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Can I plan for pregnancy while being on TB medication?

Q: I am a 29 years old female, had an ectopic pregnancy. During the laparoscopic removal of the foetus from the tube, the doctor found some spots on my tubes. A smear from the tubes was sent to the lab to test for TB, which came out negative. In spite of this, the doctor asked me to start TB medication and I was put on AKT-4 and Benadon for 2 months. For the last two months, I am on R-cinex and Benadon and the medicine would continue for the next five months. As per my doctor, I can start planning for pregnancy again. Is it okay to conceive while taking R-cinex and Benadon? Will it affect my pregnancy in any way?

A:If the TB test and Histopathology was negative, why was anti TB treatment started? Anti TB treatment can be life saving but if given without any medical logic it is extremely hazardous. Either way, it is not something you take lightly. There are two problems with taking it without confirmed diagnosis, one is obviously the side effects (of which there are many) with anti TB treatment, but equally important is that if God willing you actually need it in future because of a genuine infection, it may not work at all as resistant strains would have developed by then you would get relief with treatment. Besides the whole problem of indiscriminate use may lead to resistant strains of TB, which is a national and international problem. So, please clarify with your treating physician as I am sure there is some miscommunication and no body can give such medication for months without a definite diagnosis. In case of doubt please seek an opinion of a TB specialist. Of course it is a very toxic treatment and you should not conceive while you are taking this medication. But in case you do conceive there is no need to abort or anything like that. The net risk of abnormality in the fetus is not much. In future when you conceive you must get a Beta HCG test and ultrasound done at an early stage and in case of a repeat Ectopic get a medical treatment done. Once you get an ectopic you have a higher chance of having it again, though most pregnancies after an ectopic are normal and inside the uterus, still be careful and get an early diagnosis. Ectopic if treated early does not require any surgery and most cases now resolve with medical treatment and careful follow up. You have an overall risk of 10% of recurrent ectopic, that means 90% of your future pregnancies should be normal so you do not have to be too scared but have to be careful next time. At this stage, please get a review for your TB treatment and if really required and essential continue a short treatment which now a days is much shorter than it used to be and then plan a pregnancy. But if you do get pregnant in the meanwhile, even while the treatment is on, do not worry too much and continue, get serial Beta HCGs from the day you miss a period and urine pregnancy test is positive and get an early ultrasound. If there is any sign of ectopic get a medical treatment, if normal pregnancy, just continue, I wish you all the best for your future pregnancy.

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