Hepatitis C and pregnancy
Trouble-free pregnancy, easy childbirth, the birth of a healthy child - this is all that every sensible woman dreams of. But not all the period of waiting and the birth of the baby runs smoothly. The organism of future mothers, due to weakened immunity, is subject to various diseases, in which case doctors will need to take measures to preserve the pregnancy and full-fledged crumbs. This article will discuss one of the most serious topics about how are childbirth with hepatitis C.
What it is?
A similar diagnosis for future mothers sounds like a sentence. What kind of disease is hepatitis C and how is it transmitted? This is a viral disease, the affected area of which is the liver. It is transmitted only in one way - through the blood. The main problem is that it is very difficult to recognize the disease at an early stage, and then it develops into a chronic form.
The number of patients with similar diagnoses is increasing annually. In total, there are several main reasons why absolutely healthy people become carriers of this virus:
- Drug intake. Enough one shot to get hepatitis in the body.
- Manicure. The infection can be transmitted to the client during the cosmetic procedure through nail scissors.
- Blood transfusion or use of a syringe after a sick patient.
- Share scissors, razors and other personal care products with a carrier.
- Unprotected intercourse.
If the disease was detected in the mother, then hepatitis C can naturally occur in children. The virus enters the body through the placenta or the birth canal. It is important to remember that hepatitis C is not transmitted by contact through the household or by airborne droplets, it enters the body only through blood.
Before finding out information about how to go with childbirth with hepatitis C, you need to list the groups of people who are more susceptible to the acquisition of this virus:
- medical workers,
- drug addicts,
- children and relatives of people with a similar disease,
- people who underwent surgery until 1992,
- women and men who have promiscuous unprotected sex,
- people with liver disease or HIV infection.
The future mother should take care of her baby and avoid contact with infected people. In particular, it is not recommended to use other people's hygiene items. Distinguishing a healthy person from a carrier of hepatitis C will allow characteristic symptoms.
Symptoms of the disease
It is rather difficult to hide a progressive disease from prying eyes, and you can easily recognize the presence of such a virus. There are several characteristic signs of hepatitis C in women:
- Discoloration of the skin, in most cases it becomes dark or yellow.
- The appearance of circles and swelling under the eyes.
- Sharp weight loss.
- The appearance of general weakness and reduced performance.
- A sharp deterioration in appetite.
- The emergence of nausea and vomiting.
- The most obvious symptom is a sensation of pain or mild discomfort in the liver.
- Another symptom is a change in the color of urine; in the presence of a virus in the body, it changes color from light yellow to dark brown, similar to the color of beer.
The first signs of hepatitis C in women appear only in 20% of cases. Most often, it is possible to recognize a viral disease only when it has passed into the chronic stage and has led to the destruction (cirrhosis) of the liver.
What to do if the disease is detected before pregnancy?
Chronic hepatitis C is not treated. The only thing that a patient can achieve is the achievement of remission, subject to continuous medication. Can a man or a woman with a similar diagnosis become parents?
Doctors say that you can get pregnant with this disease. In addition, chronic hepatitis C is not a contraindication for IVF. But patients with a similar diagnosis are under special control of doctors, they more often than other patients have to undergo blood and urine tests to determine the degree of load on the liver.
If a woman becomes pregnant from a man with a similar diagnosis, then the risk of becoming infected with hepatitis C is quite high. In this case, she needs to undergo a diagnostic examination. If the virus is not transmitted, then at the time of carrying the baby she will have to refrain from sexual intercourse with a partner.
You should not worry about pregnancy with hepatitis C. In most cases, pregnancy in patients passes without complications, women manage to give birth to a healthy baby. But still there are risks. First, because of the increased load on the body, health can deteriorate. Secondly, there is a high probability that the baby will be born premature or with low weight due to the high activity of the liver processes. If a woman is aware of her illness, then in the early stages of waiting for the baby, she is required to visit an infectious disease specialist, who will select a sparing therapy.
What to do if the disease is detected during pregnancy?
There are cases when hepatitis appears during pregnancy. In this case, the chances of curing it are much greater. The fact is that a pregnant woman periodically undergoes tests and visits to doctors, therefore, it is much easier to identify the disease at an early stage of its development even before the onset of symptoms of hepatitis C during pregnancy. Accordingly, it is possible to take timely measures and begin treatment activities even before the liver is affected. Hepatitis during pregnancy can be transmitted from a partner during unprotected intercourse or through a medical instrument during therapeutic procedures.
How does the virus affect pregnancy?
Future mothers always take care of their children. That is why they are very concerned about the question of whether it is possible to give birth with hepatitis C. Experienced gynecologists have established how this virus affects pregnancy:
- Transaminase levels may increase dramatically. This will cause the patient to feel much worse.
- Against the background of hepatitis C, other chronic diseases can develop during pregnancy, for example, sugar (or gestational) diabetes. Doctors strongly recommend the expectant mother to eat right and not to allow a strong weight gain.
As a rule, if a woman adheres to all the recommendations of a doctor, then pregnancy and childbirth with hepatitis C do not harm her health.
How will the virus affect the child?
Separately, you should consider what happens to the baby in a similar situation. It is worth noting that the risk of developing hepatitis in newborns is quite high. Moreover, a dangerous disease can be detected even during pregnancy, at birth and even several months after childbirth.
