TB+screening+in+prenatal+patients

TB screening in prenatal patients
Please screen pregnant women for TB //only// if they are at high risk for exposure, meaning:
 * Out of the US in a high incidence country for longer than a month in the last 5 years
 * In jail, homeless or used street drugs in the last 2 years
 * Had a positive PPD in the past AND 1) has NOT taken INH x 6 months 2) has NOT had a subsequent negative Quantiferon
 * Known exposure to tuberculosis since last screening

To screen high-risk women:
 * Ok to use Quantiferon for all women, (if PPD already negative this pregnancy, do not do Quantiferon), then CXR if positive
 * If the Quantiferon is indeterminate, consider repeating the Quantiferon or place a PPD, then CXR if positive.

Screening patients in future pregnancies:
 * Once a patient has a positive QFT, there is no need to repeat the test.
 * Patients do not need repeat CXRs. If the patient has a known positive QFT, negative CXR and has not undergone treatment, you only need to document a negative Symptom Screen. No repeat CXR is necessary.

If the patient is low risk, please mark "Low Risk" in the appropriate section of the prenatal record and do no further testing.

See the TB page for more details.