At right approach to conception, future parents undergo a full examination at the stage of planning a child. The most common detection of viral hepatitis C occurs when a woman undergoes a complete screening examination. Hepatitis C and pregnancy can coexist peacefully in female body. Pregnancy in a woman with hepatitis does not aggravate the course of the disease.
Hepatitis C and pregnancy can exist peacefully in the female body
What is dangerous and sources of infection
Hepatitis C is the most severe in the group of hepatitis viruses. The main mode of transmission of the disease is through the blood. The source of infection can be fresh and dried blood. You can also get the virus along with any other liquids. human body – seminal fluid, saliva . Methods of infection:
- when using non-sterile or poorly disinfected medical instruments;
- during blood transfusion;
- in tattoo parlors, in manicure and pedicure rooms;
- with unprotected sexual contact;
- from mother to child (vertical infection);
- in the course of labor activity.
The risk level 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 during gestation there are problems with the placenta, then 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 an infant can occur during childbirth. At the same time, how 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;
- transmission during labor;
- infection in the postpartum period.
Baby can get hepatitis C after birth
If during the period of gestation and during 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, mom needs to 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 mother's liver can provoke premature birth 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 turned out to be positive, then the expectant mother will have to visit the doctor much more often, be under the close supervision of doctors and give birth in a separate infectious diseases department.
The patient may be prescribed drugs for the liver, which are not contraindicated during gestation.
Symptoms and Diagnosis
In most cases, the disease proceeds without pronounced symptoms and does not manifest itself for a long time. It is possible to distinguish the general symptoms of the presence of the hepatitis virus in the body:
- skin and eyes become yellow;
- weakness;
- drowsiness;
- nausea and vomiting;
- temperature increase;
- pain under the ribs on the right side.
A woman may mistake some symptoms for ailments during pregnancy and not pay attention to them.
An accurate diagnosis can only be made after the expectant mother has a blood test for hepatitis (anti-HCV). Markers for the presence of hepatitis C virus are detected by blood immunofermentation.
To obtain the most reliable result for the presence of hepatitis C, the polymerase chain reaction method is used. The essence of the method lies in the multiple duplication of the selected DNA fragment using enzymes under artificially created conditions.
Is there a diagnostic error?
An error in diagnosing hepatitis C during pregnancy occurs in medical practice. Therefore, the woman must retake the analysis. In women in position, the analysis for hepatitis can be false, not only as a result of an error, but also for a number of reasons:
- the presence of autoimmune diseases;
- the presence of tumors;
- complex infectious diseases.
A positive indicator for hepatitis C can result from the presence of another virus in the body, so an additional examination is carried out:
An ultrasound of the liver is used to accurately diagnose hepatitis C.
- ultrasound examination of the liver;
- general blood test;
- ultrasound examination of the abdominal cavity;
- polymerase chain reaction method.
How is gestation
Pregnancy with hepatitis C is not a death sentence for mother or child. The impact that the disease can have on the fetus and the course of pregnancy depends entirely on its form and on the amount of viral RNA in the woman's blood. If the content of the virus is less than one million copies, then the woman will feel normal when carrying a child, and the likelihood of infection of the fetus is minimized.
Manifestation chronic symptoms diseases and high blood levels (more than two million copies) of viral RNA carry the risk of miscarriage and the development of pathologies in the fetus. The baby may be born prematurely.
If the virus was detected in a woman at the stage of pregnancy planning, then the disease should first be treated and six months later, after the drugs are discontinued, start conception.
What is the danger of the virus
Hepatitis C can be passed from mother to child during fetal development, during childbirth and after childbirth. Infection of the fetus can occur if the protective barrier (placenta) is broken. When a baby is born, antibodies can be detected in his blood. This fact should not cause great concern, since they usually disappear by the age of two. It is possible to detect infection after two years. An 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 from the mother during pregnancy and childbirth, then whether the virus will be transmitted later will depend on the mother's compliance with all precautions.
You can give birth to a baby to a mother with hepatitis naturally so by caesarean section. The method of delivery does not affect the likelihood of infection.
Pregnancy and hepatitis in the mother can have a negative impact 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 dangerous for both mother and baby. As a result of complications, a woman may develop a malignant tumor of the liver. A severe form of hepatitis C can adversely affect the development and viability of the fetus, provoke premature birth, asphyxia and hypoxia in the newborn. The body of a baby who was born much ahead of schedule, is very weak, so the mortality among such children is up to 15%.
