There was once a female patient who only remembered to go to the hospital when she was 4 months pregnant. When she got the test sheet, it was found that she was a hepatitis B virus carrier, a \”small three positive\”. After discovering such unexpected results, the patients and their families were dumbfounded and went to various hospitals. Some doctors told them that a vaccine should be injected during fetal period, while some doctors directly told them that the child had already If infected, they can choose to give birth or induce labor. At this time, the whole family was in chaos. In fact, such cases are not uncommon clinically.
As we all know, mother-to-child transmission is the most important way of transmitting hepatitis B. About 30% to 50% of hepatitis B patients in my country are caused by mother-to-child transmission. More than 90% of adult liver cirrhosis and liver cancer are caused in infants and young children. Infected with hepatitis B virus. The body fluids of hepatitis B patients are infectious, including semen, vaginal secretions, breast milk, blood, lymph, cerebrospinal fluid, thoracic fluid, peritoneal fluid, joint fluid, amniotic fluid, etc. These are all body fluids of the human body. As long as the body fluids contain hepatitis B virus, they are contagious.
Mother-to-child transmission includes two aspects, one is vertical transmission, and the other is horizontal transmission. Everyone always thinks that mother-to-child transmission is vertical transmission, but it is not. Only 10% are caused by intrauterine transmission, and only 10% are transmitted to the fetus in the womb during pregnancy, which is not very high. The main level of transmission is close living contact during the perinatal and postnatal period. As a mother with a major triple positive, the probability of the child being infected after birth is 90% to 95%. The probability of infection of a child born to a hepatitis B mother who is negative for the E antigen is half lower than that of a mother who is positive for the E antigen, about 45% to 40%. .
However, we have found clinically that in many families, their children become hepatitis B virus carriers because their mother or father is infected with hepatitis B virus. In addition to mother-to-child transmission of hepatitis B, fathers with hepatitis B have also been found to transmit the virus to their children. The difference is that mother-to-child transmission of hepatitis B mainly involves the transmission of the virus to the child during the perinatal period, and the child may have been infected with the hepatitis B virus before birth, while father-to-child transmission of hepatitis B mainly occurs after the child is born, due to the child\’s sensitivity to the hepatitis B virus. People who lack immunity are infected with hepatitis B virus through close contact in life. This mode of infection is called horizontal transmission.
Two necessary conditions are generally required for father and child to be infected with hepatitis B virus through close contact in their lives: first, the child’s immune system is not perfect or the child has inherited a defect in their immunity to hepatitis B virus, which makes them exposed to the infection in life. Hepatitis B virus. The second is damage to the child’s skin and mucous membranes.Injuries provide opportunities for the transmission of hepatitis B virus. This kind of infection in close contact mainly occurs in younger children with compromised immune systems.
So, can patients with hepatitis B get pregnant? What if I get pregnant?
Normally, hepatitis B virus carriers and those whose condition has been stable for a long time after treatment can get married and have children. In fact, most hepatitis B patients are chronic hepatitis B virus carriers. They have no physical discomfort, can live and study normally, and their liver function tests are completely normal. The test results of these carriers usually only show positive hepatitis B virus indicators ( Major three yang, small three yang, etc.), it is completely possible to get married and have children.
Pregnant patients with hepatitis B should pay attention to infant preventive treatment
For pregnant women carrying hepatitis B virus, whether they have major or minor three yangs, they should be injected with \”hepatitis B\” as soon as possible Immunoglobulin\” followed by monthly booster injections. Pregnant women should also go to the hospital to have their liver function tested once a month and actively receive liver-protective treatment. Babies should also be injected with hepatitis B immune globulin immediately after birth; as a mother who is a hepatitis B virus carrier, her milk contains hepatitis B virus, so she must not breastfeed. When feeding, extra attention should be paid to hygiene. Every time a mother uses a bottle to feed her baby, she must sterilize the bottle and wash her hands carefully. She should not kiss her baby, let alone feed her baby mouth-to-mouth. She should try to reduce excessive physical contact with the baby and use the baby\’s own hands. Toiletries and tableware must be disinfected frequently and kept completely separate from baby\’s supplies.
