[TB Screening of Pregnant Women in Accordance with the German Protection Against Infection Act]

Abstract

Pregnant women should be tested with immune tests for tuberculosis when they undergo TB screening according to the German Infectious Diseases Protection Act. Interferon Gamma Release Assays (IGRAs) should be the priority tests used for pregnant refugees and asylum seekers, especially when migrating from high incidence countries (> 20 cases/100.000 population according to the ECDC) or when they fled from crisis regions; positive tuberculin skin tests should be veryfied with IGRA. Once immunological tests are suggesting a latent tuberculosis infection it should be considered that pregnant women have an increased risk of developing active tuberculosis with potential health threats for the unborn child. Therefore, in case of a justified clinical suspicion of active tuberculosis or when a positive immunological test is present, pregnant women should be considered for chest X-ray examination, in order to rule out active pulmonary TB. Further examinations (such as ultrasound) to rule out extrapulmonary TB should be undertaken, once active pulmonary TB has been ruled out. A treatment indication is given for pregnant women during pregnancy, once active TB has been veryfied.