Tuberculosis Treatment During Pregnancy

Tuberculosis (TB) is an infection that can have devastating effects on the lungs, the brain, the spine and the kidneys. It's usually spread through close contact with someone who has an active case. Fortunately, TB is usually cured easily with modern treatments. During pregnancy, TB is a serious disease, but no more serious than in other cases. It does not infect the fetus except in rare cases. However, if the infection is still active after the woman gives birth, it's possible she will pass it on to her infant, with potentially fatal results.

The Facts

• Tuberculosis is caused by the bacterium Mycobacterium tuberculosis. It is spread through the air when an infected person sneezes or coughs. But you usually need a high level of exposure in order to be infected. You're not likely to get it in casual situations, such as on the bus or at the movies. You're much more apt to be infected by someone you spend prolonged periods in close quarters with, such as a family member, roommate or co-worker.

  The infection can be active or latent. Active TB can cause severe illness and even death, though some cases are mild. Symptoms commonly include a persistent cough, night sweats, fevers, tiredness, weight loss and, sometimes, coughing up of blood. Latent TB means you have the germ, but it is well contained by the body. You don't come down with symptoms, and you aren't contagious. It's possible, however, for the latent infection to become active at some point, so doctors still commonly try to eradicate the germ with medications.

Treatment During Pregnancy

• Pregnant women diagnosed with TB through a positive skin test and X-ray results suggestive of the infection should generally be treated immediately, according to the New York Department of Health and Mental Hygiene's Bureau of Tuberculosis Control. Among the medications that can be used are isoniazid, rifampin and ethambutol. Many other medicines are to be avoided because of potential harmful effects on the developing fetus.

  Treatment for pregnant women diagnosed with latent TB should generally be postponed until two to three months after the baby is born, the Bureau of Tuberculosis Control says. Latent TB should be treated during pregnancy in situations where the mother has HIV or has been in close contact recently with a person who has an active case---with medications to be started, in either case, during the first trimester.