Hepatitis C and pregnancy. This is not a sentence! Viral hepatitis B in pregnant women - what do you need to know? Got pregnant while being treated for hepatitis

Hepatitis C and pregnancy are a combination that frightens expectant mothers. Unfortunately, these days this diagnosis is increasingly being discovered during pregnancy. The disease is diagnosed using standard screening for infections - HIV, hepatitis B and C, which all expectant mothers undergo. According to statistics, the pathology is found in every thirtieth resident of our country, that is, the disease is quite common.

Today, very little is known about the interaction between chronic hepatitis C and pregnancy. It is only known that the consequences of this condition may include miscarriage and premature birth, the birth of a child with insufficient body weight, infection of the fetus during childbirth, and the development of gestational diabetes in the expectant mother.

Hepatitis C is a viral liver disease. The virus enters the human body mainly through the parenteral route - through the blood. Signs of hepatitis C infection usually appear in an erased form, so the pathology, remaining undetected at a certain moment, easily becomes a chronic process. The prevalence of hepatitis C among the population is steadily increasing.

Main routes of infection:

• blood transfusion (fortunately, in recent years this factor has lost its significance, since all donor plasma and blood are necessarily tested for the presence of the virus);
• unprotected sexual intercourse with a virus carrier;
• using a syringe after a sick person;
• non-compliance with personal hygiene standards - sharing razors, nail scissors, toothbrushes with a virus carrier;
• infection with contaminated instruments when applying piercings and tattoos to the skin;
• professional activities related to blood - infection occurs accidentally, for example, during hemodialysis;
• infection of the fetus during its passage through the birth canal.

The virus is not transmitted through household contact and airborne droplets.

Risk groups for hepatitis C infection include:

• people who underwent surgery before 1992 inclusive;
• health care workers who regularly work with people infected with hepatitis C;
• people who use drugs by injection;
• HIV-infected persons;
• people suffering from liver pathologies of unknown origin;
• persons regularly receiving hemodialysis;
• children born to infected women;
• people who are promiscuous without using condoms.

Symptoms

It should be noted that most people infected with the hepatitis C virus do not notice any symptoms for a long time. Despite the fact that the disease is hidden, a mechanism of irreversible processes is triggered in the body, which can ultimately lead to the destruction of liver tissue - cirrhosis and cancer. This is the insidiousness of this disease.

In approximately 20% of infected people, symptoms of the pathology still appear. They complain of general weakness, drowsiness, deterioration in performance, lack of appetite and constant nausea. Most people with this diagnosis lose weight. But most often there is discomfort in the right hypochondrium - exactly where the liver is located. In rare cases, pathology can be judged by pain in the joints and rashes on the skin.

Diagnostics

In order to make a diagnosis, a probable carrier of the virus must undergo the following diagnostic tests:

• determination of antibodies to the virus in the blood;
• determination of AST and ALT, bilirubin in the blood;
• PCR - analysis to determine the RNA of the virus;
• ultrasound examination of the liver;
• liver tissue biopsy.

If the studies have shown a positive result for the presence of hepatitis C in the body, this may indicate the following facts:

1. A person is sick with a chronic form of the disease. He should undergo a biopsy of liver tissue in the near future to clarify the extent of its damage. You also need to do a test to identify the genotype of the virus strain. This is necessary to prescribe appropriate treatment.
2. The person has had an infection in the past. This means that the virus previously entered the person’s body, but his immune system was able to cope with the infection on its own. There is no data on why the body of specific people was able to overcome the hepatitis C virus, while others continue to suffer from it. It is generally accepted that much depends on the state of immune defense and the type of virus.
3. The result is false positive. Sometimes it happens that during the initial diagnosis the result may be erroneous, but upon repeated analysis this fact is not confirmed. The analysis needs to be repeated.

Features of the course of infection in pregnant women

Typically, the course of hepatitis C has no relationship with the process of pregnancy; complications occur quite rarely. A woman suffering from this disease requires more careful monitoring throughout her gestation period, since she has an increased risk of spontaneous abortion and the likelihood of developing fetal hypoxia compared to healthy women.

A patient with this disease should be monitored not only by a gynecologist, but also by an infectious disease specialist. The probability of fetal infection during pregnancy and childbirth is no more than 5%. However, it is impossible to prevent the baby from becoming infected 100%. Even if a woman, as a carrier of hepatitis C, undergoes an operative birth - a cesarean section, this is not a prevention of infection.

Therefore, after birth, the child is tested to determine the virus in the blood. In the first 18 months of a baby's life, antibodies to hepatitis C obtained during pregnancy can be detected in the blood, but this cannot be a sign of infection.

If the baby’s diagnosis is still confirmed, it is necessary to monitor him more carefully with a pediatrician and infectious disease specialist. Children born to infected mothers are allowed in any case, since the virus is not transmitted through milk.

