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 TB in Pregnancy  



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Author11 Posts
  #1

Hi everyone...can someone tell me what is the best inital test and best diagnostic test in a pregnant women with TB?

Different books give different answers...like some say that u can use Xrays while others say just to do a skin test and sputum culture. Can someone please help?




  #2

first skin test we have to see induration.


  #3

theres a is a clinical protocol,
1.-PPD
2.-Sputum
3.-X-ray as a last mesuare for protection of the product


  #4

the MAIN point is that the PPD is NOT contraindicated in pregnancy, even if the mother is in so many words "freaking out" about having it!


  #5

Cedrick, i have the protocol being

1. PPD
2. CXR
3. Sputum culture X 3

are u sure about ur answer?
please correct me if i am wrong



  #6

Yes it is:

1.PPD to see if there is any TB

2.CXR to see if its active or latent (so never give isoniazid prophylaxis for a positive PPD before you ordered a CXR)

3.Sputum culture to see if its open or closed (I m not sure if that are the correct words, but thats the translation for the words we use for the difference between TB patients who have and dont have positive sputum. ;-)



  #7

There are two types of patients...dont mix them...

frist those who are at risk for TB....For those we Do PPD,Followed By chest Xray..and finally sputum for AFB to make sure weather it is active TB or just latent TB

second ones are those who have symptomatic TB ...for those we dont need PPD...PPD is always for Asymptomatic....we dont do it for symptomatic ppt..for these we go straight for CXR and then sputum for AFB and also culture sensitivity...

in former case ...asymptomatic pt we use only inh , unless pt is AFB positive..

in later case....symptomatic pt...we use full 4 drug therapy...we dont use pyrazinamide...or streptomycin..inh,rifampin, ethambutol is ok..fourth drug is some other drug..

it is not a detailed analysis of Treatment...but just a point...to highlight that management of symptomatic pt and at risk pt is different



  #8

thanks jinxed131!


  #9

ppd. if positive, CxR, then treatment


  #10

yeah thats right but if ppd positive and cxr negative than ?? smiling face

than we use inh for 9 months...

and if ppd positive cxr positive and afb negative than ? smiling face

than we also give inh for 9 months

and if ppd positive and cxr positive and afb positve smiling face

now treat as proper tb...



so u see it is not that straight



  #11

and one more thing ...if ppd positive ..next step cxr and after that next step is not treatment...it is sputum for afb





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