The risk of transmitting the disease from mother to baby is quite low, this probability is only 5%. To protect the baby from this disease, a woman needs:
- Visit two specialists: infectious diseases and genetics. Doctors of narrow specialties will give the necessary recommendations and prescribe an effective therapy in order to protect the baby as much as possible.
- Most often there is a need to do a cesarean section for hepatitis. This is due to the fact that there is a fairly high risk of infection during the passage of the crumbs through the birth canal, since the child comes into contact with the mother’s bleeding during birth.
The second risk to the child is premature birth and low birth weight. These factors can adversely affect the full development of the baby. To prevent their occurrence, mothers need to eat right, maintain hygiene, lead a healthy lifestyle and take medications prescribed by a doctor. In this case, the consequences of hepatitis C during pregnancy for the fetus are minimal.
Before we talk about whether childbirth with hepatitis C is possible or not, it is necessary to verify the correctness of the diagnosis. For this purpose, a diagnostic examination is carried out, consisting of a set of procedures:
- Examination by a gynecologist or a therapist. The specialist will listen to the patient's complaints and compare them with the possibility of the disease by this virus.
- If a specialist has any suspicions, he will additionally designate a blood and urine test for the content of antibodies, virus and bilirubin in the blood.
- Ultrasound of the liver organs is carried out only if any abnormalities were detected in the analyzes.
- Liver tissue biopsy.
The first thing that can be identified as a result of the study is the presence or absence of a virus in the human body. To obtain this information, it is enough to pass a blood and urine test. Often, doctors recommend doing a reanalysis after a certain period of time for accurate confirmation of the diagnosis.
If the presence of hepatitis C is not confirmed, then further examination is not carried out. In the presence of a virus in the body, a person will need to do an ultrasound and a biopsy. These diagnostic methods will assess the degree of liver damage. Based on the data obtained, the doctor will already be able to determine whether a birth is possible in a natural way or still have to do a cesarean section.
Features of the course of pregnancy
Experienced gynecologists and infectious diseases do not see the interaction of hepatitis C with pregnancy and childbirth. In extremely rare cases, a number of complications can occur:
- the risk of spontaneous abortion in the early stages - up to 12 weeks,
- small chance of fetal hypoxia,
- the possibility of infection and the development of hepatitis C in a child,
- risk of increased liver damage due to increased stress.
The probability of occurrence of complications is approximately 5%, but it still exists. For this reason, women with a similar diagnosis are put on special control for the entire period of pregnancy.
There are some minor factors. For example, the girl will be worried about how the diagnosis will affect the development of the baby. Accordingly, she may be under stress, which negatively affects her state of health.
Is the baby infected?
After the birth activity of a woman with hepatitis C has been completed, doctors take a series of tests for the presence of a virus in the body. Blood and urine are standard for its detection. According to the testimony identified in the first days of life, the diagnosis is not made, since these data are not reliable. Antibodies to this disease, which were formed during pregnancy, can affect a positive result, but they have nothing to do with the virus.
And, on the contrary, this disease may not yet appear immediately after birth, but it will be felt a little later. Accordingly, in order to make or refute the diagnosis, from time to time the baby will have to pass a series of tests until the age of 1.5 years. If, nevertheless, the diagnosis is confirmed, then the crumb will be observed for a long time by the infectious disease specialist and pediatrician and receive appropriate medical therapy.
Is hepatitis C treated during pregnancy?
In modern medicine there is no medicine and vaccine that would prevent or save a person from the appearance of hepatitis C. But still, there are methods to suppress it. Doctors claim that the earlier the disease was detected, the more likely it is to get rid of it. A pregnant woman with a similar diagnosis is prescribed a complex of therapy:
- Reception of medicines, namely "Ribavirin" and "Interferon", is appointed only as a last resort, when other methods of treatment are impossible. This is due to the fact that they negatively affect the fetus.
- Taking a separate group of drugs based on ursodeoxycholic acid. They contribute to the suppression of the virus and are completely harmless to the baby. Medical therapy is prescribed courses, after which you want to take a break.
In addition to treatment, infected patients are given recommendations on nutrition and lifestyle, which should also be followed.
Features of the birth
For several decades now, experienced experts have been actively debating whether it is possible to give birth with hepatitis C. As practice shows, there is still a high probability of carrying a healthy baby. But still there are some features of childbirth.
In the late stages of pregnancy, at about 33–36 weeks, a woman will need to undergo a urine and blood test and a biopsy to obtain liver function tests. If the results of the diagnostic examination are unsatisfactory, then the specialist will make an unambiguous decision to perform a cesarean section, since natural birth will cause a significant risk to human health.
The task of the medical staff during labor activity is to completely exclude the contact of the baby with the mother's bleeding, through which infection may occur. If there is heavy bleeding during labor, the doctors take steps to do an emergency cesarean section.
Can I breastfeed?
The birth was successful, the baby was born healthy and on time. But mother's anxiety does not end there. The second question that will worry her is whether you can breastfeed your baby with hepatitis C. Doctors say that infection through milk is impossible. They managed to come to this conclusion as a result of numerous studies. But nevertheless it is necessary to observe some measures in order not to harm the baby:
- 2-3 times a day it is required to wash the breasts with water
- Before each feeding, the nipple integrity should be monitored; there should be no wounds and microcracks on them.
If you follow these two important conditions, you can completely reduce the risk of transmission of the virus from mother to child.