During the height of epidemics, the death rate of mothers with hepatitis is 17%. There may be complications after childbirth in the form of bleeding, which appear against the background of a violation of blood clotting.
Treatment during pregnancy
To support liver function and reduce the risk of developing cirrhosis, the patient is prescribed light drugs.
Treatment of hepatitis C during pregnancy is carried out in case of exacerbation, in which case liver intoxication occurs, leading to termination of pregnancy. With a calm course of the disease, doctors monitor the patient with frequent examinations and laboratory tests. Many drugs that are used to fight hepatitis are prohibited during pregnancy.
To support work and reduce the risk of developing cirrhosis of the liver, the patient is prescribed light preparations of hofitol, Essentiale, and diet is recommended. It is important to eat right while expecting a baby and when you have hepatitis C. You need to eat in small portions with short breaks between meals. The diet should be dominated by food that is easily digested and digested, products of plant origin.
An infected woman who is expecting a child should avoid exposure to substances that poison the body: evaporation of varnishes and paints, exhaust from cars, smoke, etc. Antibiotics and drugs against arrhythmia are forbidden to be taken.
Undesirable are heavy loads leading to overwork, prolonged exposure to the cold.
How is childbirth and what are the consequences
If hepatitis C was detected during pregnancy, then evaluate possible consequences It's very difficult for a baby. Since the baby may not become infected during childbirth. It is necessary to give birth according to the testimony of a doctor. What method of delivery is shown to a woman, this is how you need to give birth. For infection with hepatitis, the way the child is born special significance does not have. But, there is an opinion that caesarean section reduces the risk of infection of the newborn. The doctor needs to inform the woman about the likely risks to the fetus, show the statistics of infection during spontaneous childbirth and with the help of a caesarean section.
Patients with chronic hepatitis are sent to the infectious department for delivery. 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 department. Also, the expectant mother can lie in the general department of pregnancy pathology and expect childbirth.
There is no single opinion about breastfeeding newborns. Studies show that in some cases in women with chronic HCV infection, breast milk was not infected. But according to the results of other experiments, virus RNA was found in milk, but its concentration was low.
When the baby is born, the pediatric infectious disease specialist monitors his condition for a year. The final study is carried out after 24 months from the date of birth of the child, then you can accurately determine whether he has become infected or not.
After the birth of a baby, a woman may experience an exacerbation of the disease. One month after giving birth, a mother with hepatitis needs to do a blood test. Based on the results of laboratory studies, further actions should be planned.
Abortion with hepatitis C
A doctor may insist on termination of pregnancy for medical reasons or in connection with a threat to the life of the mother
Since the course of hepatitis is asymptomatic, its detection occurs during routine tests during registration at the antenatal clinic. Future parents can be frightened by such a diagnosis. Abortion in hepatitis C is contraindicated during exacerbation. If there is a threat of termination of pregnancy, then doctors try their best 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 you can have an abortion only at the end of the icteric stage.
A doctor may insist on termination of pregnancy for medical reasons or in connection with a threat to the life of the mother. I single out clinical indications for abortion:
- hepatitis and cirrhosis of the liver in severe form;
- placental abruption, bleeding;
- cancers requiring chemotherapy;
- acute neuroinfections;
- diabetes;
- risk of uterine rupture, etc.
Different types of abortion are used depending on the duration of pregnancy and the health of the woman. Allocate:
- surgical termination of pregnancy;
- vacuum;
- abortion with the help of medications (miscarriage occurs);
- abortion after thirteen weeks of pregnancy (complex abortion).
Spontaneous abortion in hepatitis C is observed in 30% of cases.
With a mild form of the disease, hepatitis C is not an obstacle to motherhood and abortion should be done only in extreme cases.
Video
Hepatitis C and pregnancy. Hepatitis C treatment and pregnancy planning.
Hepatitis C during pregnancy is dangerous with a high risk of intrauterine infection of the fetus. Infection can also occur when a child passes through the birth canal. The urgency of the problem of hepatitis is constantly increasing, because the number of infected annually increases. The disease in a pregnant woman is more severe.
