During your pregnancy, your physician will conduct various routine tests to identify any potential health issues that could pose a risk to you or your developing baby. Additionally, if you experience symptoms such as weight loss, loss of appetite, chills, fever, night sweats, cough, or chest pain, your doctor may recommend testing for tuberculosis (TB) in addition to the routine tests. These symptoms will prevail only if you have active TB and it is crucial to get yourself tested in case you have these symptoms, as it might affect your pregnancy. On this World Tuberculosis Day, Dr Manisha Tomar, Senior Consultant, Obstetrician & Gynecologist, Motherhood Hospital, Noida, explains TB during pregnancy, its treatment and complications for expecting mothers and newborns.
What Is Tuberculosis
TB is a bacterial infection that typically affects your lungs. When a mother has TB, it is risky for her as well as the child. According to Dr Tomar, pregnant women with TB are twice as likely to give birth to preterm or underweight children. Also, there are some chances that the baby will be born with congenital TB.
Also Read: World Tuberculosis Day 2023: Pulmonologist Explains Drug-Resistant Tuberculosis & Its Treatment
Types of Tuberculosis
There are two types of TB, namely latent TB and active TB. The severity of the disease is higher in its active state. Yet, both latent and active TB can harm your unborn child.
Latent TB shows no symptoms as the bacteria in your body are inactive. This type of TB is also called inactive TB and is not contagious, but getting it treated is crucial as it has the potential to become active TB. Active TB makes you fall sick and, in most cases, can spread to others. It can occur shortly or even years after getting infected.
Tuberculosis Treatment During Pregnancy
You might be concerned that taking tuberculosis medication could be harmful to your unborn kid. However, Dr Tomar stated that leaving it untreated is even worse. She said that your infant is exposed to the TB medications you use, yet, there is no evidence that they are harmful to the unborn child.
She further mentioned that certain anti-TB medications can cause birth abnormalities or other issues in a developing baby. But if you are pregnant or want to become pregnant, your doctor will not recommend those medications. What type of TB you have will determine the medication you receive.
Also Read: Tuberculosis: Importance Of Early Diagnosis And Treatment
Latent TB Treatment
You will likely take the medication (isoniazid) if testing reveals that you have the condition despite the absence of any symptoms. You might have to take it twice a week for the first nine months, or every day. You will need to take vitamin B6 supplements concurrently. Another option is to have a three-month course of isoniazid and rifampin.
To prevent giving a lot of medicine to pregnant women, therapy for latent TB infection can typically be postponed until two to three months after delivery. Treatment for latent TB infection should not be postponed based solely on pregnancy, not even during the first trimester, especially for women with a high risk of developing TB disease from latent TB infection. This is particularly in cases when they recently came into touch with someone who has an infectious TB disease.
Active TB Treatment
Isoniazid, rifampin, and ethambutol are typically the first three medications you receive in the course of treating this type of TB. Most likely, you will need to take all three each day for two months. Or you will probably only take isoniazid and rifampin, either daily or twice a week, throughout the remainder of your pregnancy, according to Dr Tomar.
Breastfeeding
Even if you are still on your first-line TB medications after giving birth, you should be able to breastfeed your child without any problems. Continue taking vitamin B6 if you are on isoniazid, even if you are nursing your infant. Although a small quantity of the medication will enter your breast milk, it will not do any harm to the child.
Also Read: Is Tuberculosis In Children Different From Adults? Know The Symptoms, Causes, Treatment
Complications
Dr Tomar said that some of the complications we see in newborns born out of mothers who had TB during pregnancy are the following.
- The child might weigh less than a child born to a healthy mother.
- Though uncommon, the child might get TB from birth.
- TB transmission from the mother to the child happens after birth if the disease is still active and the mother was not treated timely.
If the initial medications you try do not treat your TB, you might have a drug-resistant strain of the condition. Your physician might advise you to switch to medicines that are considered second-line. Dr Tomar advised that several medications should not be used while pregnant as they are capable of causing birth abnormalities and other issues. In case you need second-line treatment, you might have to delay your pregnancy.
Counselling
Along with taking treatment for TB you can also consult your doctor and go for online counselling or therapy, as dealing with the situation can be stressful and consuming. If you have active TB there are high chances of others getting the infection. Talking to someone about what you are going through emotionally and physically can help you cope better with the disease and the situation.
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