Complete childbearing is possible, but only if the effect of the virus on the body is at the stage of compensation, and the liver is minimally affected. No doctor can guarantee that pregnancy and childbirth will go well, since the risks of miscarriage, threatened miscarriage, premature and complicated births exist even when the mother is completely healthy. There is an equal proportion of the likelihood of infecting a child, both in caesarean section and in natural childbirth.
In conclusion, it is worthwhile to list preventive measures that will allow you to avoid infection with the hepatitis C virus:
- You should not use shared toothbrushes, needles, cotton, harnesses, dishes and any objects that are injected. Virus can exist on items up to 4 days.
- All procedures: manicure, piercing, tattoos - should be carried out only in elite salons in accordance with sanitary standards.
- In the absence of confidence in the partner’s health, it is imperative to use condoms when entering into sexual intercourse.
- It is worth avoiding close contact with infected people.
In the modern world, the number of infected patients is constantly growing. But doctors have already learned how to translate this virus into remission. If, however, to avoid infection with hepatitis C is still not possible, then do not despair. With this virus, you can fully live and give birth to healthy children.
How is hepatitis C transmitted?
There is an opinion that infection with hepatitis C is possible only through sexual contact. This is partly true, but the main mode of transmission is hematogenous. In other words, the disease begins to develop when the hepatitis C virus enters the blood of a healthy person. It can happen in the following cases:
- When using used disposable syringes and needles. This is the most common way of transmitting hepatitis. It is believed that half of the people who use intravenous drugs suffer from this disease,
- When conducting medical manipulations with poorly sterilized instruments,
- When applying a tattoo or body piercing with a previously used needle,
- With direct contact of a healthy person with a patient through the blood, in particular through a transfusion. However, today this method of infection is rare, since since 1999 all donor materials have been checked for the presence of the hepatitis C virus before the patient is given.
It is noteworthy that the causative agent of the disease can maintain vitality in dried blood for several weeks. This means that you can become infected by using nail tools, a razor, a toothbrush, and other personal belongings of an infected person.
Hepatitis C and pregnancy: how to understand, is there a reason for panic?
The surest way to dot the i's is to take a test for hepatitis during pregnancy. Как мы уже упоминали, он входит в плановый скрининг, который проходят все будущие мамы.Relying on the presence of specific manifestations of the disease is not worth it - for many people with hepatitis C, the clinical symptoms are either absent at all, or appear to a small extent, or are perceived as signs of another illness. However, one should not underestimate the cunning of this virus - slowly but surely, hepatitis can lead to cirrhosis and even liver cancer.
In the case of primary infection with hepatitis C, fatigue and general malaise may occur, as with the flu. Jaundice, which signals a liver malfunction, is uncharacteristic for patients with hepatitis C. In the chronic course of the disease, it is rather difficult to correlate the observed symptoms with hepatitis. Patients usually complain about:
- Muscle pain
- Anxiety, depression,
- Pain in the right side (liver),
- Problems with memory and concentration.
Hepatitis C treatment during pregnancy
Specific antiviral treatment of hepatitis C with interferon and ribavirin during pregnancy is strictly prohibited. This is explained by the fact that ribavirin has a teratogenic effect, and the effect of interferon on the development of the fetus is not well understood. If the disease was detected at the planning stage, it is recommended to conceive not earlier than 6 months after the end of therapy. In the period of gestation, such women are prescribed plant-based hepatoprotectors safe for the fetus (Essentiale, Karsil, Hofitol). Special attention is paid to the observance of a special diet.
And although hepatitis C and pregnancy seem incompatible, abortion is contraindicated in the acute stage of any viral hepatitis. In the event of a threat of miscarriage, doctors are doing everything possible to save the child. Births in infected patients take place in specialized departments of maternity hospitals with strict observance of anti-epidemic measures. It is worth noting that the probability of infection of the newborn at caesarean section is slightly lower than at independent births. Measures of specific prevention of transmission of hepatitis C virus to a child do not currently exist.
Children born to women with such a diagnosis are under the supervision of infectious disease doctors. It is possible to establish finally whether the transmission of the disease from mother to child occurred only by two years.
Possible consequences of hepatitis C during pregnancy
Women who have pregnancy and hepatitis C at the same time, are wondering: what is the likelihood of infection with the fetal disease? As shown by data from numerous studies, the frequency of infection of the child ranges from 3 to 10% and is regarded as low. As a rule, the transmission of the virus occurs during childbirth. The likelihood of infecting a baby with hepatitis C during breastfeeding is extremely low, so doctors are not advised to deprive it of mother's milk. At the same time, it is necessary to monitor the condition of the nipples: the presence of microtraumas significantly increases the risk of infection, especially in cases where the mother has a high viral load.
More serious consequences of hepatitis C during pregnancy are for the woman herself. Against the background of the disease, the expectant mother may begin preeclampsia, possibly the development of fetal hypoxia, premature birth, and the threat of miscarriage. When combined with overweight hepatitis C, there is a high probability of gestational diabetes. However, recent studies show that, in general, the hepatitis C virus does not significantly affect the course of pregnancy and the condition of the unborn child. Babies born to infected mothers usually develop normally, the risk of premature birth and developmental delay increases in chronic forms of the disease.
