Abstract
Multidrug-resistant tuberculosis (MDR-TB) is identified from the time of introduction of antituberculosis treatment and is a known worldwide public health crisis affecting women of reproductive age group. Management issues raised by pregnant women with MDR tuberculosis are challenging due to the limited clinical experience available with the use of second line drugs. We hereby report two cases of MDR-TB during pregnancy: one patient was on second line drugs, while another one was evaluated and diagnosed to have MDR-TB in last trimester. At 6 months of follow-up both mothers and babies are doing well. The approach to such cases along with review of the literature is discussed.
Highlights
Multidrug-resistant TB (MDR-TB) is described as M. tuberculosis infection resistant to rifampicin and isoniazid with or without resistance to other drugs
Paucity of data and lack of consensus regarding management of MDR-TB during pregnancy set it as controversial issue
Most clinicians had discouraged patients from becoming pregnant or proceeding with existing pregnancy [14]. In many times these patients are undertreated by health care providers because of posed management challenges, that is, insufficiency of data regarding safety
Summary
Multidrug-resistant TB (MDR-TB) is described as M. tuberculosis infection resistant to rifampicin and isoniazid with or without resistance to other drugs. This form of tuberculosis is prevalent in most countries [1]. There are less than 100 reported cases of gestational MDR-TB and its prevalence is likely to increase because of increased resurgence of TB in pregnancy. There is increased risk of obstetrical complications like spontaneous abortions, fetal growth restriction, oligohydramnios, preterm labor, and increased neonatal mortality [8,9,10,11]. More assertive treatment with second line drugs is required for treating such cases which are generally more virulent and require closed supervision. Prolonged antitubercular treatment of 18–24 months after sputum culture conversion is the standard of care for such patients
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