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Social & Preventive Medicine General 236a6734

Treatment of choice for sputum positive pulmonary tuberculosis detected in 1st trimester of pregnancy ?

A
Defer till second trimester
B
Sta cat. I immediately
C
Sta cat. II immediately
D
Sta cat. III immediately
High-Yield Explanation
Ans. is 'b' i.e., Sta cat. I immediately Sputum positive tuberculosis falls under category I; therefore category I treatment should be staed Treatment of tuberculosis in Pregnanacv Work up and treatment of tuberculosis should not be delayed in Pregnant women. All pregnant women with active tuberculosis should be treated immediately because the risk to the mother and fetus is 1.6 much higher from maternal tuberculosis than it is from potential harm from the anti-tubercular drugs. First line drugs can be safely used in pregnancy except streptomycin which is contraindicated because of its associated with fetal ototoxicity. Second line drugs are not recommended in pregnancy (They are used only if benefit outweighs the risk, as in case of MDR tuberculosis) Pyrazinamide is not recommended by CDC (USA) in absence of sufficient safety data, however many tubercular authorities all over world suppo its use. CDC recommends an alternative 9 month regimen containing isoniazid and rifampin throughout (supplemented by ethambutol, until drug susceptibility results are available). Breastfeeding is not contraindicated in women using antituberculosis drugs.

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