Chapter 11: Tuberculosis

Question 1

Tuberculosis (TB)

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Answer 1

infectious, communicable disease caused by Mycobacterium tuberculosis

• causes inflammatory infiltrations most commonly in the respiratory tract; may also affect GI and GU tracts, bones, joints, nervous system, lymph nodes, and skin
• TB can lead to fetal infection

Question 2

What happens to the fetus with TB

Answer 2

may lead to fetal infection
-TB can spread to the fetus from the maternal blood if the bacilli cross the placenta and enter the umbilical vein
-fetal blood then passes through the liver, and this organ serves as the primary focus for the disease in the fetus and newborn
>if the bacilli bypass the fetal liver, the lungs may become the primary infection site
>neonates may become infected at the time of birth by aspiration of infected amniotic fluid or by aspiration of infected blood and tissue if mother has tuberculosis endometritis
>also become infected airborne route if individuals in infant’s environment have pulmonary tuberculosis

Question 3

Treatment

Answer 3

for active TB; isoniazid, ethambutol, and rifampin that are considered safe during pregnancy
-therapy continued for 9 months
-breastfeeding not contraindicated and can continue during anti-TB therapy; medication does not cross into breastmilk
>if infant concurrently taking oral anti-tuberculosis therapy, excessive drug levels may be reached in the neonate and breastfeeding should be avoided

Question 4

Immunizations during Pregnancy

Answer 4

ideal time is usually during the preconceptional period
-can administer tetanus toxoid, reduce diphtheria toxoid, and acellular pertussis vaccine (Tdap) during each pregnancy, irrespective of patients prior history of receiving Tdap