TB Skin Testing While Pregnant

Nurses General Nursing

Published

Has anyone recieved the Mantoux tuberculin skin testing while pregnant? I'm hesitant to take the test while pregnant. There was not any information on the drug information sheet except it is not usually given unless the risk or TB outweigh possible risk of the drug.

sparrow

57 Posts

As an Employee Health Nurse, I make it a practice to only give the PPD to pregnant or nursing employees only with a written order from their OB/Gyn. Most don't object but occasionaly one does. Most ICP and EH nurses differ on this and there really is not a standard.

monica f

63 Posts

Sparrow - Do you know of any side effects of taking the TB Test while pregnant? My facility uses something called Tubasol (not quite sure if that is spelled right). On the lable it states to use only if risks of TB outweigh those of the drug. I'm approx. 5 months pregnant and leary of taking anything. Thanks for all the info.

KSEFLINK

51 Posts

As an Employee Health nurse for the last 4 years, I have given many PPD's to pregnant employees. Most MD's do not want any testing done in the first trimester, but are not against testing after that. Only one MD has asked his patient not to do testing, and that is because this particular employee was considered a high risk pregnancy and he did not want to chance anything. In fact, I have also given PPd's to pregnant docs; and in all of these cases, we have not seen any untoward affects. Always check with your own OB first, but speaking from experience I have never had any problems in this area. Thanks....Good wishes also on a healthy and happy pregnancy!

sparrow

57 Posts

I've not only never seen any adverse reactions, I've never even read of any. But it is individual physician preference and that is how I prefer to protect my nursing license!

Zumarrad

1 Post

[h=2]tuberculin purifed protein derivative (ppd)

the following was excerpted from the package insert for tubersol: [/h][h=2][color=#4f81bd]pregnancy and breastfeeding[/h]certain medicines should not be used during pregnancy or breastfeeding. however, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • tuberculin skin testing should not be carried out during pregnancy or breastfeeding, unless considered essential by your doctor. seek medical advice from your doctor.

[h=2][color=#4f81bd]side effects[/h]medicines and their possible side effects can affect individual people in different ways. the following are some of the side effects that are known to be associated with this medicine. because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

  • pain at the injection site
  • itching around the area of injection
  • ulceration at the injection site
  • headache
  • rash
  • nausea
  • fever (pyrexia)
  • dizziness
  • itchy rash (urticaria)
  • a general feeling of being unwell (malaise)
  • an extreme allergic reaction (anaphylaxis)

the side effects listed above may not include all of the side effects reported by the drug's manufacturer.

for more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

[h=2][color=#4f81bd]how can this medicine affect other medicines?[/h]tuberculin skin tests should not be carried out within four weeks of receiving a live viral vaccine, for example measles, mumps and rubella (mmr), oral polio, rubella, yellow fever.

also, the following information was gleaned from:

"the rationale for tb screening of healthcare workers and other low-risk populations: a critical review of cdc policy" by david ayoub, md

www.vaclib.org/basic/tbtest.htm

tubersol ingredients

the most commonly used mantoux skin test is tubersol® manufactured by aventis pasteur. the package insert claims that "tubersol is prepared from a large batch master batch, connaught tuberculin (ct68) and is a cell-free purified protein fraction obtained from a human strain of mycobacterium tuberculosis grown on a protein-free synthetic medium, and inactivated. tubersol is a sterile isotonic solution of tuberculin in phosphate buffered saline containing tween 80 as a stabilizer. 0.28 percent phenol is added as a preservative."

the 1972 edition of encyclopedia and dictionary of medicine and nursing defines phenol as "an extremely poisonous antiseptic, germicidal and disinfectant." the oxford universal dictionary (1955) defines phenol as "a hydroxyl derivative of benzene, commonly known as carbolic acid."

the current research on the stabilizer tween 80 reveals the following:

"neonatal female rats were injected ip (0.1 ml/rat) with tween 80 in 1, 5 or 10 percent aqueous solution on days 4-7 after birth. treatment with tween 80 accelerated maturation, prolonged the oestrus cycle, and induced persistent lady partsl oestrus. the relative weight of the uterus and ovaries was decreased relative to the untreated controls. squamous cell metaplasia of the epithelial lining of the uterus and cytological changes in the uterus were indicative of chronic oestrogenic stimulation. ovaries were without corpora lutea, and had degenerative follicles." ~ pmid: 8473002 [pubmed - indexed for medline]

in other words, female lab rats injected with tween 80 developed impaired sexual organs as well as premature development of their sexual organs. one can only imagine the cumulative effects of tween 80 in conjunction with all the other adjuvants and preservatives our own children are injected with.

this test is also composed of a protein fraction derived from a human strain of tuberculosis. aside from the shedding of rna and dna into the lymphatic system from this test, the presence of foreign proteins in one’s blood has been associated with the development of allergies.

how safe is it?

according to the tubersol package insert: “this product has never been tested for carcinogenic or mutagenic potentials or impairment of fertility” even so, aventis asserts that this product is safe to administer to pregnant women. and this is noted despite the fact that phenol is a known mutagen and associated with skin cancer development in animals that were injected intradermally.

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