Treatment methods for pregnant women

Currently, there is no vaccine against the hepatitis C virus. But it can be treated. The main thing is to notice the infection in time: the chances of recovery will be higher if the infection was noticed at the very beginning.

Treatment of hepatitis C must be comprehensive. The basis of therapy is drugs that have a powerful antiviral effect. Ribavirin and Interferon are most often used for this purpose. But, according to additional studies, these drugs have a negative effect on the developing fetus. Therefore, it is not advisable to treat hepatitis C during pregnancy.

There are cases when specialists are forced to prescribe specific therapy to a woman. This usually happens when the expectant mother develops clear symptoms of cholestasis. In this situation, her condition deteriorates sharply, and something urgently needs to be done. This happens infrequently - in one woman out of 20.

If there is a need to treat hepatitis C during pregnancy, doctors give preference to those medications that are relatively safe for the expectant mother and her child. Usually this is a course of injections based on ursodeoxycholic acid.

How is childbirth carried out in infected women?

In obstetrics, statistics have long been kept on which method of delivery increases the risk of infection of the newborn or, on the contrary, decreases. But unambiguous statistics have not yet been obtained, since the probability of infection during childbirth is approximately the same both in the case of a cesarean section and in the natural process.

If a woman has hepatitis C, delivery will be carried out by caesarean section if liver tests are unsatisfactory. Usually this happens to one expectant mother out of 15. In other cases, doctors choose the method of delivery based on the patient’s health condition.

Infection of a child during childbirth can only occur from the mother’s blood at the moment when the baby passes through the birth canal. If medical personnel are aware of the mother's illness, then infection of the child is almost impossible - no more than 4% of cases. The experience and professionalism of doctors will help to eliminate as much as possible the baby’s contact with the mother’s blood secretions; in some cases, an emergency caesarean section is performed.

Prevention of hepatitis C

When planning a pregnancy, every woman should be tested for the presence of hepatitis C virus in her blood. Since infection usually occurs through contact with the blood secretions of a sick person, you should try to avoid any interactions with this physiological environment.

You cannot share needles, water, tourniquets and cotton wool, that is, all items that are used for injections. All medical instruments and dressings must be disposable or sterilized. You should also not use someone else’s toothbrushes, manicure items, or earrings, since the virus can remain viable on all these things for up to 4 days.

Piercings and tattoos should be done with disposable sterile material. Wounds and injuries on the body must be disinfected with antiseptics, medical glue or sterile plasters. When entering into intimate relationships with different partners, you should use condoms.

It should be noted that most women, faced with hepatitis C during pregnancy, begin to consider their lives over. But you don’t need to get upset and depressed, this will only cause more harm to yourself and your child. In practice, many women whose pregnancy occurs after treatment for hepatitis C or against its background have been able to successfully carry and give birth to completely healthy children.

Useful video about the course of pregnancy against the background of hepatitis C

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Hepatitis is the general name for inflammatory liver diseases that arise from various causes. As you know, the liver is an organ that plays an important role in digestion and metabolism, or, in other words, the central organ of the body’s chemical homeostasis. The main functions of the liver include the metabolism of proteins, fats, carbohydrates, enzymes, the secretion of bile, the detoxifying function (for example, the neutralization of alcohol) and many others.

A variety of liver dysfunction in a pregnant woman can be caused by pregnancy, or can only coincide with it in time. If pregnancy proceeds normally, the structure of the liver does not change, but during this period there may be a temporary disruption of its function. This disorder occurs as a reaction of the liver to a sharp increase in the load on it due to the need to neutralize fetal waste products. In addition, during pregnancy, starting from the first trimester, the content of hormones, primarily sex hormones, the exchange of which also occurs in the liver, increases significantly. Temporary dysfunction in pregnant women can lead to changes in some biochemical parameters. Similar changes also appear during liver diseases, therefore, to diagnose the stability of the disorder, they should be examined in dynamics, repeatedly, and compared with the physical state of the pregnant woman. If within 1 month after birth all the changed indicators returned to normal, the disorder was temporary, caused by pregnancy. If normalization is not observed, this may confirm hepatitis. The main cause of hepatitis is viruses.

Acute viral hepatitis

Viral hepatitis, and, in particular, acute viral hepatitis (AVH) are the most common liver diseases that are not causally related to pregnancy. Typically, the severity of viral hepatitis increases with increasing pregnancy.

Currently, there are several variants of acute viral hepatitis.

