Will mother’s hepatitis B be transmitted to baby? Doctors teach you to prepare for pregnancy scientifically and block mother to child transmission

Chronic hepatitis B virus carriers are sometimes in a vulnerable position in their work and life, especially the female compatriots. In fact, we don’t need to take a different view. Although hepatitis B can’t be cured for the time being, its infectivity can be controlled by drugs to achieve clinical cure, that is, continuous virological response after stopping treatment, disappearance of HBsAg, normalization of liver function indexes and improvement of liver tissue disease; age appropriate women can block mother to child transmission and give birth to healthy babies through scientific intervention My baby. Chronic hepatitis B virus infection has become a global health problem. At present, more than 400 million people are affected worldwide, and 75% of them are in Asia, Western Pacific and sub Saharan Africa. There are about 93 million people with chronic HBV infection in China, including about 20 million patients with chronic hepatitis B. based on the huge infection rate, the obstetrics group of Obstetrics and Gynecology branch of Chinese Medical Association formulated the first edition in 2013. The guidelines clearly pointed out that all pregnant women need prenatal screening for hepatitis B serological markers. It is convenient for the mother to carry the infectious disease, and the doctor to be knows whether to make the diagnosis and treatment plan in advance. < / P > < p > for chronic hepatitis B patients with fertility requirements, if they have treatment indications, they should try to use interferon or nucleotide analogues before pregnancy, and complete the treatment 6 months before pregnancy; it is worth noting that men should also consider fertility after 6 months after withdrawal of interferon. Both male and female should take reliable contraceptive measures during interferon treatment. For patients with hepatitis B during pregnancy, mild increase of liver function index can be closely observed. For patients with severe liver disease, after weighing the advantages and disadvantages, tenofovir fumarate or telbivudine can be used for antiviral treatment. < / P > < p > for patients with unexpected pregnancy during antiviral treatment, it is recommended to terminate pregnancy if interferon is used. If the use of oral nucleotide analogues drugs: such as telbivudine, tenofovir fumarate or lamivudine, in the case of weighing the pros and cons, the treatment can continue; if the use of entecavir, adefovir dipivoxil, in the case of weighing the pros and cons, the use of tenofovir fumarate, telbivudine to continue treatment, termination of pregnancy is not recommended. < / P > < p > high serum HBV DNA load in pregnant women is one of the high risk factors of mother to child transmission. Studies have shown that for infants born to HBsAg positive mothers, if no neonatal preventive measures are taken, the infection rate of hepatitis B is as high as 90%. Standard neonatal hepatitis B immunoprophylaxis and effective antiviral treatment by mothers can reduce the transmission rate of hepatitis B by at least 95%. If the HBV DNA load is more than 2 × 10 ^ 6 IU / ml in the second and third trimester of pregnancy, antiviral drugs such as tenofovir fumarate, telbivudine or lamivudine can be given from the 24th to 28th week of pregnancy. < / P > < p > pregnant women with hepatitis B infection are often in the immune tolerance period, with HBeAg positive and high viral load. The advantage of early initiation of antiviral prophylactic treatment is that it can obtain enough treatment time to reduce HBV load to prevent mother to child transmission; while the advantage of late initiation of treatment is that it can reduce fetal exposure to antiviral drugs and potential toxicity risk, and also reduce the risk of drug resistance of mothers. < / P > < p > existing studies have shown that starting antiviral therapy in late pregnancy can prevent mother to child transmission of hepatitis B. In addition, some studies recommend stopping antiviral therapy at about 12 weeks postpartum and monitoring closely thereafter. < / P > < p > for the parturients with simple hepatitis B infection, if their babies received hepatitis B human immunoglobulin or hepatitis B vaccine at birth, the risk of breast-feeding transmission of hepatitis B can be ignored. According to China guidelines, after regular prevention, newborns of pregnant women with HBeAg positive or negative can be breastfed without testing for HBV DNA in their milk. < / P > < p > for patients treated with antiviral drugs, if they have lactation needs, it is recommended to stop taking antiviral drugs 1-3 months after delivery, and they can breastfeed after stopping taking antiviral drugs. However, studies have shown that in the milk of women treated with tenofovir, the drug content is only 0.03% of the recommended oral dose for infants, and low levels of tenofovir will not have adverse effects on infants. < / P > < p > sometimes medicine can’t jump out of the probability theory. Although through systematic intervention, the probability of neonatal infection with hepatitis B has been extremely low, there is still the possibility of infection. Therefore, the newborns of HBsAg positive pregnant women still need to be followed up. It is suggested that the serological markers of hepatitis B should be detected when the baby is 7-12 months old. If HBsAg is negative and anti HBS is positive, it means that the prevention is successful and has resistance; if HBsAg is negative and anti HBS is negative and the prevention is successful, but it still needs to be inoculated with three more doses of vaccine; if HBsAg is positive, the prevention fails and becomes a chronic infected person. < / P > < p > successively won the title of “excellent pharmacist” in the hospital in 2018, the title of “excellent young pharmacist” in Shanghai in 2018, the “first prize” in Shanghai and the “second prize” in eastern China in the fourth China pharmacist vocational skills competition in 2018, the “Qingyun plan” in health science creation on today’s headline platform in 2019, and the eighth Chinese medicine culture publicity Series in Pudong New Area in 2020 The most popular award was “the 2020 popular science red man” in 2020. The second Internet plus health China science contest was awarded the headline health truth officer in 2020. < p > < p > original title: < A= https://twhosting.com/american-companies-begin-to-give-up-r-d-who-should-pay-for-corporate-research/ target=_ blank>Continue ReadingAmerican companies begin to give up R & D: who should pay for corporate research?

Author: zmhuaxia