Stages of hepatitis C
It lasts 7-8 weeks, in some cases it increases up to six months. Viral infection occurs in 3 stages:
- acute;
- hidden;
- reactive.
Jaundice occurs in every fifth patient. Antibodies in the blood can be detected several months after the virus enters the body. The outcome of the disease has two options: an acute infection ends with recovery or goes into chronic form. The patient may not even be aware of the presence of hepatitis C.
The reactivation phase lasts 10–20 years, after which it turns into cirrhosis or liver cancer. A special analysis helps to identify the disease. If antibodies are found during the study, then hepatitis is suspected. This means that the person has been infected. Next, a blood test is performed for the RNA of the infectious agent. If it is detected, it is necessary to determine the viral load and type of hepatitis.
A biochemical blood test helps to choose the most effective therapeutic regimen.
The course of the disease
If during the period of bearing a child, antibodies to hepatitis C are detected in the blood of a woman, they look at how common it is. If more than 2 million replicas are found, the chance that the fetus will also become infected approaches 30%. With a low viral load, the risk of infection will be minimal. rarely causes complications during pregnancy. Infection of the child occurs during childbirth, especially with the development of bleeding in the mother.
A child is born healthy if antibodies were found in the woman's blood, but no virus RNA was detected. Antibodies in the body of a child are present on average until the age of two. Therefore, the analysis for hepatitis C up to this point is not informative. If both antibodies and RNA of the infectious agent were found in a woman, it is necessary to carefully examine the baby. Doctors recommend diagnosing at 2 years of age. When planning a pregnancy and, a woman must be tested for HIV and hepatitis C. After antiviral therapy, she will have to wait at least six months.
Treatment of pregnant women
When a virus is detected in a woman's body, she needs to be examined. First of all, pay attention to the presence of symptoms of liver damage. A detailed examination is carried out after the birth of the child. of the virus should be informed about the possibility of transmission of the infection in the household way. It is necessary to have personal hygiene items:
Antiviral therapy can be started only with the permission of a doctor. The risk of hepatitis C increases with HIV infection.
Since the disease negatively affects pregnancy, regular determination of viral load is necessary. A similar analysis is carried out in the 1st and 3rd trimester. It helps to assess the likelihood of infection of the unborn child. Some diagnostic methods cannot be used due to the high risk of intrauterine infection. The duration of the therapeutic course during pregnancy is 6-12 months. In the recent past, drugs from the group of linear interferons were used, which have low efficiency:
Tactics of conducting labor in patients with hepatitis
The optimal mode of delivery for infected women is a controversial issue. Some experts believe that dangerous consequences for the child do not occur during a caesarean section. According to statistics, surgery reduces the risk of perinatal infection by up to 6%. Whereas during natural childbirth, it approaches 35%. In any case, the woman makes her own decision. It is important to determine the viral load. Specialists must take all measures aimed at preventing infection of the child.
The theory regarding the possibility of infection of the newborn during breastfeeding has not received official confirmation. However, it should be remembered that other infections, such as HIV, can be transmitted through mother's milk. The child of a woman diagnosed with hepatitis C should be under constant supervision. Tests are performed at 1, 3, 6 and 12 months of age. If RNA of the virus is detected in the blood, the child will be considered infected. It is also necessary to exclude chronic forms of hepatitis.
Why is hepatitis C dangerous for a pregnant woman? Even if the child does not get infected from the mother, the infection weakens her body. Hepatitis C treatment should preferably be completed before delivery. The danger of chronic hepatitis lies in the occurrence of severe complications. In addition, the disease disrupts the functions of the liver, and this organ is involved in the metabolism between the organisms of the mother and child. The most common complications are:
- cholestasis;
- late toxicosis (gestosis);
- fetal hypoxia;
- spontaneous abortion.
”occurs during pregnancy or its planning. This is due to the screening of pregnant women for various infections, among which are hepatitis C, hepatitis B and HIV. According to statistics, in Russia hepatitis C markers are detected in every thirtieth pregnant woman. We will try to answer the main questions that future mothers have in this situation, selected taking into account the activity of visitors to our site.
Does pregnancy affect the course of chronic hepatitis C (CHC)?
