TUBERCULOSIS IN PREGNANCY AND NEWBORN What is Tuberculosis? is a bacterial infection caused by a germ called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but they can also damage other parts of the body. TB spreads through the air [Droplet] when a person with TB of the lungs or throat coughs, sneezes or talks. Assessment The diagnosis of tuberculosis in pregnancy is made by: Taking Health History Physical Examination Diagnostic Exams: Mantoux test (PPD) - and sputum exam Chest X-ray is usually not because of the damaging effects of radiation to the baby but it can be done carefully as long as the mother’s abdomen is shielded. Signs and Symptoms Chronic cough Weight loss Hemoptysis Night Sweats Low grade fever Chronic Fatigue Effects I. Mother Pre-partal: a. Gravid uterus pushes diaphragm and lungs to different shape may rupture calcified lesions activating disease (PTB) b. Pushing during labor; increase intrapulmonary pressure Post-partal: c. Lungs suddenly returns to pre-pregnant position and breaks open calcified lesion II. Infant Spread thru: 1. Placenta (circulation) 2. After birth (droplet) a. Should have 3 consecutive negative sputum for AFB b. Holding and caring c. No need to be isolated d. Newborn with INH prophylaxis a. Skin test with 3 months intervals b. If mother is on INH & infant also on INH – infant should not be breastfed causes overdose (toxic effects) Treatment Anti-tuberculous therapy No increase in congenital malformations or fetal damage when Rifampicin, Isoniazid and Ethambutol are used in combination. Isoniazid (INH)- supplement with pyridoxine (vit. B6) Streptomycin is contraindicated because it can cross the placenta.

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TUBERCULOSIS IN PREGNANCY AND NEWBORN

What is Tuberculosis? is a bacterial infection caused by a germ called Mycobacterium tuberculosis. The

bacteria usually attack the lungs, but they can also damage other parts of the body. TB spreads through the air [Droplet] when a person with TB of the lungs or throat

coughs, sneezes or talks.

AssessmentThe diagnosis of tuberculosis in pregnancy is made by:

Taking Health History Physical Examination Diagnostic Exams:

Mantoux test (PPD) - and sputum exam Chest X-ray is usually not because of the damaging effects of radiation to the

baby but it can be done carefully as long as the mother’s abdomen is shielded.

Signs and Symptoms Chronic cough Weight loss Hemoptysis Night Sweats Low grade fever Chronic Fatigue

EffectsI. Mother Pre-partal: a. Gravid uterus pushes diaphragm and lungs to different shape may rupture calcified lesions activating disease (PTB) b. Pushing during labor; increase intrapulmonary pressure Post-partal: c. Lungs suddenly returns to pre-pregnant position and breaks open calcified lesion

II. Infant Spread thru: 1. Placenta (circulation) 2. After birth (droplet) a. Should have 3 consecutive negative sputum for AFB b. Holding and caring c. No need to be isolated d. Newborn with INH prophylaxis a. Skin test with 3 months intervals b. If mother is on INH & infant also on INH – infant should not be breastfed causes overdose (toxic effects)

TreatmentAnti-tuberculous therapy

No increase in congenital malformations or fetal damage when Rifampicin, Isoniazid and Ethambutol are used in combination.

Isoniazid (INH)- supplement with pyridoxine (vit. B6) Streptomycin is contraindicated because it can cross the placenta.