A 6 week pregnant lady is diagnosed with sputum positive TB. Best management is:
Ans. is b, i.e. Start category I ATT in first trimesterRef Textbook of Obs. Sheila Balakrishnan 1/e, p 387,Indian Journal of TuberculosisTB during pregnancy, requires prompt treatmentATT can be given at any period in pregnancy, including the first trimester:First line drug used are:-INH, Rifampicin, ethambutol and pyrazinamide-Streptomycin is contraindicated during pregnancy Q-The 2 drugs which should be used throughout are - INH and Rifampicin-If a third drug is to be used it is usually ethambutol-Pyridoxine 50 mg is given along with chemotherapy.Drug RegimenInitial 3 drugs for 3 months followed by 2 drugs for 6 monthsORInitial 4 drugs for 2 months followed by 2 drugs for 4 monthsBreastfeeding is not contraindication if the woman is on treatment Q but contraindicated if active lesions are presentBaby should be given INH prophylaxis for 3 months. If montoux test is negative after 3 months, prophylaxis is stopped and BCG vaccination given.
Wait for 2nd trimester to start ATT
Start category I ATT in first trimester
Start category II ATT in first trimester
Start category III ATT in second trimester
Medical & Surgical Illness Complication Pregnancy