Pregnancy in CHC patients does not adversely affect the course and prognosis of liver disease. ALT levels usually decrease or even return to normal during the second and third trimesters of pregnancy. At the same time, the level of viremia, as a rule, increases in the third trimester. ALT and viral load return to pre-pregnancy levels on average 3-6 months postpartum.
Can you give birth with HCV? Does hepatitis C affect pregnancy?
Studies conducted to date suggest that HCV infection does not reduce reproductive function and is not considered as a contraindication to conception and pregnancy. HCV infection does not affect the condition of the mother and fetus.
Can hepatitis C be passed from mother to child?
Dozens of studies have been conducted to assess the risk of mother-to-child transmission, according to the results of which the frequency of infection in a child ranges from 3% to 10%, averaging 5%, and is regarded as low. Transmission of the virus from mother to child can occur intranatally, that is, during childbirth, as well as in the prenatal and postnatal period (when caring for a child, breastfeeding). Infection during childbirth is of primary importance. In the prenatal and postnatal period, the frequency of infection of children from HCV mothers is extremely low. An important risk factor in the transmission of the virus from mother to child is viral load (hepatitis C RNA concentration in blood serum). It is considered more likely if the mother's viral load is above 10 6 -10 7 copies/ml. Among all infections, 95% occur in mothers with these viral load values. Anti-HCV-positive and HCV RNA-negative (the virus is not detected in the blood) mothers are not at risk of infecting the child.
Should hepatitis C be treated during pregnancy?
Taking into account the peculiarities of the course of CHC in pregnant women, as well as the adverse effects of interferon-α and ribavirin on the fetus, AVT is not recommended during pregnancy. In some cases it may be necessary drug treatment(for example, the appointment of drugs ursodeoxycholic acid), aimed at reducing the signs of cholestasis.
Is it necessary to do a caesarean section? Is it possible to give birth in a regular maternity hospital?
The results of studies of the influence of the method of delivery (through the natural birth canal or caesarean section) on the frequency of infection of the child are contradictory, however, in most studies, no significant differences were obtained in the frequency of infection of the child, depending on the method of delivery. Caesarean section is sometimes recommended for women with high viremia (over 10 6 copies/ml). Established that in mothers with HCV-HIV co-infection, planned caesarean section reduces the risk of HCV infection (as well as HIV), and therefore, in such pregnant women, the choice of delivery method (planned caesarean section only) is based solely on HIV status. All women with HCV infection give birth in conventional maternity hospitals on a common basis.
Can I breastfeed with hepatitis C?
The risk of transmission of hepatitis C is extremely low during breastfeeding, so it is not recommended to stop breastfeeding. However, when feeding, you need to pay attention to the condition of the nipples. Microtrauma to the mother's nipples and exposure of the baby to her blood increase the risk of infection, especially when the mother has a high viral load. In this case, you need to temporarily stop breastfeeding. In women with HCV-HIV co-infection who are breastfeeding, the incidence of HCV infection in newborns is significantly higher than in artificial feeding. For such women, the recommendations developed for HIV-infected people prohibit breast-feeding newborns.
The child was found to have antibodies to the virus. He is sick? When and what tests should be done?
In all newborns from HCV-infected mothers, maternal anti-HCV, which crosses the placenta, is detected in the blood serum. Maternal antibodies disappear during the first year of life, although in rare cases they can be detected up to 1.5 years. The diagnosis of HCV infection in newborns can be based on the detection of HCV RNA (the first study is carried out between 3 and 6 months of age), but it must be confirmed by repeated detection of HCV RNA (due to the possibility of a transient nature of viremia), and also anti-HCV detection at 18 months of age.
The child has HCV. What is the prognosis of the disease? Do I need to be vaccinated against other hepatitis?
It is believed that in children infected in the intranatal and perinatal period, hepatitis C proceeds mildly and does not lead to the development of cirrhosis and hepatocellular carcinoma (HCC). However, the child should be examined annually to control the course of the disease. Because superinfection with hepatitis A or B viruses may worsen the prognosis of HCV infection, hepatitis A and B vaccination should be considered in HCV-infected children.
Hepatitis B vaccine and pregnancy
Is it possible to vaccinate against hepatitis B during pregnancy, breastfeeding?
The influence of HBsAg antigens on fetal development is not yet fully understood, therefore, during pregnancy, hepatitis B vaccination should be carried out only at a high risk of infection. Accidental administration of a vaccine is not an indication for abortion. No negative effects have been identified during vaccination during lactation, so breastfeeding is not a contraindication to the introduction of the vaccine.
