From the Guidelines
Yes, you can get a TB test when pregnant, as the tuberculin skin test is considered safe during pregnancy and does not have adverse effects on the pregnant mother or fetus 1.
Importance of TB Testing During Pregnancy
The two main types of TB tests, the tuberculin skin test (TST) and the interferon-gamma release assay (IGRA) blood test, are both considered safe during pregnancy. These tests don't contain live bacteria and won't cause TB infection or harm the developing baby.
Risks of Untreated TB
In fact, testing for TB during pregnancy is important because untreated TB can lead to complications for both mother and baby, including premature birth, low birth weight, and increased maternal and infant mortality.
Who Should Get Tested
If you're at high risk for TB (such as having close contact with someone with active TB, being from a country with high TB rates, or having HIV), your healthcare provider may recommend testing 1.
Follow-Up Evaluation
If a TB test is positive, additional evaluation including a chest X-ray (with proper shielding) may be needed.
Treatment Options
Treatment for TB, if needed, can be safely administered during pregnancy using medications like isoniazid, rifampin, and ethambutol, though some TB medications like streptomycin should be avoided during pregnancy. Key points to consider:
- Pregnancy has minimal influence on the pathogenesis of TB or the likelihood of LTBI progressing to disease 1
- The current classification scheme for interpreting the Mantoux tuberculin skin test is likely valid in pregnancy, although it has not been verified in this group of women 1
- Pregnant women should be targeted for tuberculin skin testing only if they have a specific risk factor for LTBI or for progression of LTBI to disease 1
From the FDA Drug Label
Pregnant Women with Tuberculosis The options listed above must be adjusted for the pregnant patient Streptomycin interferes with in utero development of the ear and may cause congenital deafness. Routine use of pyrazinamide is also not recommended in pregnancy because of inadequate teratogenicity data. The initial treatment regimen should consist of isoniazid and rifampin Ethambutol should be included unless primary isoniazid resistance is unlikely (isoniazid resistance rate documented to be less than 4%).
The answer to whether you can get a TB test when pregnant is not directly addressed in the provided drug label. However, it discusses the treatment of tuberculosis in pregnant women, implying that TB testing is a necessary step before treatment.
- Key points:
- The label provides guidance on treating tuberculosis in pregnant women.
- It does not explicitly state that TB testing is contraindicated in pregnancy.
- The focus is on adjusting treatment regimens for pregnant patients. Therefore, based on the information provided, it appears that TB testing is not contraindicated in pregnancy, but the label does not directly answer the question 2.
From the Research
TB Testing During Pregnancy
- A TB test can be performed during pregnancy if indicated by a TB evaluation, which consists of a TB risk assessment, medical history, physical examination, and a symptom screen 3.
- The diagnosis of TB may be delayed in pregnancy due to the masking of its symptoms by those of pregnancy, making timely testing and treatment crucial 4.
- Interferon-gamma release assays and the tuberculin skin test are acceptable screening tests for TB during pregnancy, with the latter supported by more data in pregnancy 5, 6.
Indications for TB Testing
- A TB test should be performed if a pregnant woman has signs or symptoms of TB or if the test result for TB infection is positive 3.
- Women who are severely immunosuppressed, human immunodeficiency virus positive, or recently exposed to TB should be considered for prophylaxis, which may be deferred until 3 months postpartum 5.
- Pregnant women with latent TB infection may not require treatment while pregnant, but close follow-up and monitoring are necessary 3, 6.
Safety of TB Testing and Treatment
- Isoniazid with pyridoxine for 9 months is a preferred treatment for latent TB infection during pregnancy, with reasonable safety in pregnancy and breastfeeding 5.
- Monitoring for maternal hepatotoxicity is recommended when treating latent TB infection during pregnancy 5, 6.
- Efforts should be made to improve adherence with follow-up and treatment post-partum, as the incidence of active TB may be increased during the postpartum period 6.