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Is It Possible To Treat TB During Pregnancy?
Question: Hi Doctor,
My wife is pregnant (18weeks) so far all the tests for the baby are very good. 3weeks ago her neck wasn't feeling well and we thought at that time that it might be a stiff neck but as time passed her neck got swollen. Last week we went to our hospital and the doctor suggested it might be Lymph Node Tuberculosis. After we did the PPD skin test the result read 2cm x 2cm which in all cases are read as Positive i think. There is another sample test they took out of the Lymph Nodes and sent to the Lab. We have yet to receive the result for this test tomorrow. If my wife is diagnosed with Lymph Node TB, what are the possible steps for us?
Is it possible to treat the TB during pregnancy and still have the baby?
Thank you very much.
My wife is pregnant (18weeks) so far all the tests for the baby are very good. 3weeks ago her neck wasn't feeling well and we thought at that time that it might be a stiff neck but as time passed her neck got swollen. Last week we went to our hospital and the doctor suggested it might be Lymph Node Tuberculosis. After we did the PPD skin test the result read 2cm x 2cm which in all cases are read as Positive i think. There is another sample test they took out of the Lymph Nodes and sent to the Lab. We have yet to receive the result for this test tomorrow. If my wife is diagnosed with Lymph Node TB, what are the possible steps for us?
Is it possible to treat the TB during pregnancy and still have the baby?
Thank you very much.
Brief Answer:
regular medicine intake & fetal growth monitoring
Detailed Answer:
Hello sir, thanks for trusting health care magic.
Skin PPD test and the history given by you are strongly suggestive of tuberculosis.
The test sent for analysis will confirm the same in case tubercular bacteria (acid fast bacilli) are detected in it.
It is a treatable condition and drugs currently used are very effective and safe in pregnancy.
Medicine once started should be taken strictly and right on time and avoid missing any dose.
Also it needs regular monitoring of certain blood parameters (liver function tests) which are at times deranged because of the drugs.
It is possible to have a live and healthy baby while being still on anti-tubercular medication, but constant monitoring of fetal growth by serial ultrasounds and strict dose schedule are of Paramount importance.
Wish her the best of health. Take care.
regular medicine intake & fetal growth monitoring
Detailed Answer:
Hello sir, thanks for trusting health care magic.
Skin PPD test and the history given by you are strongly suggestive of tuberculosis.
The test sent for analysis will confirm the same in case tubercular bacteria (acid fast bacilli) are detected in it.
It is a treatable condition and drugs currently used are very effective and safe in pregnancy.
Medicine once started should be taken strictly and right on time and avoid missing any dose.
Also it needs regular monitoring of certain blood parameters (liver function tests) which are at times deranged because of the drugs.
It is possible to have a live and healthy baby while being still on anti-tubercular medication, but constant monitoring of fetal growth by serial ultrasounds and strict dose schedule are of Paramount importance.
Wish her the best of health. Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you for your answer.
We are currently getting looked at in Beijing China at Beijing College University Hospital. We are thinking about going to Singapore hoping it would be a little bit better for treatment but we are not sure about it.
What are the drugs that are safe in pregnancy?
By "safe" you mean what exactly, how long has this safe drug been recorded as safe?
Given the fact my wife is 18weeks pregnant, does this lower the risk of harming the baby when taking the drugs? would it have bend different before 12weeks?
Where would you suggest we should go for the treatment and prescribing the drugs?
We are currently getting looked at in Beijing China at Beijing College University Hospital. We are thinking about going to Singapore hoping it would be a little bit better for treatment but we are not sure about it.
What are the drugs that are safe in pregnancy?
By "safe" you mean what exactly, how long has this safe drug been recorded as safe?
Given the fact my wife is 18weeks pregnant, does this lower the risk of harming the baby when taking the drugs? would it have bend different before 12weeks?
Where would you suggest we should go for the treatment and prescribing the drugs?
Brief Answer:
china treatment will suffice, safe in pregnancy
Detailed Answer:
Hello sir, I understand your anxiety related to the treatment but at the university level in China I think you are in safe hands because treatment in case of tuberculosis in pregnancy is very well defined and all gynecologists know the regimen very well. But still if you have better faith in doctors at Singapore then you can have opinion from them and then follow up the same with university at China which will be more convenient to both of you.
Most common drugs given are Isoniazid, rifampicin, pyrizinamide and pyridoxine.
These are readily available and are given in doses which are usually well tolerated and with minimal side effects when well monitored with liver function tests.
These drugs are given for full 6 months without a miss when started.
These drugs will also help by saving the baby from effects of tuberculosis bacteria.
These drugs are rated safe in pregnancy and specially when used after 12 weeks of pregnancy when organs of the baby have formed already.
This neck swelling is a recent finding like 3 weeks as you said so your period of 12 weeks of pregnancy was saved from both the effect of bacteria and anti tuberculosis treatment.
I hope I have answered your questions but in case you have any query I will be happy to help.
china treatment will suffice, safe in pregnancy
Detailed Answer:
Hello sir, I understand your anxiety related to the treatment but at the university level in China I think you are in safe hands because treatment in case of tuberculosis in pregnancy is very well defined and all gynecologists know the regimen very well. But still if you have better faith in doctors at Singapore then you can have opinion from them and then follow up the same with university at China which will be more convenient to both of you.
