Pulmonary Tuberculosis in Pregnancy

Pulmonary Tuberculosis in Pregnancy

It is often aggravated by pregnancy, especially when no adequate care and nutrition is given. The woman appears to be improved in pregnancy, because the growing fundus presses on the diaphragm and splint the lung as a pneumothorax.

Diagnosis - Loss of weight, night sweat, coughing and X-ray confirms the diagnosis.

Treatment

Early detection and treatment is very important.

Colapse treatment till 36weeks.

X-ray chest for all expectant mothers.

TB has very little effect on pregnancy, nor is the baby usually infected in utero.

Constant supervision is necessary.

Treat anaemia.

In very advanced cases, especially if the home conditions are poor, a therapeutic abortion may be performed before the 12th week.

Labour

·              Sedation producing the maximum amount of rest.

·              Short 2nd stage; strenuous pushing must be avoided. Give episiotomy, and forceps or inhalation of nitrous oxide.

·              Bleeding must be minimized.

Puerperium

·              Isolation in the hospital or send her to a sanatorium in active Stage.

·              Collapse therapy to be continued.

·              Fresh air good nutrition and prolonged rest. Baby should be isolated from the mother.

·              Give BCG vaccination.

If Mantoux test is not positive in three months, BCG must be repeated or given according to the schedule.

Prognosis; TB is a social and economic problem. Although woman may give birth to two or three children without deterioration in her condition, but the hard work involved in child-rearing may prove to be even more detrimental than child-bearing. So it maybe desirable that she avoids many pregnancies.