Hepatitis B is a liver disease, has a viral form. Hepatitis B is transmitted to humans through sexual contact or through contact with infected blood. In most adults, the body can cope with the disease without treatment for several months.
Approximately one in 20 people who become ill remains a carrier of the virus. The reason for this is not a complete treatment. The disease turns into a long chronic form. If left untreated, over time this will lead to serious damage to the liver (cirrhosis, liver failure, cancer).
The effect of hepatitis B on the child
Hepatitis B during pregnancy in almost 100% of cases is transmitted from mother to baby. Most often this occurs during natural childbirth, the child becomes infected through blood. Therefore, doctors advise expectant mothers to give birth with a caesarean section to protect the baby.
The effects of hepatitis B on pregnancy are serious. The disease can cause premature birth, development of diabetes, bleeding, low birth weight.
If the level of the virus in the blood is high, the treatment will be prescribed during pregnancy, it will protect the child.
To get rid of the newborn from infection will allow vaccination against hepatitis B. The first time it is done at birth, the second - in a month, the third - in a year. After that, the child is tested to make sure that the illness has passed. Next time vaccination is done in five years.
Can an infected woman breastfeed?
Yes. Specialists of the American Center for Disease Control and Prevention and the World Health Center have established that women with hepatitis B can breastfeed their children without fear for their health.
The benefit of breastfeeding outweighs the potential risk of infection. In addition, a hepatitis B vaccine is given to the child at birth, which reduces the risk of infection.
Diagnosis of hepatitis B during pregnancy
At the beginning of pregnancy, all women are asked to undergo a blood test for hepatitis B. Women who work in the field of health care or live in disadvantaged places, and also live with an infected person, must be tested for hepatitis B.
There are 3 types of tests that detect Hepatitis B:
- Hepatitis surface antigen (hbsag) - Detects the presence of a virus. If the result is positive, then the virus is present.
- Hepatitis surface antibodies (HBsAb or anti-hbs) - checks the body's ability to fight the virus. If the test is positive, then your immune system has developed protective antibodies against the hepatitis virus. This prevents infection.
- Hepatitis main antibodies (HBcAb or anti-HBs) - assesses the tendency of a person to be infected. A positive result would indicate that the person is prone to getting hepatitis.
If the first test for hepatitis B during pregnancy turned out to be positive, the doctor prescribes a second test to confirm the diagnosis. In the case of a repeated positive result, the expectant mother is sent for examination to a hepatologist. He assesses the condition of the liver and prescribes treatment.
After identifying the diagnosis, all family members must be tested for the presence of the virus.
Hepatitis B treatment during pregnancy
The doctor prescribes treatment for hepatitis B in pregnancy if the test results are too high. The dosage of all drugs prescribed by the doctor. In addition, the future mom is prescribed a diet and bed rest.
The doctor may prescribe treatment even in the third trimester of pregnancy, then it should be continued for 4-12 weeks after delivery.
Do not be nervous if hepatitis B is found in your pregnancy. Follow the doctor and follow the recommendations, then your baby will be healthy.
What is hepatitis C and how is it transmitted? Who is at risk?
Hepatitis C is a viral liver disease. The virus enters the human body mainly parenterally - through the blood. Signs of infection with hepatitis C usually appear in a worn form, so the pathology, remaining unnoticed at a certain point, easily becomes a chronic process. The prevalence of hepatitis C among the population is steadily increasing.
The main ways of infection:
- blood transfusion (fortunately, in recent years this factor has lost its significance, since all donor plasma and blood are necessarily checked for the presence of a virus),
- unprotected sexual intercourse with a virus carrier
- use a syringe after a sick person,
- failure to comply with personal hygiene standards - sharing of razors, nail scissors, toothbrushes,
- infection with contaminated instruments when applied to the skin of body piercing and tattoos,
- professional activities related to blood - infection occurs by chance, for example, during hemodialysis,
- infection of the fetus during its passage through the birth canal.
The virus is not transmitted by contact-household and airborne routes.
The risk group for hepatitis C infection includes:
- people who have undergone surgery until 1992, inclusive,
- health workers who regularly work with persons infected with hepatitis C,
- people who use drugs in the form of injections,
- HIV-infected individuals
- people suffering from liver disease of unknown origin,
- regular hemodialysis
- children born to infected women
- sex workers without condoms.
It should be noted that most people infected with the hepatitis C virus for a long time do not notice any symptoms. Despite the fact that the disease is hidden, the body starts the mechanism of irreversible processes, which ultimately can lead to the destruction of liver tissue - cirrhosis and cancer. This is the cunning of this disease.
About 20% of infected people still have symptoms of pathology. They complain of general weakness, drowsiness, poor performance, lack of appetite, and constant nausea. Most people with this diagnosis lose weight. But most often marked 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.
In order to make a diagnosis, the probable carrier of the virus must undergo the following diagnostic tests:
- detection of antibodies to the virus in the blood,
- definition of AST and AlAT, bilirubin in the blood,
- PCR - analysis to determine the RNA of the virus,
- liver ultrasound,
- liver tissue biopsy.
If the conducted studies have shown a positive result for the presence of hepatitis C in the body, this may indicate the following facts:
- A person is sick of a chronic form of the disease. He should soon conduct a biopsy of the liver tissue to clarify the extent of its damage. You also need to do a test to identify the genotype of the virus strain. It is necessary for the appointment of appropriate treatment.
