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DR-TB Treatment in Pregnancy: Recommendation for the Use of Contraception
Learning ObjectivesDR-TB Treatment in Pregnancy: Recommendation for the Use of Contraception
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All women of childbearing age who are awaiting results of the Culture and Drug Susceptibility Test (C&DST), as well as those receiving Drug-resistant TB (DR-TB) treatment, should be advised and counselled intensively to use birth control measures because of the potential risk to both the mother and the foetus.
- It should be noted that oral contraceptives might have decreased efficacy due to vomiting and drug interactions with DR-TB drugs (use of Rifampicin in mono/poly resistant TB).
- Contraception methods that can be used during DR-TB treatment, based on individual preference and eligibility are:
- Barrier methods (e.g., condoms/ diaphragms), intrauterine devices (e.g., CuT), Depot medroxyprogesterone (Depo-provera).
- In women, the Isoniazid (H) mono/poly DR-TB regimen may be started or continued safely, except that care should be taken while using oral contraceptives.
- A woman on oral contraception, while receiving rifampicin treatment may choose between two options following consultation with a physician:
- Use of an oral contraceptive pill containing a higher dose of oestrogen (50 μg)
- Use of another form of contraception.
Resources
- Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
- Consolidated Guidelines on Tuberculosis: Module 4 - Treatment: Drug-resistant TB Treatment, 2020.
- Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-resistant Tuberculosis, 2014.
- Collaborative Framework for Management of Tuberculosis in Pregnant Women, 2021.
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