Pregnancy combined with tuberculosis is common in women in China, and tuberculosis can involve all organs of the body. The principles and methods of anti-tuberculosis drug treatment in pregnancy combined with tuberculosis have their special characteristics, and are described below. The treatment of active tuberculosis in pregnancy is still based on chemotherapy, and special attention should be paid to the rational selection of anti-tuberculosis drugs in chemotherapy to ensure the safety of the fetus and to avoid damage or influence on the physiological function and development of the fetus. At present, it is believed that the principles of treatment of TB in pregnancy are similar to those of general TB, that is, the principles of early, combined, regular, moderate and full treatment must be followed. (1) Isoniazid: Although isoniazid can pass the placental barrier, it has not been found to have significant teratogenic effects. In a study conducted by the American Public Health Agency in the 1970s, 14 pregnant women were treated with INH and rifampin for 5-7 months and INH and ethambutol for 8-18 months, resulting in 11 normal deliveries and 11 viable infants (except for 3 pregnant women who chose the drug abortion trial) without any complications or fetal malformations. A total of 1302 women with TB in pregnancy were treated with INH and only one fetal abnormality was observed. This suggests that INH is safe for use in active TB in pregnancy. However, it is important to emphasize the use of vitamin B6 when applying INH to avoid unresponsiveness and encephalopathy in the infant. (2) Rifampicin: Since rifampicin can inhibit DNA-dependent RNA polymutase, especially in previous animal studies, RFP has been shown to have teratogenic effects during the third trimester of pregnancy. Therefore, there is concern that it may interfere with or affect fetal development and growth and produce malformations, especially during the first trimester of pregnancy. The malformations include physical disability, central nervous system lesions and hemorrhage. However, in recent years, Snider’s analysis of the literature reported 442 cases of women receiving RFP antituberculosis treatment during a total of 446 pregnancies, and the incidence of congenital fetal malformations was within the range of fetal malformations in the normal population. The Anti-TB Association of China stipulates that rifampicin-based antituberculosis drugs are prohibited during the third trimester of pregnancy. (3) Ethambutol: Ethambutol is one of the three drugs commonly used for TB complications in pregnant women. The use of EMB in pregnant women with drug-selective abortion for 12 weeks resulted in no abnormal findings in the aborted fetuses examined for optic nerve and other organs. bobrowitz reported that in 38 pregnant women treated with EMB during 42 pregnancies, 8 infants showed abnormalities, but no damage or effect of EMB on fetal optic nerve development was found, indicating that it had no effect on intrauterine development. (4) Aminoglycosides: These include streptomycin, kanamycin, and butamycin, the most commonly used being streptomycin. arpela E et al. reported that 82% of 40 pregnancies resulted in normal infants, but up to 17% of infants had damage to the eighth pair of cranial nerves, ranging from mild hearing loss to deafness in both ears. It can also cause teratogenicity. Therefore, aminoglycosides such as streptomycin are contraindicated for TB in pregnancy. (5) Pyrazinamide: Pyrazinamide is often used as the first-line antituberculosis bactericidal drug. The Clinical Committee of China Anti-TB Association pointed out in 1993 that: ① rifampicin should not be used in the first 3 months of pregnancy, but can be used after 3 months; ② avoid the use of aminoglycosides; ③ avoid the use of 1314Th, 1312Th; ④ prohibit fluazinic acid. 2. treatment of pregnancy complicated by multidrug-resistant tuberculosis infection With the emergence of multidrug-resistant tuberculosis bacilli, the treatment of pregnant women with combined tuberculosis often requires the application of second-line antituberculosis drugs, but the adverse effects of second-line antituberculosis drugs are not well understood. in the 1950s and 1960s, PAS was often used in combination with INH for antituberculosis treatment. snider DE Jr et al. reported that out of 1302 pregnant women PAS has mainly gastrointestinal adverse effects, which are difficult to tolerate during pregnancy. Although thiisonicotinamide and cycloserine have been reported to have no specific teratogenic effects, there is insufficient evidence to determine their safety in pregnancy, and both drugs are contraindicated in cases of TB in pregnancy. Fluoroquinolones (mainly fluazinic acid and ciprofluoperazine) may cause osteoarthropathy, and therefore this adverse effect must be taken very seriously and considered only in the setting of MDR-TB infection. Given the unclear safety and efficacy of many second-line antituberculosis drugs, there is a lack of guidance for the treatment of MDR-TB infection. Some physicians advocate early elective abortion in conjunction with antituberculosis treatment in pregnant women with MDR-TB infection.