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The treatment of DR-TB in pregnant women poses significant risks to both mother and fetus, but it is not contraindicated. <\/span><\/span><\/span><\/strong><\/p>\n\n

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\n\t
Specific medications carry particular risks, second-line injectables are contraindicated due to potential harm to the fetus\u2019s auditory nerve.<\/span><\/strong><\/span><\/span><\/span><\/li>\n\t
The use of Eto i<\/strong><\/span>s discouraged in the first 32 weeks due to teratogenic effects. <\/span><\/span><\/span><\/li>\n\t
Instead, Lzd is recommended <\/strong><\/span>for pregnant and breastfeeding women in a shorter oral regimen for MDR\/RR-TB. <\/span><\/span><\/span><\/li>\n\t
Bedaquiline has been linked to lower birth weights<\/span><\/strong> but shows no long-term adverse outcomes.<\/li>\n\t
Pretomanid (Pa) <\/strong><\/span>is not recommended during lactation unless breastfeeding is replaced with formula. <\/span><\/span><\/span><\/li>\n<\/ul>\n"},"subContentId":"146ec922-e16e-478a-b38a-e4a20f3fcead","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":6.533115468409585,"y":75.17913978494624,"width":15.250544662309368,"height":15.913978494623654,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672a21bdafe95.png","mime":"image\/png","copyright":{"license":"U"},"width":348,"height":74}},"metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"6f7da671-b95b-47a5-9ec4-47eab1860e93"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":9.803921568627452,"y":75.26881720430107,"width":7.9520697167756,"height":15.698924731182794,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672a21a1da174.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"0e1a8ae2-dfb4-4f03-9b28-f37c84cf34ed"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":23.202614379084967,"y":77.63440860215053,"width":73.63834422657952,"height":11.82795698924731,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Thus, the recommendation of the BPaLM regimen doesn\u2019t apply to pregnant and breastfeeding women.<\/strong><\/span><\/em><\/span><\/p>\n"},"subContentId":"ee8ca0a1-a77e-40d6-a4b6-a6c8ca929ff8","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":5.662222222222222,"y":6.440408602150538,"width":82.6797385620915,"height":22.58064516129032,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Women of childbearing age should be counselled <\/strong><\/span>on birth control, as DR-TB treatments can reduce the efficacy of oral contraceptives; and pregnant women with DR-TB should be managed collaboratively by a gynaecologist and a pulmonologist. Treatment decisions depend on gestational age and specific drug regimens:<\/span><\/p>\n"},"subContentId":"207f9f4a-b296-4aed-86ba-0ea17b96e9ee","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":5.446623093681917,"y":38.70967741935483,"width":30.174291938997822,"height":24.731182795698924,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
The BPaLM regimen can be considered if the woman is willing to undergo a medical termination of pregnancy (MTP) within 24 weeks.<\/span><\/span><\/span><\/p>\n"},"subContentId":"e315dfb4-eaee-4ce9-b4d5-adc3fd160baf","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":37.03703703703704,"y":38.70967741935483,"width":28.649237472766885,"height":16.559139784946236,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
If Lzd is used instead of Eto, all pregnant women may qualify for the 9-month shorter regimen.<\/span><\/span><\/span><\/p>\n"},"subContentId":"728f4116-a35b-4498-84ea-7c9bb21090a3","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":67.53812636165577,"y":38.70967741935483,"width":29.193899782135077,"height":24.731182795698924,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
If neither option is available, a longer regimen may be necessary, with modifications based on resistance and drug tolerability.<\/span><\/span><\/span><\/p>\n"},"subContentId":"55739e21-67e0-422f-8bcf-b20284a85dcd","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":88.23529411764706,"y":5.806451612903225,"width":8.169934640522875,"height":16.129032258064516,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672a22925867d.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"subContentId":"4436da17-d2c3-4eeb-b07f-8792cb50fba7","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":35.07254901960785,"y":34.98817204301075,"width":0.32679738562091504,"height":27.956989247311824,"action":{"library":"H5P.Shape 1.0","params":{"line":{"borderWidth":"2","borderStyle":"solid","borderColor":"rgb(166, 164, 164)"},"type":"vertical-line","shape":{"fillColor":"#ffffff","borderColor":"#000000","borderWidth":"0","borderStyle":"solid","borderRadius":"0"}},"subContentId":"2f022280-a6aa-4e69-a2bc-a24521bf76ca","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":65.79063180827886,"y":34.34150537634408,"width":0.32679738562091504,"height":27.956989247311824,"action":{"library":"H5P.Shape 1.0","params":{"line":{"borderWidth":"2","borderStyle":"solid","borderColor":"rgb(166, 164, 164)"},"type":"vertical-line","shape":{"fillColor":"#ffffff","borderColor":"#000000","borderWidth":"0","borderStyle":"solid","borderRadius":"0"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"9e51980b-9f42-4d39-ae3e-dfc7853ba14c"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":17.429193899782135,"y":26.451612903225804,"width":5.446623093681917,"height":10.75268817204301,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672a22c0887fe.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"subContentId":"ea628f80-ce31-4c22-9163-752faca2e31b","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":46.84095860566449,"y":26.451612903225804,"width":5.443572202725161,"height":10.75268817204301,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672a22e794685.