General recommendations for pregnant women infected with HCV and their children:
It is advisable to study the level of HCV viremia in the III trimester of pregnancy in all pregnant women with anti-HCV in the blood serum;
- it is recommended to avoid amniocentesis, electrodes on the skin of the fetus, the use of obstetric forceps, as well as a long anhydrous period of childbirth, especially in women with a high level of viremia;
- there is no reason to recommend a planned caesarean section in order to reduce the risk of infection of the child;
- it is not recommended to prohibit breastfeeding of a newborn;
- all children diagnosed with perinatal HCV infection are subject to observation, including children with intermittent viremia.
For women with HCV-HIV coinfection, the recommendations developed for HIV-infected women apply:
- Mandatory planned caesarean section and prohibition of breastfeeding.
Chronic hepatitis C and pregnancy
A very large percentage of women in such developed country how Russia detects the hepatitis C virus in its blood when it begins to undergo a routine examination for early stages pregnancy.
On the one hand, early is better than “late”, given the insidious nature of the development of the disease. On the other hand, it is an alarming indicator of the scale of the spread of the virus and our attitude to our health.
What you need to know about hepatitis
Hepatitis is a dangerous infectious inflammatory disease of the liver.
There are several types of hepatitis - A, B, C, D and E. The common unifying feature of these diseases is that they are all diseases of one organ - the liver. And the difference is manifested in the severity of the course of the disease and its consequences, methods and time of treatment, and in the possibility of a cure as such.
In addition, the causative Each type of hepatitis is served by different viruses. Therefore, the hepatitis B vaccine will be helpless in trying to neutralize the hepatitis C virus when it enters the human body.
It is important to know that hepatitis types are transmitted in different ways. Yes, the most common hepatitis A, or banal jaundice, can be contracted through unwashed vegetables and fruits and drinking unboiled water.
Hepatitis E can be infected in a similar way. But, there is an important difference - this type of disease is very widespread in the so-called "third world countries" with a hot tropical climate. Lack of sufficient clean drinking water, low level developments in medicine contribute to the high prevalence of the disease.
Hepatitis E is extremely insidious for pregnant women, fraught with severe pregnancy and dangerous complications for women and children.
Therefore, if you have already found yourself in these conditions, it is recommended to avoid drinking suspicious water and even ice, the safety of which may be in doubt.
Hepatitis B and hepatitis C virus enters the body through the blood or through sexual contact. If pregnancy occurs, an infected woman has a chance of passing on hepatitis C through the placenta or during childbirth.
Certain types of hepatitis are relatively easy to diagnose and treat. For example, acute form of hepatitis B, which initially resembles the flu, already on the third day from the onset of the disease shows characteristic signs: nausea and vomiting, icteric skin tone and pain in the right hypochondrium.
With a correct and timely diagnosis and professional care, acute hepatitis B is cured within a week or two, and hepatitis C - within six months without fatal consequences.
In the case of the transition of the acute stage of the disease to the chronic one, the treatment takes not months, but years, and there is no 100% chance of a complete recovery. In the worst case, everything can end with cirrhosis or liver cancer.
A common characteristic feature of all types of hepatitis is yellowing of the skin, mucous membranes and whites of the eyes. If all this is accompanied by signs of a strong food poisoning, nausea and vomiting occur, body temperature rises - do not pull, this is an alarming symptom.
All hepatitis is a liver disease, and although this is perhaps the most patient human organ, in acute inflammatory process he makes himself known. If the liver is visually enlarged and this is accompanied by any signs of discomfort in the form of pain, this is a compelling reason to consult a doctor.
The most insidious type of hepatitis is the silent killer, chronic hepatitis C. For quite a long time, an infected person may not notice any signs of this disease. The characteristic symptomatology manifests itself at the chronic stage of the disease, when the processes of liver damage have already gone far enough.
This is a violation of carbohydrate metabolism, which is characterized by a constant high content of sugar in the blood. And like any deviation in pregnant women, it is not welcome because of possible complications.
Rarely, pregnant women infected with hepatitis C have signs of cholestasis or, as it is also called, .