Hepatitis A is transmitted by the fecal-oral route (with contaminated feces of a sick person with water, food, dirty hands, household items, etc.) and is cured spontaneously, without the intervention of doctors. Viral hepatitis A is an intestinal infection. It is contagious in the pre-icteric stage of the disease. With the appearance of jaundice, the patient ceases to be contagious: the body has coped with the causative agent of the disease. In the vast majority of cases, this type of viral hepatitis does not become chronic; there is no carriage of the virus. People who have undergone HCV A acquire lifelong immunity. Typically, hepatitis A does not have a significant effect on the course of pregnancy and childbirth, or on the development of the fetus. The child will be born healthy. He is not at risk of infection and does not need special prevention. If the disease occurs in the second half of pregnancy, it is usually accompanied by a deterioration in the woman’s general condition. Childbirth can worsen the course of the disease, so it is advisable to delay the delivery date until the end of jaundice.

Hepatitis B and C transmitted parenterally (i.e. through blood, saliva, vaginal secretions, etc.). Sexual and perinatal routes of transmission play a much less significant role. Often the disease becomes chronic. In mild cases, the virus attack is asymptomatic. In other patients, jaundice may also be absent, but there are complaints from the gastrointestinal tract and flu-like symptoms. The diagnosis can be difficult to even suspect if there is no evidence of possible infection with hepatitis viruses. The severity of the disease accompanied by jaundice can vary - from the form when the disease ends in complete recovery, to its chronic course. There is some possibility of the virus passing through the placenta and, accordingly, the possibility of intrauterine infection of the fetus. The risk of infection increases significantly during childbirth.

Hepatitis D(delta) is also transmitted parenterally and affects only people already infected with hepatitis B. As a rule, it worsens the course of hepatitis.

Hepatitis E Like hepatitis A, it is spread through the fecal-oral route, with the source of infection usually being contaminated water. This virus is especially dangerous for pregnant women, since the incidence of severe forms of the disease is high when infected.

In general, the clinical course of hepatitis A, B and C is similar, although hepatitis B and C are more severe.

Chronic hepatitis

In the International Classification of Liver Diseases, chronic hepatitis (CH) is defined as an inflammatory disease of the liver caused by any cause and lasting without improvement for at least 6 months. Up to 70-80% of all chronic hepatitis are hepatitis of viral etiology (hepatitis B and C viruses). The remaining part accounts for autoimmune toxic (for example, drug) and nutritional (in particular, alcoholic) hepatitis. Pregnancy due to hCG is rare; this is largely due to menstrual dysfunction and infertility in women with this pathology. The more severe the disease, the higher the likelihood of developing infertility. This is explained by the fact that the liver is an organ involved in the metabolism of hormones, and during chronic processes in the liver there is a serious imbalance in the concentration and ratio of sex hormones. As a result, there is a lack of ovulation (the release of an egg from the ovary) and a normal menstrual cycle. However, in some cases, doctors manage to achieve remission of the disease, restoration of menstrual function and fertility. However, permission to continue pregnancy can only be given by a antenatal clinic physician or a hepatologist after a thorough comprehensive examination of the woman. Therefore, a pregnant woman suffering from hCG should be hospitalized in a hospital already in the first trimester, where there is an opportunity for a full examination. The degree of activity and stage of hCG outside pregnancy are determined by morphological examination of a liver biopsy. Liver biopsies are not performed in pregnant women in our country, so the main diagnostic methods are clinical (based on an analysis of the woman’s complaints and her life history) and laboratory.

Diagnostics

The main clinical signs of hepatitis in pregnant women, as well as in non-pregnant women, are the same and include a number of syndromes:

• dyspeptic (nausea, vomiting, loss of appetite, stool, increased gas formation in the intestines),
• asthenoneurotic (unmotivated weakness, fatigue, poor sleep, irritability, pain in the right hypochondrium),
• cholestatic (jaundice due to impaired bile secretion, skin itching).

These symptoms can also occur during a more or less normal pregnancy without hepatitis, so do not diagnose yourself ahead of time, but contact your doctor with complaints, so that he, in turn, can understand the causes of these conditions. Do not self-medicate, because after all, hepatitis cannot be completely ruled out before examination, and you will waste precious time. If you suspect AVH, the doctor always tries to find out whether there was a possibility of infection, asking about contacts, recent travel, previous injections and operations, blood transfusions, dental treatment, presence of tattoos, piercings, eating unwashed vegetables, fruits, raw milk, shellfish (4 epidemics of AHSA have been described due to the consumption of raw shellfish and oysters from contaminated water bodies).

To resolve the issue of possible viral liver damage, to determine the type of virus and stage of the disease, it becomes necessary to conduct special tests. One of them is a blood test for the presence of HBs antigen (HBs – Ag 2 ). The HBs antigen is a fairly reliable sign of infection with the hepatitis B virus. Since hepatitis B is a widespread infectious disease, which is not only a serious problem for a pregnant woman and her child, but also potentially dangerous for people in contact with her, there is a need for mandatory testing for this virus.

During pregnancy, it is now mandatory to donate blood three times to detect the HBs antigen. In the absence of a negative test during the last three months before birth or with a positive test for HBs-Ag, a pregnant woman, as a rule, cannot give birth in the same maternity unit with uninfected women in labor. This frequency of testing is associated with the possibility of false negative results, as well as the likelihood of infection already during pregnancy as a result of injections, dental treatment, etc.

