TBC ON PREGNANCY

By AMIN
Supervisor
dr. Ida Bagus Wicaksana Sp.OG

EPIDEMIOLOGI
incidency
Data on indonesia

Introduce

the influence of TBC in Pregnancy

Depend by location

Transmition to fetal
Lymph
hematogen
Direct.

Sign and Symptom

Sign and

Not

Pregnan

Symptom
Cough

pregnan
50%

70%

Febris

30%

30%

Bloody cought

25%

20%

Decrease of

40%

30%

weight

30%

30%

Malaise

10%

10%

DIAGNOSE
Anamnesis
Pemeriksaan fisik
Pemeriksaan penunjang

the influence of pregnancy in TBC

TB disease occurs in a small but definite percentage of
pregnant woman.
Relative immuno-compromise may allow latent infection
to progress to active TB disease.
Pregnant women with active TB have a higher risk of
complications (pre-eclampsia, vaginal hemorrhage and
fetal loss).

Treatment
Trimester I
Trimester II and III
Pre partum

Safety Classification of Medications

During Pregnancy
A = safety established in human studies.
B = safety presumed based on animal studies.
C = safety uncertain; no human or animal studies reveal
an adverse effect.
D = safety uncertain; evidence of risk but use is
justified in certain circumstances.

Isoniazid
Safety class C
Experience with patients suggests safety
Pyridoxine (vitamin B6) should be used during
pregnancy

Rifampicin
Safety class C
Experience with patients suggests safety

Ethambutol
Safety class B
Experience with pregnant patients suggests safety

Pyrazinamide
Safety class C
Formal studies are limited but there is much clinical
experience

Streptomycin
Safety class D
Documented toxicity to the developing fetal ear (8-11%).
Toxicity is higher in the first trimester.

Risks and benefits should be carefully considered.

Use should be limited to severe cases when clinical
status and drug resistance warrants use.

Evaluation
2 years after health

Prognose
Dubia et sanam