This phenomenon is associated with insufficient liver function and, as a result, a decrease in the removal of bile to the intestines. As a result of this failure, bile salts accumulate. All this leads to the fact that there is severe itching, and most often at night. However, these phenomena safely disappear within two weeks after childbirth.
Pregnant women with hepatitis C may be at risk of developing preeclampsia, a few percent more likely than a healthy woman. This extremely unpleasant phenomenon, characteristic of the late stage of pregnancy, is also called "late toxicosis".
Doctors, who for the most part are condescending to first trimester toxicosis, consider these manifestations to be quite dangerous and require treatment in order to avoid placental abruption and fetal death.
For the development of the fetus "mother's" hepatitis C can bring some trouble. The risk of preterm birth and the birth of an underweight baby is considered a proven risk.
Such a newborn child, of course, will need increased attention and care.
Features of the treatment of hepatitis C during pregnancy
If you are pregnant and you have a positive reaction to hepatitis C antibodies, or vice versa: if you are infected and “discovered” pregnancy, you need to understand that there will be certain nuances.
Pregnant women are contraindicated a number of drugs that are used in the treatment of hepatitis C. These necessarily include interferon and ribavirin. This is due to optional, but possible risks of developing pathologies in the fetus. And the task of each doctor is to provide even a hypothetical probability of such a risk.
It is worth focusing on the obvious: a woman in a position who has a history of hepatitis C, and at the same time wants to give birth to a healthy child, Absolutely do not drink alcohol in any form.
This will almost certainly increase the risk of liver damage, which will affect your health and the serious, in percentage terms, the likelihood of late toxicosis. And this, in turn, can cause rejection, and as a result, the death of the fetus.
The second option for the development of events -. Also, I must say, good enough.
Ideally, you should also give up smoking, and complete this series of feats in the name of the unborn child by switching to a healthy and balanced diet.
Not recommended neither in the first nor in the subsequent trimesters of pregnancy conducting antiviral therapy. It involves the use of interferon-α and ribavirin, the undesirability of which has already been discussed.
There are cases when a pregnant woman with hepatitis C virus drug treatment may be indicated. This is the last trimester of pregnancy to reduce signs of cholestasis or to minimize the risk of preeclampsia.
There is a high risk of intrauterine infection of the fetus, as well as infection during difficult births. The urgency of the problem of hepatitis C during pregnancy is increasing, as, according to statistics, the number of infected people is increasing.
Viral hepatitis
In a pregnant woman, hepatitis is much more severe. There are the following viral hepatitis: A, B, C, D and E.
- Hepatitis A. Acute enterovirus infection often affects preschoolers and schoolchildren. The route of infection is fecal-oral.
- Hepatitis B. Infection with the virus can be both acute and chronic. Incubation period may take six months. The risk of infection of the baby during childbirth is 50%.
- Viral hepatitis C disease can occur in 40-75% of women asymptomatically. Chronic hepatitis develops in 50%, and cirrhosis of the liver is recorded in 20%. Infection occurs through blood, saliva, vaginal discharge. Hepatitis C is considered the most severe and dangerous viral infection.
- Hepatitis D. With this viral disease, markers of hepatitis B may be absent in the blood. The disease develops rapidly and ends with recovery.
- Transmission route viral infection E - water and fecal-oral. The incubation period is 35 days.
Symptoms
The incubation period for hepatitis C is on average 7-8 weeks, but other intervals are possible - 2-27 weeks. A grade 3 viral infection has an acute, latent, and reactivation phase.
Jaundice develops in only 20% of infected patients. Antibodies appear a few weeks after infection. An acute infection can result in a complete recovery, but more often this form passes into a latent phase. Patients do not even know about their disease.
The reactivation phase is characterized by chronic hepatitis. The disease, which continues in this form for 10-20 years, turns into cirrhosis of the liver and a malignant tumor (hepatocellular carcinoma).
Diagnostics
The diagnosis of infection with a dangerous virus can only be made by the results of a blood test. If antibodies to the hepatitis C virus are detected, a disease is suspected, but this only means that the virus was in the human body. After that, it is necessary to conduct a blood test for the RNA of the virus. If, as a result, it is nevertheless detected, a blood test should be carried out for the amount of virus and genotype. In order to choose the right method of treatment, a biochemical blood test is performed.