- The man has had an infection in the past. This means that the virus had previously penetrated into the human body, but his immune system was able to cope with the infection on its own. The data on why the body of specific people was able to overcome the hepatitis C virus, while others continue to hurt them - no. It is believed that much depends on the state of immune protection and the type of virus.
- The result is false positive. Sometimes it happens that during the initial diagnosis, the result may be erroneous, but when re-analyzing this fact is not confirmed. Need to analyze again.
Features of the course of infection in pregnant women
Typically, the course of hepatitis C does not have a relationship with the pregnancy process, complications occur quite rarely. A woman suffering from this disease during the entire period of gestation requires more careful observation, since she has an increased risk of spontaneous abortion and the likelihood of fetal hypoxia compared with healthy women.
Not only the gynecologist, but also the infectious disease specialist should be involved in observing the patient with this disease. The probability of infection of the fetus during pregnancy and childbirth is not more than 5%. At the same time to prevent infection of the baby is 100% impossible. Even if operative labor is delivered to a woman as a carrier of hepatitis C — cesarean section — this is not the prevention of infection.
Therefore, after birth, the child is tested for the determination of 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 observe it more carefully at the pediatrician and infectious diseases specialist. Breastfeeding of children born to infected mothers is permitted in any case, since the virus with milk is not transmitted.
Treatment methods for pregnant women
Nowadays, there is no vaccine against the hepatitis C virus. But he can be treated. The main thing in time to notice the infection: the chances of recovery will be higher if the infection was noticed at the very beginning.
Hepatitis C treatment should be comprehensive. The basis of therapy consists of drugs with a powerful antiviral effect. Most often, ribavirin and interferon are used for this purpose. But, according to additional research, these drugs have a negative effect on the developing fetus. Therefore, treatment of hepatitis C during pregnancy is undesirable.
There are cases when specialists are forced to prescribe a specific therapy for a woman. This usually happens when the future mom has clear symptoms of cholestasis. In this situation, her condition is deteriorating dramatically, and urgently needs to be done. This happens infrequently - in one woman out of 20.
If it became necessary to treat hepatitis C during pregnancy, doctors prefer those drugs that are relatively safe for the expectant mother and her child. This is usually a course of injections based on ursodeoxycholic acid.
How to carry out the delivery of infected women?
In obstetrics, there is a long history of statistics on how the method of delivery increases the risk of infection of the newborn or, on the contrary, decreases. But no single digits of the statistics have so far been received, since the probability of infection during childbirth is approximately the same as in the case of cesarean section, and during the natural process.
If a woman has hepatitis C, labor will be carried out by cesarean section with poor liver function tests. Usually this happens in one expectant mother out of 15. In other cases, doctors choose a mode of delivery, starting from the patient's state of health.
Infection of the child in childbirth can occur only from the mother's blood at the moment when the baby passes through the birth canal. If the medical staff is aware of the disease of the woman in labor, then the infection of the child is almost impossible - no more than 4% of cases. The experience and professionalism of the doctors will help to eliminate the contact of the infant with the mother’s bloodstream as much as possible, in some cases, an emergency caesarean section is performed. Read more about cesarean section →
Prevention of Hepatitis C
During pregnancy planning, each woman should be tested for the presence of hepatitis C virus in the blood. Since infection usually occurs on contact with the discharge of a sick person’s blood, you should try to avoid any interactions with this physiological environment.
You can not use common needles, water, harnesses and cotton wool, that is, all items that are used for injection. All medical instruments and dressings must be disposable or sterilized. You also can not use other people's toothbrushes, manicure objects, earrings, because the virus can remain viable on all these things for up to 4 days.
Piercing and tattoos should be made with a disposable sterile material. Wounds and lesions on the body must be disinfected with antiseptics, medical glue or sterile patches. When entering into intimate relationships with different partners should use condoms.
It should be noted that most women, faced with hepatitis C during pregnancy, begin to consider their lives finished. But do not get upset and go into depression, so you can only hurt yourself and your child more. In practice, many women who become pregnant after treatment for hepatitis C or against it, were able to successfully endure and give birth to perfectly healthy children.
Author: Olga Rogozhkina, doctor,
specifically for Mama66.ru
What are the symptoms and treatment of hepatitis during pregnancy
The most common symptom of hepatitis is jaundice, that is, the skin, mucous membrane and eyes take on a yellow color. There are also signs of intoxication, vomiting, fever and headache.
There is one very insidious symptom - pain in the right hypochondrium, which occurs due to an enlarged liver. There are several types of such pain: acute, dull, sharp or aching.
But it so happens that the symptoms do not make themselves felt (this occurs in hepatitis C), and the disease is slow and sure, and the disease can only be detected at its full height.
Лечение при острой форме гепатита не всегда может уничтожить вирус. Врачи советуют дождаться, пока иммунитет сам с ним не справится, поэтому советуют придерживаться диеты, не допускать полного обезвоживания организма и следить за работой всех органов тела.
Обычно лечение проводят в специализированных медицинских учреждениях.
If a chronic form of hepatitis is found, the treatment should be handled by a qualified specialist. Self-medication should not be done, since all drugs threaten the health of your future baby, and therefore they should be taken only under the supervision of a doctor.
