Pulmonary Tuberculosis

Subject: Midwifery I (Theory)

Overview

Pulmonary tuberculosis is an infectious lung illness caused by Mycobacterium tuberculosis (Acid-fast bacilli). Hospital deliveries had an incidence of 1-2 percent. Low-grade fever, nocturnal sweating, loss of appetite, cough with or without expectoration lasting more than 6 weeks, nausea, chest pain, and in advanced cases, hemoptysis and dyspnea. As a result of TB in pregnancy, there is always the danger of abortion and intrauterine fetal mortality. We can manage tuberculosis with the watchful supervision of an obstetrician and a specialist physician, but if the infection is advanced, hospitalization may be required. During the active phase, Tuberculosis therapy is initiated in accordance with the DOTS regimen. Pregnant women with active tuberculosis should be treated, even if they are in the first trimester. Isoniazid, rifampin, and ethambutol may be used.

Mycobacterium tuberculosis causes pulmonary tuberculosis, an infectious illness of the lungs (Acid fast bacilli). In hospital deliveries, the incidence ranges between 1-2 percent.

Risk Factors

You are more likely to contract tuberculosis if you:

  • You live in an area with a high TB prevalence.
  • You have had close contact with someone who has active tuberculosis, such as family members, relatives, friends, or housekeepers.
  • You have a sickness or health condition that weakens your immune system, such as HIV or diabetes, which makes you more susceptible to infection.
  • You are a smoker. Tobacco use raises the chance of tuberculosis infection.
  • You have bad health as a result of an unhealthy diet, drunkenness, drug misuse, or homelessness.
  • You live in substandard or overcrowded housing.

Clinical Features

  • Low-grade fever
  • Night sweating
  • Loss of appetite
  • Cough with or without expectoration lasting for more than 6 weeks.
  • In advanced, the patient may present with hemoptysis, breathlessness.
  • Nausea
  • Chest pain

Effects of Pregnancy

  1. There is always a risk for abortion, intrauterine fetal death.
  2. Anemia
  3. Premature labor
  4. The neonate canbe infected

Diagnosis

  • Positive family history
  • Clinical features
  • X-ray examination
  • Sputum for ABF examination

Management

  • The patient should be monitored by an obstetrician and a cheat physician.
  • The sufferer should be rested both physically and emotionally.
  • If the infection has progressed, hospitalization may be required.
  • Tuberculosis therapy is initiated during the active period in accordance with the DOTS protocol.
  • Pregnant women with active tuberculosis should be treated, even if they are in their first trimester. It is possible to utilize isoniazid, rifampin, and ethambutol. Pyrazinamide is only prescribed to women with probable multidrug-resistant tuberculosis in the United States (MDR-TB). Pyrazinamide is routinely used in pregnant women with tuberculosis in other parts of the world. Streptomycin should not be used because it has been demonstrated to be detrimental to the fetus.
  • To reduce issues such as anemia and PIH, prenatal care should be administered throughout the pregnancy.
  • Even when the infection has been controlled, the patient's condition may recur, necessitating a good diet and rest.
  • The patient should be handled separately in an isolation room during labor.
  • Blood loss in the third stage of labor is reduced by administering Inj oxytocin 10 IU IM.
  • Breast feeding is not recommended in active instances.
  • Family planning is essential.
  • As needed, follow up with the patient.

Management of Newborn Baby

  • If the mother is contagious, she can care for and breastfeed her child. The BCG immunization is used to safeguard the infant.
  • If the mother is actively infected, preventive isoniazid 20mg/kg/day should be given for 3 months.
Things to remember
  • Mycobacterium tuberculosis causes this infectious lung illness (Acid-fast bacilli).
  • In hospital deliveries, the incidence ranges between 1-2 percent.
  • If you have an illness or health condition that impairs your immune system, such as HIV or diabetes, you are more sensitive to infection, and smoking increases your chances of contracting tuberculosis.
  • Low-grade fever, nocturnal sweating, loss of appetite, cough with or without expectoration lasting more than 6 weeks, nausea, chest pain, and in severe cases, the patient may present with hemoptysis and dyspnea.
  • As a result of TB in pregnancy, there is always a danger of abortion and intrauterine fetal mortality. If the infection is progressed, we can control it by giving close supervision to an obstetrician and a cheat physician.
  • Tuberculosis therapy is initiated during the active period in accordance with the DOTS protocol.
  • Pregnant women with active tuberculosis should be treated, even if they are in their first trimester. It is possible to utilize isoniazid, rifampin, and ethambutol.
Questions and Answers

Clinical Features

  • A minor fever
  • Sweating at night
  • Reduced appetite
  • Coughing for longer than six weeks, whether or whether there is expectoration.
  • When advanced, the patient could have hemoptysis and shortness of breath.
  • Nausea
  • Chest pain

Effects of Pregnancy

  • The possibility of abortion and intrauterine fetal death exists constantly.
  • Anemia
  • Preterm birth
  • The newborn may be infected.

Management

  • The patient needs to be under the care of an obstetrician and another doctor.
  • The sufferer needs to relax both physically and mentally.
  • Hospitalization can be necessary if the infection is advanced.
  • The DOTS program is followed when starting the tuberculosis treatment during the active phase.
  • Even in the early stages of pregnancy, pregnant women with active TB should receive treatment. It is possible to utilize ethambutol, rifampin, and isoniazid. Pyrazinamide is only prescribed to women in the US who have suspected multidrug-resistant TB. Pyrazinamide is frequently used in pregnant TB patients elsewhere in the world. Because it has been demonstrated that streptomycin harms the fetus, it should not be used.
  • To reduce issues like anemia, PIH, attention should be given continuously during the antenatal period.
  • Even after the infection is under control, the patient's condition could recur, necessitating appropriate nutrition and rest.
  • The patient should be treated separately in an isolation room throughout labor.
  • By injecting 10 IU of oxytocin intramuscularly, blood loss during the third stage of labor is reduced.
  • Breastfeeding is not advised in cases that are active.
  • Planning your family is necessary.
  • Keep an eye on the patient as needed.

Management of Newborn Baby

  • Even if the mother is contagious, she can take care of and breastfeed her child. The BCG vaccine is used to safeguard the infant.
  • Give prophylactic isoniazid 20 mg/kg/day for three months if the mother is actively contagious.

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