Features of the course of infection
When hepatitis C RNA virus is detected in a pregnant woman, they look at its prevalence. If more than 2 million copies are found, the chance of intrauterine infection approaches 30%. If the number of viruses is less than 1 million, the likelihood of infection of the fetus is minimal.
Chronic viral hepatitis C in pregnant women proceeds without complications. Infection of the fetus can occur during childbirth if the mother's blood enters the injured areas of the baby's body.
The probability of infection of the infant is zero if the pregnant woman has antibodies to the hepatitis C virus, and the virus RNA is not detected. At the same time, doctors state that the fetus will not be infected. Mother's antibodies remain in the baby's blood for up to 2 years. Blood tests for the presence of the virus in a child are carried out no earlier than this age. If both antibodies and virus RNA are found in the mother's blood test, it is worth examining the child. Doctors recommend doing this when the baby is 2 years old.
A blood test for hepatitis C is done before pregnancy. After successful viral therapy, pregnancy can be planned in six months.
Treatment methods for pregnant women
If a pregnant woman is infected with the virus, a general assessment of her health should be made. Look for signs of chronic liver disease. A more complete examination of the mother is carried out after childbirth.
If the mother is a carrier of the virus, she should be aware of the possibility of transmitting the infection through the household. Tools such as Toothbrush and razor, must be individual. Getting the virus through wounds, sexually transmitted infection - she should be aware of all this. Viral therapy (both during pregnancy and after childbirth) is carried out as directed by a doctor. The risk of contracting hepatitis C increases with HIV infection.
In the first and third trimester, the viral load of the pregnant woman should be measured. The conducted studies will help to make a more accurate forecast of infection of the fetus. It is not recommended to use some methods of perinatal diagnosis due to the possibility of intrauterine infection.
Medications
The duration of treatment for hepatitis C virus during pregnancy is 24-48 weeks. Until the 90s, only one drug was used, which belongs to the group of linear interferons. This medicine has low efficacy.
The medical drug "Ribavirin" was synthesized in the late 90s. It began to be used in combination with interferon, which increased the percentage of recovery. The highest results were achieved with the use of pegylated interferons. By increasing the action of interferons, the stability of the virological response also increases.
The American Pharmaceutical Corporation has created a new medicine- Boceprevir. It has been used successfully to treat chronic hepatitis, but the drug is prohibited during pregnancy as it may cause fetal defects.
Another medical drug, Telaprevir, is produced by another American pharmaceutical corporation. The drug has a direct antiviral effect and increases the level of virological response. Pregnant women for the treatment of hepatitis C should only be prescribed by a doctor after examination.
How is childbirth carried out in infected women?
Doctors do not have a common opinion about the optimal way of giving birth for infected women. Italian scientists claim that the risk of transmission of hepatitis from mother to child is reduced by caesarean section. According to their data, during surgery, the risk of infection of the newborn is only 6%, and during natural childbirth - 32%.
Scientists say only that a woman should be informed, but she makes the decision herself. It is important to determine the mother's viral load. It is necessary to take all measures and, if possible, prevent infection of the fetus.
Lactation
There is no scientific evidence that a baby can become infected with hepatitis C through milk. German and Japanese scientists conducted studies that gave a negative result. At the same time, you need to know that other infections are transmitted through mother's milk - for example, the immunodeficiency virus.
The child was born from an infected mother
If the mother is infected with the hepatitis virus, then the child should be constantly monitored. Testing is carried out at different ages - 1, 3, 6 months and when the child is one year old. If the RNA virus is absent in all tests, this indicates that the baby is not infected. The chronic form of the infection should also be ruled out.
Prevention of hepatitis C
Scientists are researching technologies for a hepatitis C vaccine, but so far one exists. At the moment, Americans are engaged in clinical trials of such a drug.
- do not use other people's devices for personal hygiene;
- avoid cuts during medical examinations;
- to do tattoos, permanent makeup, pedicure, manicure and piercing in compliance with all safety and hygiene rules. Also observe the use of disposable needles and sterile instruments;
- monitor the sterility of dental and other medical equipment;
- use condoms and get vaccinated against hepatitis B if the partner is infected.
At-risk groups
There are 3 risk groups. The highest group (1) includes:
- drug addicts;
- people who were transfused with clotting factors prior to 1987.