And then, finally, they came to the diagnosis of the disease. During the entire period of pregnancy, the gynecologist prescribes three times the analysis for hepatitis. In the study of the patient's blood for hepatitis B, the laboratory technician determines the virus of the virus - HBs antigen, and in the analysis of hepatitis C - antibodies, this means that there are proteins that the body produces for the presence of the virus.
According to the results of the blood test, the laboratory assistant concludes. If the test for hepatitis is positive, then mommy will have to give birth in a specialized infectious maternity hospital, but if in your city there is a maternity hospital in which a special infectious unit is equipped, then you will be sent there.
What are the consequences of hepatitis in pregnant women? If during pregnancy pregnancy the fetus did not become infected from the mother, then still the virus greatly weakens the woman’s body, which is why doctors recommend that you deal with this disease as soon as possible before the onset of labor.
If you refuse treatment, then you will face many problems in the future with the body. And your child needs a healthy, cheerful and strong mother. Do not forget that this disease has a huge burden on the liver, and through this organ there is an exchange of important substances between you and the child.
If the liver does not work well, then it threatens the underdevelopment of the fetus due to insufficient penetration of micronutrients.
Doctors immediately warn that during childbirth the child may become infected, which is why birth is carried out not naturally, but by caesarean section.
Most women who have had hepatitis are wary of planning future pregnancies. Experts say that if no antibodies are found in the blood, then pregnancy can be planned. But do not forget about the observation of an immunologist, a hematologist. If you have never encountered this ailment in your life, then when planning a pregnancy be sure to get vaccinated against the virus.
How exactly the disease will affect the course of pregnancy is not known, because every woman is an individual, and the cases are unique. Hepatitis E is considered the most dangerous and tragic, and all other types can be investigated and diagnosed.
Do not forget the main thing - in no case do not be discouraged. This disease is not an indication for abortion. If you decide to fight this ailment, then you need to follow all the doctor's prescriptions.
What is hepatitis
Hepatitis is an inflammatory disease of the liver that is often triggered by viral pathogens. In addition to the viral forms of the disease, another group is isolated, which is caused by the toxic effects of substances. These include autoimmune hepatitis and radiation.
Hepatitis C is a viral group of diseases. Promotes the development of cirrhosis and malignant neoplasms.
Today, this species is the most dangerous. The characteristic latent form of the course of the disease often leads to serious complications. Causes disability or death.
How pregnant can become infected with hepatitis C
Viral hepatitis C is widespread throughout the world. He is considered a disease of the young. Most often it is diagnosed in people under the age of 30 years.
Main ways of infection:
- Piercing piercing.
- The introduction of a common needle injection (including drug addiction).
- The sharing of personal care products (toothbrushes, razors, tools for manicure).
- During operations.
- In the treatment of teeth.
- Unprotected sex with an infected person.
Thus, the main route of infection with hepatitis C is blood and genital fluids.
The disease is not transmitted by airborne droplets, through hugs and handshakes, when using common dishes.
Perhaps living together with a sick person, subject to all precautions.
Pregnancy can provoke the development of hepatitis C, if a woman has previously been its carrier. This is due to a decrease in the efficiency of the immune system.
Is the disease transmitted to the fetus
Every woman who has been diagnosed with hepatitis C during pregnancy is worried about the possibility of infection and the consequences for the child.
The probability of infection exists, but it is quite small.
Doctors claim that the probability of intrauterine infection of a child does not exceed 5%.
Also, it is believed that the possibility of infection in the process of childbirth is higher than during the gestation period. As the risk of mother’s blood entering the child’s body increases.
Ways of transmitting the virus from mother to child:
- during childbirth - when maternal blood enters the child’s body,
- a newborn baby can get the virus from the mother at the time of caring for it - the umbilical cord is processed. However, if you take precautions, the probability of such an infection is small,
- during breastfeeding - if nipples are injured (cracks or sores).
After the birth of the child put on the control and regularly check his blood for the presence of antibodies. Analyzes take at the age of 1, 3 and 6 months.
If there is no RNA virus in the blood, then the child is healthy.
If the test results are positive, then the child will be given the appropriate treatment.
Types of the disease and their effect on the course of pregnancy
There are 2 forms of flow of viral hepatitis C:
Chronic hepatitis C is a form when a person has been ill for more than 6 months.
Often pregnant women find this type of hepatitis in themselves.
It should be noted that for the fetus the chronic form is practically safe. It is not the cause of congenital abnormalities of the child’s development and pregnancy complications.
Chronic hepatitis C does not adversely affect the possibility of conceiving a child.
Along with this, this form is often the cause of premature birth and the child is stunted. This is due to the presence of cirrhosis in the mother.
There is a risk of giving birth to a dead child due to liver failure.
If a pregnant woman is diagnosed with an acute form of hepatitis C, then she is sent under observation to special infectious departments of maternity homes.
The chances of intrauterine infection of the child in this case are small.
Manifestation of hepatitis C during pregnancy
From the moment the virus enters the woman's body until the first signs of the disease usually occur, it takes about 8 weeks. Sometimes this period can reach 18-20 weeks.
Signs and symptoms of viral hepatitis C during pregnancy:
- Increased fatigue
- Bad mood and tearfulness,
- Poor appetite
- Feeling nauseous, sometimes vomiting,
- Light cal,
- Dark urine
- Temperature rise,
- Painful sensations in the right hypochondrium,
- Feeling of aching joints
- Skin yellowing,
- Yellowing of the whites of the eyes.
