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Will taking drugs for tuberculosis harm my foetus?

Q: I am a 25 year old married woman and I am 15 weeks pregnant. This is my 1st pregnancy. I have a close family history of tuberculosis and that is why I underwent some tests for TB. My IgA and IgM came positive, Mantoux was negative. My doctor prescribed the PCR test for live bacteria, unfortunately it came positive. Now I have to take ATT. There is no clinical complaint and, in fact, I am overweight with 62 kg. Is it necessary to take ATT right now? Can I delay it up to my delivery five months later? Is it true that I will gain weight during ATT? Is it harmful for my baby?

A:I am not sure of what you mean by a family history in tuberculosis. In a country like India practically everyone has a family history of TB and IgM and IgA are found positive in a large population. They only mean you have been exposed to TB which most of us are in India. The PCR test is even more inconclusive. I do not know if you have no signs or symptoms why you have been prescribed ATT. PCR or IgM and IgA being positive certainly cannot be a reason to take ATT. There seems to be a lack of communication. I can't believe that anyone can give ATT to a pregnant woman on account of tests like PCR. I hope that you are aware of the serious consequences all these medicines have on the foetus. Please reconfirm it from your doctor the reason of why they want to give you ATT at this stage. I suggest you should take a special opinion from a tuberculosis expert and not a gynaecologist looking after your pregnancy neither a general physician. Only if he/she believes that you are suffering from tuberculosis the disease and not IgA tests or PCR should you be taking ATT. It seems pretty illogical to take these potentially hazardous medicines at this stage only on the basis of PCR. In fact PCR has no clinical value at all. The decision to treat or not to treat depends purely on signs and symptoms like fever, cough and weight loss etc. Your treating physician will make the final decision but please do not base it on a lab report like PCR.

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