and Pregnancy
If you are pregnant and have active tuberculosis (TB), you should start treatment as soon as TB is suspected. Although the TB drugs used during treatment cross the placenta, they do not appear to have any harmful effects on the fetus. TB medications such as isoniazid, rifampin, and ethambutol are often used for treatment during pregnancy. While dealing with this condition during pregnancy is not easy, proper treatment is crucial for the health of the mother and the baby.
An Introduction to Pregnancy and TB
For a pregnant woman, there are greater risks (for both her and her fetus) for not treating tuberculosis (TB) than there are in administering tuberculosis treatment and medications. Treatment of tuberculosis in pregnant women should be started whenever the possibility of TB is moderate to high. Although the TB drugs used in treatment cross the placenta, they do not appear to have harmful effects on the fetus.
Infants born to women with untreated TB may be of lower birthweight than those born to women without TB, and may also be born with TB.
Testing for TB During Pregnancy
TB skin testing is considered safe throughout pregnancy. However, TB blood testing has not been evaluated for diagnosing TB infection in pregnant women.
Treatment During Pregnancy
For a pregnant woman with suspected latent tuberculosis, isoniazid (INH) administered either daily or twice weekly for 9 months is the preferred regimen. Women taking INH should also take pyridoxine (vitamin B6) supplementation.
Pregnant women with active tuberculosis should start treatment as soon as TB is suspected. The preferred initial treatment regimen is INH, rifampin (RIF), and ethambutol daily for 2 months, followed by INH & RIF daily, or twice weekly, for 7 months, for a total of 9 months of treatment.
Streptomycin should not be used because it has been shown to have harmful effects on the fetus. In most cases, pyrazinamide (PZA) is not recommended because its effect on the fetus is unknown.