Since in diagnosing the activity (aggression) of chronic hepatitis during pregnancy, doctors cannot resort to biopsy, as the most reliable diagnostic method, this indicator is determined by a several-fold increase in the level of aminotransferases (alanine ALT and aspartic AST) - enzymes that enter the bloodstream during breakdown of liver cells. The degree of their activity corresponds to the intensity of the inflammatory process in the liver and is one of the main indicators of the dynamics of hepatitis. Therefore, the doctor may recommend repeated biochemical blood tests. It should be remembered that blood must be donated in the morning on an empty stomach after a 12-14 hour fast. Ultrasound examination of internal organs helps in diagnosing the stage of hepatitis.

Treatment

Drug therapy has undergone significant changes in recent years. For the treatment of viral hepatitis, practically the only group of drugs is etiotropic, i.e. directed directly against the virus, actions with proven effectiveness are interferons. Interferons were discovered in 1957. They are a group of proteins synthesized by human blood leukocytes in response to exposure to the virus. They can be called antiviral antibiotics. However, this type of therapy is not used during pregnancy, which is associated with potential danger to the fetus. Treatment with other groups of drugs is carried out strictly as prescribed by the doctor.

Pregnant women who have recovered from CVH or suffer from CVH in remission do not need drug therapy. They should be protected from exposure to hepatotoxic substances (alcohol, chemical agents - varnishes, paints, car exhausts, combustion products and others, from drugs - non-steroidal anti-inflammatory substances, some antibiotics, some antiarrhythmic drugs, etc.). They should avoid significant physical exertion, overwork, and hypothermia. You should adhere to a 5-6 meals a day diet, following a special diet (the so-called table No. 5). Food should be rich in vitamins and minerals.

A pregnant woman suffering from hCG should remember that a favorable course of the disease in some cases can turn into a severe one at any time, so she must strictly adhere to all the advice of the doctor supervising her.

Women with acute viral hepatitis give birth in special infectious diseases departments. Pregnant women suffering from hepatitis of non-viral etiology, who do not pose a potential danger, are in maternity hospitals in the department of pathology of pregnant women.

The question of the method of delivery is decided individually. If there are no obstetric contraindications for normal delivery, then, as a rule, the woman gives birth herself, through the natural birth canal. In some cases, doctors resort to caesarean section.

Hormonal contraception for women suffering from hepatitis is contraindicated, since both their own hormones and hormones introduced externally with a contraceptive pill are metabolized in the liver, and its function is significantly impaired in hepatitis. Therefore, after the birth of a child, you should think about another, safe, method of contraception.

It should be said that the presence of severe hepatitis in a pregnant woman can negatively affect the development of the fetus, since with severe impairment of liver function, fetoplacental insufficiency develops due to circulatory disorders and changes in the blood coagulation system. Currently, there is no clear answer to the question of the teratogenic effect of hepatitis viruses on the fetus. The possibility of vertical (from mother to fetus) transmission of the virus has been proven. Breastfeeding does not increase the risk of infection in the newborn; the risk increases if the nipples are damaged and there are erosions or other damage to the newborn's oral mucosa.

Due to the possibility of transmission of the hepatitis B virus from mother to child, immunoprophylaxis of infection carried out immediately after the birth of the child is of great importance. Combined prophylaxis prevents the disease in high-risk children in 90-95% of cases. The woman should discuss the need for such measures with her pediatrician in advance.

Pregnancy is a special condition of a woman, when she is not only awaiting the birth of a baby, but is also especially vulnerable to all kinds of infections. Hepatitis B and pregnancy can coexist peacefully, but all risks must be taken into account. Experts consider hepatitis B to be one of the dangerous diseases that poses a serious global problem. This is due, first of all, to the steadily growing number of cases. In addition, the disease easily passes into an active or advanced phase, and complications such as carcinoma and liver cirrhosis may occur.

Hepatitis B and pregnancy can coexist peacefully, but the risks must be taken into account

What are the risks of hepatitis B during pregnancy?

Any illnesses of a woman in an interesting position can negatively affect not only her well-being, but also affect the normal development of the unborn child. However, becoming pregnant and being diagnosed with hepatitis B is currently not a death sentence. These concepts are compatible provided that pregnant women have proper medical supervision and follow proper instructions regarding their own health. It is important to know the dangers of hepatitis B during pregnancy and follow all the recommendations of the hepatologist. To do this, you need to register with the antenatal clinic as early as possible, take the necessary tests and draw up a correct observation or treatment plan.

