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Additional Monitoring During Pregnancy and Lactation in Women on Shorter/Longer Oral MDR-TB Regimen
Learning ObjectivesMonitoring of pregnant women on shorter/ longer oral Multidrug-resistant TB (MDR-TB).
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Additional monitoring is recommended for pregnant women managed with a shorter/ longer oral Multidrug-resistant TB (MDR-TB) regimen including foetal and neonatal monitoring.
| INVESTIGATION | INDICATION / FREQUENCY |
|---|---|
| Basal Thyroid Stimulating Hormone (TSH) in Pre-treatment Evaluation (PTE) |
TSH Deranged in PTE - Monthly TSH Normal in PTE- Quarterly |
| Baseline investigations at birth (Complete Blood Count (CBC) and TSH) | In case Para Aminosalicylic Acid (PAS), Ethionamide (Eto) or Linezolid (Lzd) is given (which causes hypothyroidism or myelosuppression) and a newborn who has been exposed to a cocktail of drugs. |
| An Ultrasonography (USG) foetal anomalies scan | 18 weeks |
| A USG growth scan | 32 weeks |
| Frequent Electrocardiogram (ECG), serum electrolytes and CBC | As and when clinically indicated. |
| Antenatal care registration and regular Obstetric/ Gynaecology (Ob/Gy) examination | As per the regular schedule of Ante-natal care (ANC) visits |
Resources
- Guidelines for Programmatic Management of Tuberculosis in India, March 2021.
- Consolidated Guidelines on Tuberculosis: Module 4 - Treatment: Drug-resistant TB Treatment, 2020.
- Collaborative Framework for Management of Tuberculosis in Pregnant Women, 2021.
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