A feature of this disease is that an asymptomatic course is often observed. This greatly complicates the treatment and condition of the woman.
Viral hepatitis C includes 3 stages:
It is the acute phase that usually has no symptoms, which leads to the fact that hepatitis has time to go into the chronic form.
The latent phase is quite short and is, in fact, the point of transition from an acute to a chronic state.
The chronic form of the disease is considered the most severe, because when it occurs the maximum damage to the liver.
Treatment of hepatitis C in pregnant women
Drug medications that are used to treat hepatitis C are contraindicated during pregnancy. This is due to the fact that they provoke the development of intrauterine pathologies of fetal development.
In most cases, all treatment at the time of pregnancy stops or does not even begin.
In some cases, it is necessary to conduct drug therapy.
Usually drugs are prescribed in cases of biliary stagnation or if stones were found.
It is necessary to understand that even if it became necessary to prescribe drugs, they will be selected in such a way as to cause the least harm to the unborn child.
If a pregnant woman has an acute form of hepatitis C, then all treatment will be aimed at preserving the pregnancy. In this case, the threat of miscarriage is significantly increased.
How to give birth with hepatitis C
To date, there is no single medical opinion on the issue of the mode of delivery of a pregnant woman who is infected with viral hepatitis C.
It is believed that the risk of infecting a child in childbirth is significantly reduced if a cesarean section is performed.
On the territory of Russia, women infected with hepatitis C have the right to choose the mode of delivery. Doctors are obliged to inform the woman in labor about possible risks and complications.
Also, a guideline for choosing a type of delivery is the level of viral load of a woman.
If it is high enough, then preference should be given to a cesarean section.
Viral hepatitis C and pregnancy are compatible. This disease is not a contraindication to the conception and birth of a child.
You just need to follow all the recommendations of the doctor and regularly undergo a scheduled examination.
The question "Is it possible to give birth in hepatitis C?" Has a definite answer "Yes." Even in the presence of the disease in the mother, the chance to give birth to a healthy child is large enough.
What is dangerous and sources of infection
Hepatitis C is the hardest in the group of hepatitis viruses. The main mode of transmission is through blood. The source of infection can be fresh and dried blood. Also you can get a virus along with any other human body fluids - seminal fluid, saliva. Ways of infection:
- when using non-sterile or poorly disinfected medical instruments,
- with blood transfusions,
- in tattoo parlors, in manicure and pedicure rooms,
- with unprotected sex,
- from mother to child (vertical infection),
- in the process of labor.
The risk of infection of the fetus during gestation is 5%. The formation of antibodies in the mother's body inhibit the development of the disease in the child. If problems occur with the placenta during gestation, the risk of infection of the fetus increases several times (up to 30%). The presence of HIV infection in a pregnant woman increases the likelihood of infection of the child. Infection of the infant can occur during childbirth. In this case, the way in which a woman will give birth does not matter.
There are three ways of "vertical transmission" of the virus from mother to child:
- in the perinatal period,
- transfer in the process of labor,
- infection in the postpartum period.
If during the period of gestation and during the process of childbirth the child was not infected with hepatitis C, then there is a high probability of infection after birth. Since the baby is in constant contact with the mother. To prevent this from happening, the mother should carefully monitor the condition of her skin, avoid cuts and injuries. And if a woman is injured, then avoid getting blood on the skin and mucous membranes of the newborn.
Hepatitis C in pregnant women does not affect the course of pregnancy. But the processes that occur in the liver of the mother, can provoke premature labor and hypertrophy in the fetus.
What to do if a pregnant woman has hepatitis C
For the entire gestational period, each woman is tested for hepatitis 3 times. If the result was positive, then the expectant mother would have to visit the doctor more often, be under the careful supervision of doctors and give birth in a separate infection ward.
The patient may be prescribed drugs for the liver, which are not contraindicated in pregnancy.
Symptoms and diagnosis
In most cases, the disease proceeds without pronounced symptoms and does not manifest itself for a long time. General symptoms of the presence of hepatitis B virus can be distinguished:
- the skin and eyes became yellow,
- nausea and vomiting,
- temperature rise,
- pain under the ribs on the right side.
Some symptoms a woman may take for the indisposition during pregnancy and not pay attention to them.
An accurate diagnosis can be made only after the expectant mother will pass a blood test for hepatitis (anti-HCV). Markers for the presence of hepatitis C virus are detected by immunofermentation of the blood.
To obtain the most reliable result for the presence of hepatitis C, the method of polymerase chain reaction is used. The essence of the method consists in multiple duplication of the selected DNA fragment when using enzymes in artificially created conditions.
Is there an error in the diagnosis
Error in making a diagnosis of hepatitis C during pregnancy takes place in medical practice. Therefore, a woman must pass the analysis again. In women in position, the analysis for hepatitis can be false not only as a result of an error, but also for several reasons:
- presence of autoimmune diseases,
- the presence of tumors
- complex infectious diseases.
A positive indicator for hepatitis C may result from the presence of another virus in the body, so additional tests are being conducted:
- liver ultrasound,
- total blood count,
- abdominal ultrasound,
- polymerase chain reaction method.
How nursing proceeds
Pregnancy with hepatitis C is not a sentence for the mother or child. The impact that a disease can have on a fetus and during pregnancy depends entirely on its shape and on the amount of viral RNA in a woman’s blood. If the content of the virus is less than one million copies, then the woman will usually feel when the child is born, and the probability of infection of the fetus is reduced to a minimum.
