DR-TB Treatment in Pregnancy: Recommendation for the Use of Contraception
Counsel women of childbearing age on contraception during DR-TB treatment and while awaiting C&DST results due to potential risks. Oral contraceptives may be less effective; consider barrier methods, IUDs, or depot injections as safe alternatives.
DR-TB Treatment in Pregnancy: Recommendation for the Use of Contraception
All women of childbearing age who are awaiting the results of Culture and Drug Susceptibility Tests (C&DST), as well as those receiving Drug-resistant TB (DR-TB) treatment, should be intensively advised and counselled to use birth control measures due to the potential risk to both the mother and the foetus.
It should be noted that oral contraceptives might have decreased efficacy due to vomiting and drug interactions with DR-TB drugs, such as the use of Rifampicin in mono/poly resistant TB.
Contraception methods that can be used during DR-TB treatment, based on individual preference and eligibility, are:
- Barrier methods (e.g., condoms/diaphragms)
- Intrauterine devices (e.g., CuT)
- Depot medroxyprogesterone (Depo-provera)
In women, the Isoniazid (H) mono/poly DR-TB regimen may be started or continued safely, except that care should be taken while using oral contraceptives.
A woman on oral contraception, while receiving rifampicin treatment, may choose between two options following consultation with a physician:
- Use of an oral contraceptive pill containing a higher dose of oestrogen (50 μg)
- Use of another form of contraception
Resources
- Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021
- Consolidated Guidelines on Tuberculosis: Module 4 - Treatment: Drug-resistant TB Treatment, 2020
- Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-resistant Tuberculosis, 2014
- Collaborative Framework for Management of Tuberculosis in Pregnant Women, 2021