Can Pregnant Women Safely Undergo Tuberculosis Skin Testing?

Is it appropriate for pregnant women to undergo skin testing for tuberculosis?

Due to a family member being hospitalized and isolated for tuberculosis, the health department has notified us that family members need to undergo chest X-rays.
My son, who is in kindergarten, will have a skin test instead.
As a pregnant woman, the health department mentioned that I could provide a sputum sample, but I am unable to produce any sputum at all.
I would like to know if I can first undergo a skin test.
The health center staff said that the skin test is primarily for children and advised me to wait until after delivery for the X-ray.
However, I am eager to know if I have been infected.
If I test positive, is it safe for a pregnant woman to take medication?

Zhang Xiaojie, 30~39 year old female. Ask Date: 2013/12/20

Dr. Zhou Ziguang reply Pulmonology

Hello,
1.
It is generally not recommended for pregnant women to undergo X-rays; instead, sputum tests can be performed three times to check for the presence of tuberculosis bacteria.

2.
Additionally, a blood test primarily for hepatitis C interferon can be conducted to determine if there is an infection.
This test requires a self-payment of NT$2500 at our hospital.

3.
A skin test can be performed, but currently, the testing reagent (PPD) is out of stock, and there is no supply available from abroad.

4.
Regardless of whether the skin test or hepatitis C interferon test is positive, it indicates an infection.
However, to initiate preventive medication, the possibility of pulmonary tuberculosis must be ruled out through a chest X-ray.
If an X-ray is absolutely necessary, abdominal protection can be provided.
Thank you,
Dr.
Wu Ying-Hsun,
Director of Internal Medicine,
Ministry of Health and Welfare

Reply Date: 2013/12/20

More Info

When it comes to tuberculosis (TB) skin testing during pregnancy, it is generally considered safe for pregnant women to undergo this procedure. The most common method for TB screening is the Mantoux tuberculin skin test, which involves injecting a small amount of purified protein derivative (PPD) into the skin. The test is designed to determine if a person has been exposed to the TB bacteria.
The safety of the TB skin test during pregnancy is supported by the fact that the amount of PPD used is minimal and does not pose a significant risk to the developing fetus. The American College of Obstetricians and Gynecologists (ACOG) states that the benefits of screening for TB in pregnant women, especially those who may be at higher risk due to exposure, outweigh any potential risks associated with the test itself.
In your case, since you have been in contact with a family member who has been hospitalized for TB, it is prudent to undergo testing to determine your TB status. If the skin test is positive, further evaluation will be necessary, which may include a chest X-ray. It is important to note that if a chest X-ray is required, special precautions will be taken to minimize radiation exposure to the fetus, such as using a lead shield.

If you are found to be positive for TB, the treatment options during pregnancy are available and can be managed safely. The first-line medications for treating active TB, such as isoniazid, rifampin, and ethambutol, are generally considered safe for use during pregnancy. However, it is crucial to work closely with your healthcare provider to monitor your health and the health of your baby throughout the treatment process.

In summary, undergoing a TB skin test during pregnancy is safe and can provide important information about your health status, especially given your recent exposure. If the test is positive, treatment options are available that are safe for both you and your developing baby. Always consult with your healthcare provider for personalized medical advice and to discuss any concerns you may have regarding your health and pregnancy.

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