The manifestation of chronic signs of disease and high blood levels (more than two million copies) of viral RNA carries the risk of not carrying a pregnancy and the development of pathologies in the fetus. The baby may be born prematurely.
If the virus was found in a woman at the planning stage of pregnancy, then the disease should be treated first and six months later, after discontinuation of the drugs, begin to conceive.
What danger does the virus carry?
Hepatitis C can be transmitted from mother to child during fetal development, during labor and after birth. Infection of the fetus can occur if the protective barrier (placenta) is broken. When a baby is born, antibodies can be detected in its blood. This fact should not cause strong fears, as they usually disappear by the age of two. Detect infection is possible after two years. The analysis for the presence of antibodies in a child of the first year of life is taken at one, three, six and twelve months.
If the child did not become infected by the mother during pregnancy and childbirth, then the virus will be transmitted later, will depend on the mother observing all the precautions.
It is possible to give birth to a baby to a mother suffering from hepatitis, either naturally, or by cesarean section. The probability of infection is not affected by the mode of delivery.
Pregnancy and maternal hepatitis can have a negative effect on the course of the disease. Since the woman's body is weakened when carrying a child, the disease can become more severe. This is a danger, both for mother and baby. As a result of complications, a malignant liver tumor can develop in a woman. Severe hepatitis C can adversely affect the development and viability of the fetus, provoke premature birth, asphyxiation and hypoxia in the newborn. The body of the baby, who was born much earlier, is very weak, so the mortality rate among such children is up to 15%.
At the height of epidemics, the death rate of mothers suffering from hepatitis is 17%. There may be complications after childbirth in the form of bleeding, which appear on the background of blood clotting.
Treatment in the process of carrying
Treatment of hepatitis C during pregnancy is made in case of exacerbation, in this case liver intoxication occurs, leading to abortion. With a calm course of the disease, doctors monitor the patient through frequent examinations and laboratory tests. Many drugs that are used to fight hepatitis are prohibited during pregnancy.
To support the work and reduce the risk of developing cirrhosis of the liver, the patient is prescribed light preparations Hofitol, Essentiale, and dieting is recommended. It is important to eat properly while waiting for the child and in case of hepatitis C. There is a need in small portions with a short break between meals. In the diet should prevail food that is easily digested and digested, products of plant origin.
An infected woman expecting a child should avoid exposure to substances that poison the body.: evaporation of varnishes and paints, exhaust from cars, smoke, etc. Prohibited to take antibiotics and drugs against arrhythmias.
Undesirable are heavy loads, leading to fatigue, prolonged exposure to cold.
How are birth and what are the consequences
Если был обнаружен гепатит С при беременности, то оценить возможные последствия для малыша очень непросто. Так как младенец может и не заразиться при родах. Рожать надо по показаниям врача. Какой способ родоразрешения показан женщине, таким и нужно рожать. For infection with hepatitis, the method of giving birth to a child does not matter. But, there is an opinion that cesarean section reduces the risk of infection of the newborn. The physician must inform the woman about the possible risks to the fetus, show the statistics of infection during independent labor and with the help of a cesarean section.
Patients with chronic hepatitis are sent for delivery to the infectious disease ward. If a woman has a non-viral form of the disease and there were no complications during pregnancy, then she can give birth in the general ward. Also, the expectant mother may lie in the general department of the pathology of pregnancy and expect to give birth.
Single opinion about breastfeeding infants does not exist. Studies show that in some cases, women with chronic HCV infection, breast milk was not infected. But according to the results of other experiments, the virus RNA was detected in milk, but its concentration was low.
When a baby is born, a pediatric infectious disease monitors its condition throughout the year. The final study is carried out after 24 months from the moment of birth of the child, then it can be accurately determined whether he has become infected or not.
After the baby is born, the woman may have an exacerbation of the disease. 1 month after giving birth, a mother suffering from hepatitis B needs to have a blood test. According to the results of laboratory studies, further action should be planned.
Hepatitis C abortion
Since the course of hepatitis is asymptomatic, its detection occurs during routine tests when registering at a antenatal clinic. Future parents may be frightened by such a diagnosis. Abortion in hepatitis C is contraindicated in exacerbations. If there is a threat of abortion, then the doctors are trying in every way to save the child.
If a woman decides to terminate the pregnancy, fearing for the health of the baby, then an abortion is performed before the 12-week period.. But an abortion can only be done at the end of the icteric stage.
The doctor may insist on the termination of pregnancy for medical reasons or because of the danger to the life of the mother. I single out the clinical indications for abortion:
- hepatitis and cirrhosis in severe form,
- placental abruption, bleeding,
- cancers requiring chemotherapy,
- acute neuroinfections,
- danger of uterine rupture, etc.
Different types of abortion are applied depending on the duration of pregnancy and the state of health of the woman. Allocate:
- surgical method of abortion,
- abortion with medication (miscarriage occurs)
- abortion after thirteen weeks of pregnancy (complicated abortion).
Spontaneous abortion in hepatitis C is observed in 30% of cases.
In the mild form of the disease, hepatitis C is not an obstacle to maternity and should be aborted only in extreme cases.
Hepatitis C and pregnancy. Hepatitis C treatment and pregnancy planning.