Average, The incubation period ranges from 6 to 12 weeks. In some cases, it can vary from 2 to 6 months. As soon as the insidious virus enters the blood, it immediately begins to multiply. The disease develops into chronic or acute. Chronic hepatitis becomes a constant companion of a person for life, since it cannot be cured. The acute type of the disease is treatable. With proper treatment, complete relief from the viral infection occurs and stable immunity is formed.

The vast majority of scientific studies do not provide evidence that hepatitis B has a negative effect on the fetus during pregnancy. The only exceptions are advanced cases of chronic hepatitis B with complications. In addition, infection of a pregnant woman provokes premature birth and the birth of low-weight babies.

If the father is sick, but the mother is healthy, then there are no consequences for the fetus

Often mothers are concerned about whether hepatitis B is transmitted to the child from the father. If the father is sick, but the mother is healthy, then there are no consequences for the fetus. To prevent possible infection, the mother should avoid any, even minor contact with the father's infected blood. It is advisable to exclude the use of common objects such as nail scissors, a straight razor, a blood glucose meter, parts of which may have invisible traces of blood and can become infected with a virus.

If during pregnancy, during testing for markers, one of them indicates a value of less than 150IU, then this is possible either with a low concentration of the virus or in its absence. Such indicators may indicate viral carriage.

Even if tests reveal that the mother became infected with the virus from her husband, the risk of transmitting it to the child is highest through childbirth. In order to exclude it completely, it is necessary to undergo testing for carriage of the virus before giving birth. If infection is confirmed in the maternity hospital, the newborn will be vaccinated against it immediately after birth. After which such babies receive 3 more vaccinations according to a special scheme, which provides them with reliable protection.

Children born to mothers who are not carriers of the virus are also provided with vaccinations within 24 hours after birth and then twice more according to the planned schedule. Sick mothers will form the same protection for themselves after three antiviral vaccines against hepatitis B.

Childbirth and caesarean section

Hepatitis infection most often occurs during labor

Hepatitis itself cannot cause harm to the embryo during pregnancy. Infection of the fetus from the mother with hepatitis occurs in most cases immediately before or after childbirth. The risk of a baby becoming infected with the maternal virus through the placenta before birth is less than 10%. Infection most often occurs during labor.

Knowing that the hepatitis virus is present in the blood, is it possible for pregnant women to give birth on their own or is it better to resort to a measure such as a caesarean section? If we compare methods of delivery according to the degree of risk of infection of the newborn, then, according to research by doctors in China, the results are as follows:

• caesarean section – 6.8%;
• natural birth – 7.3%;
• vacuum extraction - 7.7%.

Moreover, postnatal vaccination is a prerequisite for the health of newborn babies.

Is breastfeeding possible?

There is no scientific evidence that breastfeeding increases the risk of transmitting infection to the baby

The DNA-containing hepatitis B virus (HBV) causes a disease that affects the liver. During the course of the disease, the patient may not experience any discomfort at all, sometimes the symptoms resemble mild malaise, or it is asymptomatic. Transmission of the virus occurs through contact with infected blood and other bodily fluids. Sexual intercourse and childbirth are no exception. Therefore, pregnancy accompanied by hepatitis B should be monitored by specialists.

Human surface antigen (HBsAg) may be present in breast milk, but there is no scientific evidence that breastfeeding increases the risk of transmission to the baby.

Immunoprophylactic measures in relation to newborns sharply reduce and eliminate infections, even when the mother has a false positive result during the examination.

Could there be a mistake

Often during pregnancy, a false-positive test is detected. This result indicates that there is no virus in the blood, the causative agent of infection, despite the presence of specific antibodies to hepatitis B. This reaction depends on the influence of internal or external factors:

• past respiratory diseases;
• presence of influenza;
• the process of pregnancy or gestation itself;
• disrupted metabolic processes;
• changes in hormonal levels.

The fact is that the reaction involves proteins similar to those produced by the immune system of a pregnant woman in response to the penetration of foreign pathogenic microorganisms into the body. To avoid mistakes and to clarify the picture, additional studies are prescribed.

Conclusion

To ensure the healthy development of future offspring, the following points should be taken into account:

1. The state of pregnancy as a whole does not affect the course of hepatitis B, just as chronic hepatitis B does not affect the course of pregnancy.
2. The risk of transmission of viral infection to the fetus depends on increased activity of maternal hepatitis B.
3. Active immune prophylaxis is an effective measure to prevent infection of a baby from a pregnant mother.
4. If newborns are vaccinated correctly, there is no risk of transmission of the virus through breastfeeding.

Video

Hepatitis B: how is it transmitted? Hepatitis and pregnancy.

Hepatitis is an infectious disease caused by a virus and causes serious liver damage. Hepatitis B and pregnancy require close attention from doctors and a responsible attitude from patients, since the virus poses a serious threat to the health of the mother and the unborn baby, which is why doctors pay special attention to the prevention and treatment of hepatitis in expectant mothers.

Why is hepatitis B dangerous?

