妊娠合并乙型肝炎。
Hepatitis B in pregnancy.
机构信息
Department of Public Medicine and Social Security, Section of Infectious Diseases, University of Naples "Federico II", 80131 Naples, Italy.
出版信息
World J Gastroenterol. 2012 Sep 14;18(34):4677-83. doi: 10.3748/wjg.v18.i34.4677.
Abstract
Chronic hepatitis B virus (HBV) infection affects about 350 million individuals worldwide. Management of HBV infection in pregnancy is difficult because of several peculiar and somewhat controversial aspects. The aim of the present review is to provide a tool that may help physicians to correctly manage HBV infection in pregnancy. This review focuses on (1) the effect of pregnancy on HBV infection and of HBV infection on pregnancy; (2) the potential viral transmission from mother to newborn despite at-birth prophylaxis with immunoglobulin and vaccine; (3) possible prevention of mother-to-child transmission through antiviral drugs, the type of antiviral drug to use considering their efficacy and potential teratogenic effect, and the timing of their administration and discontinuation; and (4) the evidence for the use of elective caesarean section vs vaginal delivery and the possibility of breastfeeding.
摘要
全球约有 3.5 亿人患有慢性乙型肝炎病毒 (HBV) 感染。由于 HBV 感染在妊娠期间存在一些特殊且颇具争议的方面，因此妊娠期间 HBV 感染的管理颇具难度。本综述的目的是提供一种工具，帮助医生正确管理妊娠期间的 HBV 感染。本综述重点关注以下内容：(1) 妊娠对 HBV 感染的影响，以及 HBV 感染对妊娠的影响；(2) 尽管在出生时使用免疫球蛋白和疫苗进行了预防，但仍有可能发生母婴传播；(3) 通过抗病毒药物预防母婴传播的可能性，考虑到其疗效和潜在致畸作用，应使用哪种抗病毒药物，以及药物的给药和停药时机；以及 (4) 选择性剖宫产与阴道分娩的证据，以及母乳喂养的可能性。
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