Most common drugs given are Isoniazid, rifampicin, pyrizinamide and pyridoxine.
These are readily available and are given in doses which are usually well tolerated and with minimal side effects when well monitored with liver function tests.
These drugs are given for full 6 months without a miss when started.
These drugs will also help by saving the baby from effects of tuberculosis bacteria.
These drugs are rated safe in pregnancy and specially when used after 12 weeks of pregnancy when organs of the baby have formed already.
This neck swelling is a recent finding like 3 weeks as you said so your period of 12 weeks of pregnancy was saved from both the effect of bacteria and anti tuberculosis treatment.
I hope I have answered your questions but in case you have any query I will be happy to help.
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Doctor,
Thank you for your detailed answer. However, i have a friend who is a medstudent in China and he said that Rifampin is (still) listed as C drug. Could there be any newer versions of this drug that is not on the Chinese market?
Could the ranking of drugs used in china be different from international?
Could it be that for example one drug is not advanced in enough in china than for example singapore or india?
Thank you very much for your time
Thank you for your detailed answer. However, i have a friend who is a medstudent in China and he said that Rifampin is (still) listed as C drug. Could there be any newer versions of this drug that is not on the Chinese market?
Could the ranking of drugs used in china be different from international?
Could it be that for example one drug is not advanced in enough in china than for example singapore or india?
Thank you very much for your time
Brief Answer:
rifampicin can be used in pregnancy
Detailed Answer:
Hello,
I appreciate your efforts in gathering knowledge about the treatment part and its good that you are well prepared for the sequence of events in near future.
Rifampicin is the most important and best drug in the treatment of tuberculosis and it can be given in pregnancy when the benefit over risk is considered.
There are no other forms of drug and is considered safe in pregnancy worldwide.
Tuberculosis treatment is incomplete without this and patient has to take it for full 6 months for complete cure.
Don't keep any reservation in your mind against the drug and follow the regimen given by the doctor.
Take care and all the best.
rifampicin can be used in pregnancy
Detailed Answer:
Hello,
I appreciate your efforts in gathering knowledge about the treatment part and its good that you are well prepared for the sequence of events in near future.
Rifampicin is the most important and best drug in the treatment of tuberculosis and it can be given in pregnancy when the benefit over risk is considered.
There are no other forms of drug and is considered safe in pregnancy worldwide.
Tuberculosis treatment is incomplete without this and patient has to take it for full 6 months for complete cure.
Don't keep any reservation in your mind against the drug and follow the regimen given by the doctor.
Take care and all the best.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Doctor,
We just went to the Tuberculosis Hospital in China and the lead doctor said that my wife can come back after giving birth and not worry about the TB. Reasons being:
1. She was very weak because of her nausea, didnt eat well and her immune system was down.
2. If she eats well and her general health condition gets better this TB can actually go away little by little and not get worse.
3. This TB cannot spread through her whole body and will enter blood system, which is not a threat.
She should come back if ahe has a serious cough and or fever. I think that chinese doctors do not allow to take medicine during pregnancy.
Does what the doctor said make sense? Thank you very much.
We just went to the Tuberculosis Hospital in China and the lead doctor said that my wife can come back after giving birth and not worry about the TB. Reasons being:
1. She was very weak because of her nausea, didnt eat well and her immune system was down.
2. If she eats well and her general health condition gets better this TB can actually go away little by little and not get worse.
3. This TB cannot spread through her whole body and will enter blood system, which is not a threat.
She should come back if ahe has a serious cough and or fever. I think that chinese doctors do not allow to take medicine during pregnancy.
Does what the doctor said make sense? Thank you very much.
Brief Answer:
second opinion needed
Detailed Answer:
Hello sir, in my opinion she should be given anti tubercular therapy for sure in case that teat from lymph node stains positive with tuberculosis.
Pregnancy is an immunocompromised state already and as you said your wife is very weak too plus she must not be taking adequate diet because of nausea.
I would like to suggest you to take a second opinion from Singapore if that's okay with you.
Or in case you are not able to do so, wait for fifteen days and follow up with the Chinese doctor and let him see for any signs if progressing disease.
In case disease is not progressing then keep a regular follow up with him and stay vigilant for any new symptoms.
But if he finds any sign of advanced disease I'm sure he himself will like to put you on anti tuberculosis treatment.
Wish her the best of health.
second opinion needed
Detailed Answer:
Hello sir, in my opinion she should be given anti tubercular therapy for sure in case that teat from lymph node stains positive with tuberculosis.
Pregnancy is an immunocompromised state already and as you said your wife is very weak too plus she must not be taking adequate diet because of nausea.
I would like to suggest you to take a second opinion from Singapore if that's okay with you.
Or in case you are not able to do so, wait for fifteen days and follow up with the Chinese doctor and let him see for any signs if progressing disease.
In case disease is not progressing then keep a regular follow up with him and stay vigilant for any new symptoms.
But if he finds any sign of advanced disease I'm sure he himself will like to put you on anti tuberculosis treatment.
Wish her the best of health.
Above answer was peer-reviewed by :
Dr. Prasad
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