Grasp the four critical periods, and patients with hepatitis B can also give birth to healthy babies

In the outpatient clinic, women patients often come to consult, and they will be inherited to the next generation when they have hepatitis B.In fact, hepatitis B is not a genetic disease and will not be inherited to the next generation.However, mothers with hepatitis B virus can transmit hepatitis B virus to their children through blood and/or body fluid during pregnancy or production.

Hepatitis B, also known as hepatitis B, referred to as hepatitis B, is a liver disease caused by hepatitis B virus (HBV).The main source of hepatitis B is a chronic hepatitis B virus infection.The hepatitis B infectiousness depends on the height of the HBV-DNA quantification (deoxyrum acidic acid of hepatitis B virus).

Hepatitis B spreads mainly include blood transmission, maternal and infant communication, body fluid transmission, and sexual contact communication.Maternal and infant communication mainly occurred in the palace, delivery and postpartum stage.Infected infections are infected in the uterine cavity when women are pregnant.During delivery, when the fetus passes through the birth canal, the fetus is exposed to the blood, amniotic fluid or vaginal secretions containing hepatitis B virus, or due to the contraction of the uterus, the placenta capillary rupture, the mother’s blood seep into the fetal blood circulation causes infection.Postpartum infection belongs to the horizontal transmission between patients with hepatitis B and neonatal. Newborn can be infected by the damaged skin or mucous membranes to contact the mother’s blood.

If women suffer from hepatitis B, they attach importance to several critical periods, and they can also give birth to a healthy baby through standardized maternal and infants.

Period 1: Preparation Period

Based on the principles of eugenics, it is recommended that women infected with hepatitis B virus conduct relevant examinations such as five quantitative testing, liver function, hepatitis B virus genes, hepatitis B virus genes, hepatitis B virus genes, hepatitis B virus genes before pregnancy, to understand their liver conditions, and comprehensively evaluate whether they are suitable for pregnancy.At the same time, it is best to conduct five quantitative testing of hepatitis B to understand whether there is a hepatitis B virus infection and hepatitis B surface antibody level. If necessary, hepatitis B vaccine is used to avoid infection with hepatitis B through passionate contacts.

Can I still get pregnant with hepatitis B?In terms of this problem: If it is a virus carrier, you can get pregnant; if you are a patient with chronic hepatitis B or patients with liver cirrhosis, you cannot get pregnant within half a year if you are using interferon or discontinuation;Patients with chronic hepatitis B, Entica, Ercavir, or Lamif, try to get pregnant after 3 to 6 months after switching to 3 to 6 months;If there are liver cirrhosis, liver failure, or liver cancer, you cannot get pregnant.It should be emphasized that if accidental pregnancy is used during the treatment of interferon antiviral treatment, it can increase the defect rate of fetal birth, which is usually not recommended to continue pregnancy.

Critical period 2: 24 to 28 weeks of pregnancy

At present, the propagation of hepatitis B mother and baby, which is effective after the effective mother -and -child blocking measures, mainly occurs in the palace, and there is no effective measures to prevent hepatitis B virus infection in the palace.If the mother’s load of hepatitis B virus is still higher than 2 × 105IU/ml in the middle of pregnancy (24-28 weeks), antiviral treatment needs to be started.The rate can reach 98%to 100%.If the load of hepatitis B virus is low, the treatment of antiviral treatment cannot increase the blockage rate of mother and baby. At the same time, considering the side effects of drugs and possible risks, the major clinical guides are not recommended to treat antiviral treatment.Pregnant women who use nucleoside analogs (NAS) for maternal and infants are used for antiviral treatment, and medicines need to be regulated under the guidance of doctors.Patients with hepatitis B must be regularly reviewed during pregnancy, and indicators such as liver function and hepatitis B virus load in accordance with doctors.

Critical period 3: During childbirth

Some expectant mothers with hepatitis B may worry that the childbirth will increase the risk of children’s infection.In fact, most of the existing research results show that the cesarean section did not reduce the incidence of hepatitis B maternal and baby transmission, and the method of childbirth was not directly related to the risk of transmission of hepatitis B.Therefore, it is recommended that pregnant women do not deliberately choose cesarean section because they have hepatitis B, but should decide the way of childbirth according to the advice of obstetricians.

Critical period 4: After childbirth

Prevention after childbirth is currently the most important maternal and baby blocking measures.The Guidelines for Prevention and Control of Chronic Hepatitis B (2019) pointed out that vaccinating hepatitis B vaccine is the most effective way to prevent hepatitis B.Babies who take childbirth for patients with hepatitis B or hepatitis B virus will be vaccinated with hepatitis B protein and hepatitis B vaccine within 24 hours after birth (preferably 12 hours).3 Penal hepatitis B vaccine, only three stitches are completed, can play an effective protective role in babies.

Some novice mothers with hepatitis B will also worry that breastfeeding will increase the risk of maternal and baby transmission.In fact, as long as the baby is vaccinated with hepatitis B immunoglobulin and hepatitis B vaccine in time, surface antibodies are produced. Breastfeeding does not increase the baby’s hepatitis B infection rate, so it can be breastfeed.Only when the baby’s mouth is obviously damaged and ulcer, breastfeeding can be suspended.If the mother still needs to treat antiviral treatment, she needs to decide whether to breastfeed after the doctor knows the advantages and disadvantages.

Text: Li Yanwu, Department of Infectious Department of the Second Affiliated Hospital of Anhui Medical University

Edit: Guan Zhongyao Liu Yang

School pair: Ma Yang

Review: Xu Bingnan Yan Yan

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