Tuberculosis during pregnancy is the third leading cause ofmaternal deaths in the city after sepsis (severe infection) and haemorrhage (excessive bleeding), according to the data compiled by the civic body's health department.
In 2013, maternal death committee under the Brihanmumbai Municipal Corporation (BMC) recorded 278 such deaths. Any woman dying during her pregnancy and within 42 days of giving birth is classified as a maternal death.
“There is a high stress of pregnancy on the woman's body and her immunity is weakened. Hence, for women already suffering fromTB, the risk of the infection aggravating is higher. The possibility of contracting it also increases considerably,” said Dr Ashok Anand, professor of gynaecology at JJ hospital. Close to 8% maternal deaths can be attributed to pulmonary and extra-pulmonary TB.
“Although we can’t say that TB directly caused death among pregnant patients, such a high association of the infection among pregnant women could be a double scary scenario,” said Dr Deepesh Reddy, former consultant with World Health Organisation for TBcontrol.
Doctors said symptoms such as weight loss could be masked by the temporary weight gain that is natural during pregnancy/ "Also TBmight get masked in the late stages of pregnancy, which can result in the child contracting the infection. This can be fatal for the baby,” said Reddy.
The civic body is mulling over a proposal to include TB testing in the antenatal care clinics.
Dr Y Nandanwar, head of gynaecology department at Sion hospital, recalled a case of a 35-year-old woman suffering from stomach TB, who died after child birth. "The infection flared up after she delivered the child. The incidence of TB among pregnant woman is equal to the general population, but treating them is challenging,” said Nandanwar.
Top Five Causes of Maternal Deaths in Mumbai
* Post-partum and pre-partum haemorrhage
* TB and pregnancy
* Hepatitis E