PULMONARY TUBERCULOSIS IN PREGNANCY

Pulmonary tuberculosis complicates 1-2 percent of pregnancies in the country. The tubercular lesions in the lung may be active or quiescent.

Effects of pregnancy on Tuberculosis: It was considered in the past that pregnancy is harmful to the tubercular lesion. It is now established that pregnancy, if properly managed, generally do no harmful effect on the course of pulmonary tuberculosis.

Effect of Pulmonary Tuberculosis on Pregnancy: In active but acute febrile cases, there are chances of premature labor and intra-uterine foetal death. In less acute and quiescent cases, no effect on pregnancy is observed. The foetus practically escapes the infection in utero.

Management of Pulmonary Tuberculosis in Pregnancy:

1. Early diagnosis of the pulmonary lesion is very important. A suspected case must have skiagram of the chest, although mass radiography of the chest of all pregnant women by a full size film and lead apron on the abdomen should be the ideal. Skiagram is taken during 12-24 weeks of pregnancy.

2. Active treatment of all forms can be generally performed during the pregnancy. Antitubercular drugs are employed without much fear of their effects on the foetus. Initial treatment for the first three months – Inj. streptomycin 1gm. i.m. daily for 30 days and then thrice weekly; isoniazid 100mg. thrice daily and PAS 5mg. or Ethambutol 400mg. twice daily are orally given.