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"127967ab-f887-4f74-a653-596af0832008"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":76.25272331154684,"y":25.806451612903224,"width":5.443572202725161,"height":10.75268817204301,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672a22eda0802.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"ca66b2a8-eafc-447a-8885-81d2eb04db8c"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":4.3544662309368185,"y":64.43763440860215,"width":91.50326797385621,"height":0.6451612903225806,"action":{"library":"H5P.Shape 1.0","params":{"line":{"borderWidth":"2","borderStyle":"dotted","borderColor":"rgb(159, 159, 159)"},"type":"horizontal-line","shape":{"fillColor":"#ffffff","borderColor":"#000000","borderWidth":"0","borderStyle":"solid","borderRadius":"0"}},"subContentId":"1ebcbaf6-d542-4534-8b9e-4a8db3681b61","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":12.852069716775599,"y":72.76817204301076,"width":87.14596949891067,"height":22.58064516129032,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Pregnant patients must be closely monitored with additional follow-up<\/span><\/strong>, including regular blood tests, ultrasounds for fetal anomalies, and other assessments as needed. <\/span><\/span><\/span><\/p>\n\n
Breastfeeding <\/strong><\/span>is encouraged for mothers who are smear\/culture negative and not on Pa.<\/span><\/span><\/span><\/p>\n"},"subContentId":"5466d998-fe62-4c87-9413-3153c3429405","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":2.8322440087145972,"y":73.76344086021504,"width":8.061002178649238,"height":15.913978494623654,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672a233411216.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"subContentId":"18078413-546d-490d-853c-17f3e9fad449","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":91.39433551198258,"y":87.74193548387096,"width":5.446623093681917,"height":10.75268817204301,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672a2346cb217.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"subContentId":"94bec3a8-d849-4780-a806-6433ef5cf81c","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":11.98115468409586,"y":6.656021505376344,"width":85.83877995642702,"height":21.50537634408602,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
If the pregnancy exceeds 24 weeks and the patient opts against MTP, treatment should be adjusted<\/span><\/strong> to ensure the health of both mother and baby. <\/span><\/span><\/span><\/p>\n\n
Regular consultations <\/strong><\/span>with healthcare professionals are crucial throughout the treatment process.<\/span><\/span><\/span><\/p>\n"},"subContentId":"4261b3f8-f791-4299-81f2-d427d92129ce","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":2.178649237472767,"y":6.451612903225806,"width":8.056486860033237,"height":15.913978494623654,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672a239e91576.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"4732c301-ee7e-4118-aa2a-5185d580f824"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}}],"keywordListEnabled":true,"globalBackgroundSelector":{},"keywordListAlwaysShow":false,"keywordListAutoHide":false,"keywordListOpacity":90},"override":{"activeSurface":false,"hideSummarySlide":false,"summarySlideSolutionButton":true,"summarySlideRetryButton":true,"enablePrintButton":false,"social":{"showFacebookShare":false,"facebookShare":{"url":"@currentpageurl","quote":"I scored @score out of @maxScore on a task at @currentpageurl."},"showTwitterShare":false,"twitterShare":{"statement":"I scored @score out of @maxScore on a task at @currentpageurl.","url":"@currentpageurl","hashtags":"h5p, course"},"showGoogleShare":false,"googleShareUrl":"@currentpageurl"}},"l10n":{"slide":"Slide","score":"Score","yourScore":"Your Score","maxScore":"Max Score","total":"Total","totalScore":"Total Score","showSolutions":"Show solutions","retry":"Retry","exportAnswers":"Export text","hideKeywords":"Hide sidebar navigation menu","showKeywords":"Show sidebar navigation menu","fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen","prevSlide":"Previous slide","nextSlide":"Next slide","currentSlide":"Current slide","lastSlide":"Last slide","solutionModeTitle":"Exit solution mode","solutionModeText":"Solution Mode","summaryMultipleTaskText":"Multiple tasks","scoreMessage":"You achieved:","shareFacebook":"Share on Facebook","shareTwitter":"Share on Twitter","shareGoogle":"Share on Google+","summary":"Summary","solutionsButtonTitle":"Show comments","printTitle":"Print","printIngress":"How would you like to print this presentation?","printAllSlides":"Print all slides","printCurrentSlide":"Print current slide","noTitle":"No title","accessibilitySlideNavigationExplanation":"Use left and right arrow to change slide in that direction whenever canvas is selected.","accessibilityCanvasLabel":"Presentation canvas. Use left and right arrow to move between slides.","accessibilityProgressBarLabel":"Choose slide to display","containsNotCompleted":"@slideName contains not completed interaction","containsCompleted":"@slideName contains completed interaction","slideCount":"Slide @index of @total","containsOnlyCorrect":"@slideName only has correct answers","containsIncorrectAnswers":"@slideName has incorrect answers","shareResult":"Share Result","accessibilityTotalScore":"You got @score of @maxScore points in total","accessibilityEnteredFullscreen":"Entered fullscreen","accessibilityExitedFullscreen":"Exited fullscreen","confirmDialogHeader":"Submit your answers","confirmDialogText":"This will submit your results, do you want to continue?","confirmDialogConfirmText":"Submit and see results","slideshowNavigationLabel":"Slideshow navigation"}}

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Pregnancy and Lactation

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Pregnancy and Lactation

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