The hepatitis B virus is transmitted through blood and other body fluids. With the blood, it penetrates into the liver cells and activates processes in them that cause inflammation of the tissues of the organ and disruption of all its functions, which, in turn, leads to general intoxication of the body, changes in the functioning of the digestive system, and increased bleeding due to decreased blood clotting. As the disease becomes chronic, the liver begins to gradually deteriorate and there is a high risk of developing cirrhosis, which can be fatal.

One of the factors that increases the risk of disease is the high viability of the virus: it can live for three months at room temperature, an hour in boiling water, and at subzero temperatures - up to 20 years!

At first, hepatitis may be asymptomatic. The main signs are darkening of urine, discoloration of feces, nausea, vomiting, weakness and increased fatigue, pain in the right hypochondrium. Yellowing of the whites of the eyes and skin is possible.

It is quite easy to become infected with hepatitis, especially if there are small wounds, abrasions and other damage on the person’s skin or mucous membranes. Neglecting measures to ensure the proper degree of sterility can have dire consequences.

The main routes of transmission of the virus:

1. Various manipulations using cutting and piercing instruments: manicure, piercing, tattoo, shaving.
2. Medical procedures: blood transfusions, dental visits, injections, surgeries.
3. Unprotected sex.
4. Household contacts.

It should be noted that the last path is the least likely. You cannot become infected with hepatitis by airborne droplets, through handshakes, hugs, sharing utensils and other household items, if there is no damage to the outer skin. However, there is also the possibility of transmission of the virus to the child from the mother during pregnancy and childbirth.

Hepatitis B and the course of pregnancy

Hepatitis B during pregnancy is not a death sentence. At the same time, it requires the most serious treatment and significantly complicates the course of pregnancy, since it greatly weakens the female body, which is already under significant stress. The likelihood of developing all kinds of complications increases, toxicosis intensifies, and metabolism is disrupted. Problems with the liver impair blood circulation, and the developing body of the unborn child begins to feel a lack of nutrients, which can lead to developmental abnormalities.

There is also a possibility of transmitting the hepatitis B virus to your baby during pregnancy. However, if a woman is infected in the first or second trimester of pregnancy, the risk of infection of the child is relatively low. In the third trimester it is already about 70%.

In order to timely detect the disease, when registering pregnant women, they take a blood test for hepatitis B and C. In general, such a test is taken three times during pregnancy. These examinations are mandatory and allow timely implementation of the necessary measures if the virus is detected.

The greatest risk of transmitting the virus to a child during childbirth is through direct contact with blood and secretions of the birth canal. This route of infection is the most dangerous, since in 90% of cases an infection acquired by a baby during childbirth develops into chronic hepatitis without timely treatment.

Preventive measures

To prevent hepatitis B infection, you should exercise caution when visiting hairdressers, beauty salons and other places where there is a risk of contracting the virus. You should carefully observe safety precautions and do not use other people’s manicure and pedicure instruments, razors, or toothbrushes.

But the best way to protect yourself and your unborn child is vaccination.

If the test for hepatitis turns out to be positive, then you should not despair. The doctor will prescribe appropriate treatment that will help significantly alleviate symptoms and prevent complications that come with pregnancy and hepatitis. In addition, it is necessary to examine the husband and other family members and vaccinate them.

After birth, the newborn will immediately be given a vaccine containing antibodies that will protect him from the virus. If the vaccine is administered in a timely manner, breastfeeding is quite possible.

After discharge from the maternity hospital, both mother and child must be under the constant supervision of doctors, follow all recommendations and receive all required vaccinations in order to avoid the threat of developing health problems.

Hepatitis and pregnancy are not uncommon phenomena, as the number of infected people increases every year. The consequences for the child depend on the type of hepatitis. There is a risk of infection of the baby during the prenatal period or during childbirth. During pregnancy, the infection is severe and requires constant medical supervision, so the woman must be in a hospital.

Hepatitis A infection usually occurs in childhood. Adults are diagnosed with this in very rare cases. But some, usually during pregnancy, are diagnosed with Botkin's disease. The problem appears due to a decrease in the body's defenses during this period and high susceptibility to all viruses.

This virus can enter a pregnant woman’s body if:

• a woman does not wash her hands after visiting the toilet and public places;
• insufficiently washes and heat-treats fruits and vegetables;
• consumes poor quality drinking water;
• lives in unsanitary conditions;
• communicates with people suffering from hepatitis A.

The duration of the incubation period, starting from the pathogen entering the body, is from a week to two months. After the virus begins to have an adverse effect on the liver, destroying its cells, the woman becomes weaker, feels nauseous, suffers from high body temperature, increased sweating, and itchy skin.

At the same time, the desire to eat food also completely disappears, urine becomes dark in color, and feces, on the contrary, lighten.