If a hepatitis B patient has an original illness and feels unwell, and after receiving formal treatment in a regular hospital, is clinically cured, his condition has been stable for more than one year, he has no physical discomfort, and his liver function has always been normal, he can also get married at this time. During childbirth, once the baby is born, hepatitis B vaccine must be injected promptly according to the \”0, 1, 6 plan\”. In addition, when the newborn is 2 months old or 7 months old, blood must be drawn to check \”two and a half\” and hepatitis B virus DNA to understand whether the baby\’s immunity is successful.
In fact, partners of hepatitis B patients or hepatitis B carriers should also actively protect themselves. As we all know, sexual transmission is also one of the ways of transmitting hepatitis B virus. If one of the men and women is a hepatitis B surface antigen carrier, the healthy partner should also be vaccinated against hepatitis B under the advice of a doctor. After being vaccinated with the hepatitis B vaccine, immunity can generally be maintained for more than 3 to 5 years, and the vaccine can be repeated after 3 or 5 years. A large number of people can benefit from the hepatitis B vaccine once for life.
For large families with a relatively large population, if there is one hepatitis B patient in the family, the whole family should be vaccinated against hepatitis B. The whole family is a high-risk group. Usually men and women have to stop taking the medicine for half a year before having children, so as to ensure good health and good health.
But in fact, injecting hepatitis B immunoglobulin into pregnant women during pregnancy can only reduce the chance of intrauterine infection in the child, but cannot eliminate it.Infect. After many pregnant women implement measures to interrupt mother-to-child transmission, a small number of children will still experience \”immune failure.\” The most common cause of failure is intrauterine infection, in which the fetus becomes infected while still in the mother\’s womb. Intrauterine infection is currently a difficult problem to solve. Once intrauterine infection occurs, all preventive measures taken after the child is born are useless. Another reason for failure is that the amount of virus contained in the mother\’s body is too high. Studies have pointed out that 43% of the fetuses of pregnant women with high virus levels will still develop intrauterine infection even if they have been injected with hepatitis B immune globulin multiple times. In view of the above reasons, pregnant women carrying hepatitis B virus must undergo quantitative virus testing. While taking \”combined immune multiple blockade\”, some efficient and safe antiviral drugs can be used to increase the ability to inhibit virus replication, which can often significantly reduce intrauterine infection of the fetus.
When should hepatitis B patients not get pregnant
For current acute hepatitis B, accompanied by obvious liver function abnormalities, it is best to treat the disease before stabilizing it Putting pregnancy on hold. Those who have been infected with hepatitis B virus for a long time and have severe liver damage, and pathological examination of the liver biopsy has confirmed cirrhosis, accompanied by obvious thrombocytopenia, hypersplenism, and coagulation dysfunction. Liver function abnormalities in patients with chronic hepatitis B are more obvious, and liver function fluctuates greatly, often accompanied by protein ratio inversion or hypoalbuminemia; patients with chronic hepatitis B are accompanied by severe extrahepatic system manifestations, such as nephropathy, aplastic anemia, etc. Those who have had a history of pregnancy, but terminated the pregnancy because the liver could not bear it; those who are infected with hepatitis B virus and have obstetric and gynecological diseases who are not suitable for pregnancy, and those who have a history of repeated cesarean sections.
The best time for hepatitis B patients to get pregnant
Generally, as long as the liver function is normal and the condition is relatively stable for a certain period of time, regardless of the three positives, you can get pregnant. ; However, it is best for patients with severe yang to undergo treatment before getting pregnant. People with severe yang need to undergo regular antiviral treatment for half a year or a year under the guidance of a doctor, and then stop for half a year. After passing the examination, they can consider pregnancy. During the period of drug withdrawal, condoms are used for contraception; Women who are preparing to become pregnant can switch their antiviral treatment drugs to drugs that are safer for pregnancy 1 month before conception under the guidance of a doctor. Female patients with hepatitis B who are treated with interferon must stop taking the drug for more than half a year before they can consider pregnancy.
This article is provided by Baidu Reading. It is excerpted from \”Very Good Pregnancy: You Can Get Pregnant by Doing This\” Author: Yu Yue\’e