Tuberculosis During Pregnancy

Hello everyone, I am DR. Pallavi Vasal, consultant of Obstetrics and Gynaecologist, working at Gurgaon. Today I will be discussing Tuberculosis in pregnancy. The class of patients which we deal with and the surrounding around is, we always think that tuberculosis is not that common in our class but it is not so. India has the largest number of cases of tuberculosis cases in the whole world, around 1 in 600. The incidence of tuberculosis in India is around 1 in 600 and in our country tuberculosis is still very prevalent. It is transmitted through respiratory droplets, though it is very important that you be very careful about your surroundings. Now during pregnancy, we are particularly discussing tuberculosis in pregnancy because during pregnancy your immunity comes down and because of this, you become most acceptable to any kind of infection and usually we catch an infection from the surrounding. So you need to be very careful about the workers you are hiring like your maid, your driver, your gardener, you need to screen them before you hire them because they are the ones who might be carrying tuberculosis. And if you screen them it will be helpful for you also and for them also. Untreated tuberculosis is the greater risk to the mother and the baby then does the drug have. So it is very important to screen and treat tuberculosis timely and quickly as soon as it is diagnosed. Most commonly the bacteria it affects the lungs otherwise it can affect the all the organs of the body. Now, when usually the symptoms of tuberculosis are like evening rise of temperature, loss of appetite, you don’t feel hungry, despite being pregnant you start losing weight, crowning cough lasting for more than 3 weeks, generalised tiredness, breathlessness and nausea. What happens in pregnancy is the physiological changes which happen in pregnancy makes the diagnosis of tuberculosis during pregnancy a bit tricky. So it is usually based on your history then your sputum which is coming out that is examined at least 2 times and chest X-Ray can even be done in the pregnancy if you are in a high-risk category with the abdominal shielding so that the baby is unharmed. Now there is another test called tuberculosis PCR which is tested in your sputum, culture can also be sent. And there is one more test called GeneXpert which also tells us about the resistance of the tuberculosis bacteria.

The treatment of tuberculosis depends upon the intensity and the severity of the disease. It can vary from 6 months to 9 months depending upon your condition. Usually, most of the drugs can be safely taken during pregnancy even in the first trimester, except a couple of drugs like streptomycin which is not advisable to take in the first trimester of pregnancy. In India the incidents of drug-resistant tuberculosis are also increasing, so once you are tested positive you need to take a complete treatment otherwise there are high chances of relapse and you developing a multi-drug resistant TB, which is very difficult to treat. Once you diagnose with TB, it takes 2 to 3 weeks after the starting of the treatment for you to become non- infectious. Till that time you have to keep your hygiene very good and keep wearing a mask if you are having lung TB, wash your hands repeatedly, eat healthy food and get a lot of fresh air, so that in general your health remains very good. Now be regular with your visits to the gynaecologist and with the physician for the treatment of tuberculosis and for the treatment of pregnancy as well. As pregnancy advances, if the TB is treated properly, it doesn’t cause much risk but there are chances of early labour, premature delivery and rarely the baby might also carry a form of TB which is known as congenital TB. But all these can be very well presented with the drug treatment if it is taken very timely and very efficient. So if you have any doubts regarding any of these issues then we can further. We can make an appointment through Lybrate or we can fix an appointment.