With this development of events, the woman needs to be hospitalized, since the problem will not go away on its own. It is necessary to provide timely assistance to prevent the pregnant woman’s condition from worsening.

This type of hepatitis in most cases does not have a negative effect on the condition of the fetus. The development of complications in the mother is also extremely rare, but this is subject to timely treatment and being under the supervision of medical personnel during pregnancy.

To eliminate the disease, pregnant women are not prescribed medications. She must follow a diet and maintain a proper daily routine. It is important to completely eliminate any emotional and physical stress.

The expectant mother must remain on bed rest.

The diet should include low-fat cottage cheese, vegetables, fruits, and cereals. Anything fatty, salty, or pickled should be avoided.

In some cases, detoxification drugs are administered intravenously to alleviate the condition. They help cleanse the body of toxins. With the help of vitamin complexes, the recovery process is accelerated.

The inflammatory process can affect the liver at any stage of pregnancy, to reduce the risk of developing viral hepatitis, you must:

• do not contact with infected people;
• wash your hands regularly;
• subject all food products to thorough processing;
• do not drink dirty and unboiled water.

Also, the most effective method of prevention is vaccination. On forums, many women are against vaccination, but this will ensure pregnancy without complications, and r giving birth to a healthy baby.

Hepatitis B is a more serious problem in pregnant women. More than three hundred million people on the planet suffer from this disease. Statistics say that out of a thousand pregnant women, one is diagnosed with an acute form of the disease, and five are diagnosed with a chronic form.

The carrier of the virus poses a serious danger to others. It is present in all biological fluids of a sick person. The pathogen can be transmitted through sexual contact, through wounds and cuts on the skin, through the general use of scissors, nail files and other objects.

The problem poses a danger not only to the mother’s body, but also to the fetus, since the virus can penetrate the placenta. Also, a child can get the disease during contact with the mother’s blood during childbirth.

The problem may not be noticed for a long time.

But gradually hepatitis will begin to manifest itself:

• weakness;
• high temperature;
• complete loss of appetite;
• abdominal pain;
• aching in the joints of the arms and legs;
• yellowing of the skin;
• increase in liver size.

Testing for the hepatitis B virus is included in the list of standard diagnostic procedures that a woman must undergo when registering.

If a specific test is positive, the procedure must be repeated, as the result may be false positive. If the diagnosis is confirmed by repeated analysis, it means that it is not false and the expectant mother is prescribed treatment. Close relatives should also be examined, because the virus can circulate within the family.

If the analysis confirms hepatitis B during pregnancy, then more intensive therapy is prescribed after the birth of the child. The newborn is vaccinated against this disease.

The development of an acute form of hepatitis with a weakened immune system in a pregnant woman occurs very quickly. There is almost fulminant liver damage, which negatively affects the condition of all internal organs.

Exacerbation of the chronic form occurs in rare cases. But if, during pregnancy planning, liver inflammation leads to complications, then there is a lack of ovulation and conception may not occur. But even if fertilization has occurred, the woman is recommended to terminate the pregnancy, since the chances of a successful pregnancy are very small and there is a high probability of developing pathologies in the fetus.

The very presence of the virus in the body does not cause abnormalities in the development of the fetus. A similar situation can occur with the development of serious disorders that can cause fetal death.

Severe inflammatory processes in the liver are the main cause of premature birth. The risk of such a development of events increases several times.

In rare cases, the virus may enter the body child with breast milk.

To completely protect a newborn from the problem, it is necessary to vaccinate within the first hours after birth.

With hepatitis B, childbirth is carried out in a regular maternity hospital. To reduce the likelihood of infection of the baby, a caesarean section is prescribed.

To avoid developing the problem, the father and mother must be vaccinated against the virus.

During the period of bearing a child, for greater safety of the expectant mother, it is recommended:

• do not communicate with patients with hepatitis;
• visit only specialized salons and trusted medical institutions that monitor the sterility of the instruments used;
• do not have sexual contact with an unverified partner.

Many people find out about the presence of hepatitis C when registering for pregnancy, since there are usually no signs.

If there is an acute period, and the woman becomes pregnant at this time, then termination of pregnancy is recommended. This is a compelling argument, since due to the rapid development of the disease, the woman’s life is in danger; she will not be able to bear a child.

In most cases, pregnant women are diagnosed with a chronic form. The virus does not have a negative effect on the growth and development of the fetus, as well as the condition of the mother during pregnancy. But gradually the amount of the pathogen increases and in the second and third trimester of pregnancy the likelihood of premature birth increases.

In addition, the mother's well-being deteriorates significantly.

The likelihood of the virus passing through the placental barrier is low. In addition, the presence of maternal antibodies in the blood of a child under three years of age ensures the prevention of hepatitis C.

In chronic forms of the disease, a cesarean section is usually not prescribed, but some doctors are extremely careful and therefore recommend this method of delivery to their patients.

