Effects of Isoniazid + Rifampicin+ Pyridoxine on fetus during first trimester in pregnancy
A 28 years old female patient was diagnosed with Extrapulmonary Tuberculosis (Lymph node at neck) and was on following medications, i.e., Tablet Isoniazid, Rifampicin and Pyridoxine. During the course of treatment (3rd month) she was confirmed with pregnancy (7th week).The gynecologist asked the patient to contact our DIC for the effects of above tablets on fetus during first trimester.
Comments: Isoniazid and Rifampin, is considered to be relatively safe for both the mother and the fetus for treating active tuberculosis infection in pregnancy. Although a clear causal relationship has not been established, pulmonary tuberculosis infection itself has been associated with a significantly higher frequency of miscarriage. There are also case reports of infants with congenital tuberculosis and drug-resistant disease may present an increased risk to the fetus. Careful clinical and laboratory monitoring for hepatitis is recommended.
- Pyridoxine supplementation (25 milligrams/day) is recommended for all women taking isoniazid who are either pregnant or breastfeeding.
- When rifampin is given during the last several weeks of pregnancy, chances of postnatal hemorrhages may occur in the mother and infant.
- The American Thoracic Society recommends use of the anti-TB drugs for tuberculosis occurring during pregnancy because, “Untreated tuberculosis represents a far greater hazard to a pregnant woman and her fetus than does treatment of the disease”.