Holistic and multidisciplinary approaches in a grandemultiparous woman with tuberculosis

Prevalence of tuberculosis in pregnancy is highly worldwide with more than 200,000 women with active tuberculosis in 2011, especially in Africa and South East Asia. Tuberculosis infection is caused by inhaled M. tuberculosis which gets into an active or dormant state. Adequate antenatal care is very important. Our research involved a newborn baby who has a mother with active tuberculosis, and both of them were treated. Mrs A, a 37 year old grandemultiparous woman, exhibited signs of premature labor at 34 weeks’ gestation. Upon presentation, she also developed cough, weight loss, and night sweats. Her chest X-ray showed a bilateral infiltrate pattern, suggestive of tuberculosis. She had a normal delivery at term pregnancy, giving birth to a small baby who was roomed-in with the mother. After being diagnosed with tuberculosis based on clinical and chest X-ray examination, she received a one-month treatment for tuberculosis and was planned to receive a total of six months of treatment. The baby also got isoniazid prophylaxis (INH) therapy for 6 months. Tuberculosis infection in the baby was ruled out, and the baby should be given isoniazid preventive therapy instead, followed by BCG vaccination after 2 weeks of treatment and negative skin test. Management of tuberculosis during pregnancy must be carried out by adopting not only a biological approach but also a psychosocial approach. The management should be disseminated among medical professionals, public health care officials, government agencies, and the patients.