Typically, antiviral drugs Ribavirin and Interferon are used to eliminate hepatitis C. Reviews about these medications are good, but they can negatively affect the fetus, so doctors are trying to delay therapy until the baby is born.

A woman may suffer from severe itching of the skin due to stagnation of bile. The condition normalizes without treatment within a few days after childbirth.

If cholestasis is likely, ursodeoxycholic acid is prescribed, which is included in the following medications:

1. Ursosan.
2. Ursofalk.
3. Ursodex.
4. Ursohol.

Cholestatic complications are characterized by a decrease and cessation of the flow of bile into the duodenum. This is a dangerous problem.

The expectant mother may face complications of hepatitis C. With this disease, there is a high likelihood of cholestasis and premature birth.

In addition, a woman’s esophageal veins may dilate, which in a quarter of cases is accompanied by bleeding. Such problems arise mainly in the late period, at the end of the third trimester.

If hepatitis C causes the development of cirrhosis and liver failure, then this will not affect the child in any way, although there is a possibility of fetal hypertrophy. You can see what it looks like in photos on the Internet.

Hepatitis D can be observed as a complication of hepatitis B. The virus enters the body through the blood. This type is not a separate disease; for such a problem to arise, hepatitis B must be present in the body.

Infection with the D virus can occur if:

• a woman comes into contact with infected blood;
• during the visit to the tattoo parlor they used unsterile instruments;
• a transfusion of contaminated blood was performed;
• the expectant mother had sexual contact with a carrier of the virus.

The virus can spread to the child during labor.

The duration of the incubation period for hepatitis D after infection with B can last from one to three months.

The expectant mother has a number of complaints:

• there is severe pain in the joints;
• the skin, mucous membranes and whites of the eyes turn yellow;
• the skin becomes covered with a rash, hives and other types of allergic reactions are observed;
• urine darkens;
• for no apparent reason, the skin becomes covered with bruises and bruises.

Any symptom should be the basis for examination and treatment. The treatment protocol may include various medications, but pregnant women cannot take them, so they are trying to maintain health using safe methods.

The danger is largely represented by the toxic effect of the virus on the mother’s body, and in particular on her liver.

Due to hepatitis D it is possible:

• disruption of brain function;
• development of sepsis;
• the occurrence of premature birth;
• the appearance of a high probability of miscarriage.

In this case, the development of congenital pathologies and abnormalities does not occur.

If the health of the expectant mother worsens, you must immediately inform the doctor who is monitoring the course of the pregnancy.

If hepatitis B is complicated by a virus D , then the woman is immediately hospitalized. Treatment consists of eliminating symptoms, improving general well-being, and removing toxic substances from the body. An individual treatment method is selected for each patient.

If a pregnant woman already suffers from hepatitis, then to reduce the risk of developing another form it is necessary:

1. Lead a normal lifestyle, do not drink alcohol or drugs, do not smoke.
2. Do not have sexual intercourse with unknown partners.
3. Visit only specialized beauty salons and medical institutions.

To prevent the virus from spreading, you need to warn everyone in your immediate social circle about it.

Hepatitis E poses the greatest danger to pregnant women. The virus can cause epidemics, which often affect residents of subtropical climates. The virus is transmitted through nutritional routes, that is, if you do not pay due attention to washing your hands, vegetables and fruits, or drink dirty water. To a lesser extent, the disease is transmitted through household contact.

Some experts say that pathology in 100% of cases passes from mother to child. But there is no exact confirmation of this yet.

Infection after 24 weeks of gestation leads to the development of fulminant hepatitis E, which provokes liver necrosis and causes the death of the patient. Therefore, infection with it poses a mortal danger to the mother and fetus.

You can suspect the development of hepatitis E by the presence of:

• nausea, diarrhea, abdominal pain;
• yellowing of the skin followed by deterioration of well-being;
• elevated body temperature.

The disease is severe and, if left untreated, leads to the death of mother and child.

As complications of this pathology, the following development is observed:

• complete dysfunction of the liver;
• coma;
• heavy bleeding during childbirth;
• miscarriage;
• death of the fetus or newborn.

If the infection occurs in the second trimester, then it is impossible to carry and give birth to a healthy child. If the newborn survives birth, he will show signs of hypoxia and oxygen starvation. Such children do not live even for several months.

If a woman is diagnosed with hepatitis E, then an abortion can only be performed if the diagnosis was made in the first weeks, when instrumental intervention is not necessary. The expectant mother must be hospitalized, since at any moment she may need the help of a midwife.

Antiviral drugs to eliminate this form of hepatitis do not bring any results. With the help of therapeutic measures, they try to eliminate the main manifestations of the disease and save liver function.

One cannot count on a favorable outcome with such a diagnosis, since most women die even with timely treatment, and in the event of an urgent birth, severe bleeding begins, which also leaves little chance of survival.