Numerous studies suggest that pregnancy and tuberculosis associated increased risk of the disease - the reason is the decline in immunity in pregnant women. Besides, it is obvious that the chance of developing tuberculosis or reactivation elevated in women who are infected with HIV or who immunity before pregnancy has been reduced due to any other diseases.
The exact number of women suffering from tuberculosis during pregnancy is unknown. It is estimated that in developing countries, tuberculosis is detected in 18-39 out of 100,000 pregnant women. For comparison, in the UK suffer from tuberculosis, pregnant women from 4.2 to 100,000.
How pregnancy affects TB
Doctors at the time of Hippocrates wrote about the fact that pregnancy and tuberculosis - are not dangerous, and even useful combination. Thousands of years ago, doctors believed that the cavities in the lungs, which are supposed to form in TB patients can not withstand the growing pressure of the uterus, and are destroyed, whereby the structure of light is restored to a certain extent. Until the 19th century, some doctors advised patients with tuberculosis patients as quickly as possible to get married and become pregnant, to slow the progression of the disease. It is now established that pregnancy has almost no effect on primary tuberculosis. However, pregnancy after tuberculosis can lead to reactivation of the disease - that is, the secondary tuberculosis
Secondary tuberculosis - a disease of the second round
. In addition, it is noted that pregnancy can complicate diagnosis of tuberculosis, as its symptoms, such as shortness of breath, lack of appetite, sweating at night, nausea, fatigue, fever and chills are often confused with the signs of pregnancy. Weight loss that is frequently observed in tuberculosis, pregnant women may be absent altogether.
Pregnant women undergo mandatory testing for tuberculosis, but for women, which include one or more of the following risk factors should be screened. Factors that increase the risk of tuberculosis infection:
- The long and close contact with family, friends or colleagues, open tuberculosis patients;
- Working in the same room with people infected with tuberculosis, especially in the operating room ventilation is poor;
- Jobs in health care settings, including patients who have open tuberculosis patients;
- The presence of diseases such as diabetes, cancer and HIV;
- Previously migrated tuberculosis;
- Accommodation in regions with low quality of health services (because this increases the probability of contact with people who suffer from open tuberculosis and do not know about it, and / or do not receive the necessary treatment).
If you are pregnant and suspect that they could be infected with tuberculosis, be sure to tell your doctor.
As tuberculosis affects pregnancy
The impact of TB on pregnancy depends on many factors, including the form and stage of the disease, on at what stage of pregnancy a woman when she was diagnosed with tuberculosis
Tuberculosis - a full recovery is not guaranteed
From it having other diseases. The worst prognosis is for women who have or infiltrative cavernous tuberculosis was diagnosed late in pregnancy, and HIV-infected patients. Lack of adequate treatment and worsens the prognosis. TB in pregnant women increases the risk of the following complications:
- Premature birth;
- Pre-eclampsia;
- Postpartum hemorrhage.
Late diagnosis of TB
Diagnosis of tuberculosis
It increases the likelihood of complications during birth four times, and the risk of premature birth - nine times.
Pregnancy and tuberculosis: the impact on the newborn
In very rare cases, a child's mother TB patient may develop congenital tuberculosis. Infection can occur either through the umbilical vein, either as a result of getting infected amniotic fluid in the airways or the digestive tract of the child. In such cases, the disease begins to develop in the liver and lung is secondary infection. In adults, more than 80% of primary infection affects the lungs. To diagnose congenital tuberculosis can be difficult, as its symptoms are similar to symptoms of some other diseases that can occur in newborns. Approximately 50% of the congenital tuberculosis results in the death of a child; especially a high probability of death if the disease is not treated in time.
About how to prevent TB infection after childbirth, women are sick or those who have close relatives with TB should talk to your doctor. As a general rule, in order to protect the newborn from infection, it is necessary to limit its contact with people diagnosed with the open form of tuberculosis.
TB treatment during pregnancy
Untreated TB in pregnant women and their unborn children are much more dangerous than the medicines used in the treatment of tuberculosis. The process of treatment of tuberculosis during pregnancy requires not only consultation with a physician, but a gynecologist and a neonatologist (a doctor who specializes in the health of newborns). For the treatment can be used the following drugs:
- Isoniazid. Acceptance of this medication is safe, even in the first trimester of pregnancy, although women still need to have regular checkups to timely detect possible side effects;
- Rifampicin is also considered safe for pregnant women, although in rare cases it can lead to hemorrhagic disease in newborns;
- Pyrazinamide. For quite a long time, doctors prescribe this drug avoided pregnant women due to a lack of data on its teratogenicity. Currently, however, many international organizations, including the WHO, recommended to use it to treat TB during pregnancy. The results of research and experience in the use of this drug in a number of countries have shown who pyrazinamide can cause serious side effects and negatively affect fetal development.
Pregnancy after pulmonary tuberculosis
Women who have had tuberculosis of the lungs, is generally not recommended to plan pregnancy for two years after completion of treatment - in this time the body recovers from illness, and to prepare for new stress associated with pregnancy. However, unplanned pregnancy, whichever comes first, in most cases, you can save, but it is necessary as soon as possible to see a doctor and carefully follow its recommendations. In preparation for pregnancy, and during the childbearing women need to take measures to strengthen the immune system
Strengthening the immune system - help the immune system
- Lead a healthy lifestyle, use of vitamin supplements, and so on. The majority of women who follow the advice of doctors and which do not have any chronic diseases that weaken the immune system, tuberculosis after birth are safely and end the birth of a healthy baby. Currently there are no data indicating that migrated earlier and successfully cured TB is associated with an increased risk of any complications in childbirth or pregnancy.
