乙型肝炎病毒的围产期管理：澳大利亚最新管理指南的临床应用
Perinatal management of hepatitis B virus: Clinical implementation of updated Australasian management guidelines.
作者信息
Bergin Hannah, Wood Gillian, Walker Susan P, Hui Lisa
机构信息
Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.
2Department of Perinatal Medicine, Mercy Hospital for Women, Melbourne, Victoria, Australia.
出版信息
Obstet Med. 2018 Mar;11(1):23-27. doi: 10.1177/1753495X17731990. Epub 2017 Oct 25.
OBJECTIVE
To evaluate the implementation of the 2013 Royal Australian and New Zealand College of Obstetricians and Gynaecologists guideline.
METHODS
Retrospective cohort study of the clinical management and obstetric outcomes among hepatitis B virus-positive women in a single tertiary maternity hospital. Women with viral load >200,000 IU/ml were referred to a specialised clinic for consideration of tenofovir disoproxil fumarate therapy to reduce mother to child transmission.
RESULTS
A total of 11,496 women gave birth during the study period, of which 101 (0.9%) women were hepatitis B virus positive. Viral load was measured in 99 (98%) of 101 hepatitis B virus-positive women; 30 (30%) had a viral load >200,000 IU/ml. Twenty-six women accepted tenofovir disoproxil fumarate; of these, 23 had a successful virological response (viral load <200,000 IU/ml before delivery).
CONCLUSIONS
Adherence to updated management guidelines and patient acceptance of tenofovir disoproxil fumarate in our Australian population were high when provided in the context of a dedicated perinatal service.
目的
评估2013年澳大利亚和新西兰皇家妇产科医师学院指南的实施情况。
方法
对一家三级妇产专科医院中乙型肝炎病毒阳性女性的临床管理和产科结局进行回顾性队列研究。病毒载量>200,000 IU/ml的女性被转至专科门诊，考虑使用替诺福韦酯治疗以减少母婴传播。
结果
在研究期间，共有11,496名女性分娩，其中101名（0.9%）女性为乙型肝炎病毒阳性。101名乙型肝炎病毒阳性女性中的99名（98%）进行了病毒载量检测；30名（30%）病毒载量>200,000 IU/ml。26名女性接受了替诺福韦酯治疗；其中，23名病毒学反应成功（分娩前病毒载量<200,000 IU/ml）。
结论
在澳大利亚人群中，当在专门的围产期服务背景下提供时，对更新的管理指南的依从性和患者对替诺福韦酯的接受度很高。
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