病毒性丙型肝炎妇女妊娠、分娩和围产期结局的特点

Bragina T.V., Petrov Yu.A., Spiridenko G.Yu.
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摘要

本文介绍了从文献资料的回顾,在怀孕,分娩和围产期结局的特殊性的过程中,病毒性丙型肝炎妇女。目前的问题是由于丙型肝炎病毒感染在人群中的高流行率,疾病的临床无症状的过程的可能性,病毒经胎盘途径传播给胎儿的可能性。因此,病毒性丙型肝炎可以在怀孕期间诊断,因为在怀孕的每个三个月对病毒性丙型肝炎抗原进行三次M和G类免疫球蛋白的测定。病毒性丙型肝炎可对妊娠期、分娩和新生儿期的病程产生不利影响。病毒性丙型肝炎可引起以下并发症:终止妊娠的威胁,中度和重度先兆子痫,胎胎盘功能不全,导致胎儿慢性缺氧,宫内生长迟缓I和II度,并在新生儿早期发展为脑缺血I和II度,中度或重度窒息,新生儿适应反应过程受损,新生儿神经功能受损。这证明,在病毒性肝炎背景下妇女的妊娠过程问题不仅具有重要的医学意义,而且具有重要的社会意义。用于治疗病毒性丙型肝炎的药物的致畸作用和缺乏在怀孕期间安全使用的药物强调了妊娠前准备在排除或最小化妊娠期、分娩和不利围产期结局的并发症风险方面的整体作用。
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FEATURES OF THE COURSE OF PREGNANCY, CHILDBIRTH AND PERINATAL OUTCOMES IN WOMEN WITH VIRAL HEPATITIS C
This article presents data from a review of literature sources on the peculiarities of the course of pregnancy, childbirth and perinatal outcomes in women with viral hepatitis C. The current problem is due to the high prevalence of hepatitis C virus infection among the population, the possibility of a clinically asymptomatic course of the disease, the possibility of a transplacental route of transmission of the virus to the fetus. So, viral hepatitis C can be diagnosed during pregnancy as a result of the determination of immunoglobulins of classes M and G to the antigen of viral hepatitis C three times - in each trimester of pregnancy. Viral hepatitis C can have an adverse effect on the course of the gestational period, childbirth, and the neonatal period. Viral hepatitis C provokes the following complications: the threat of termination of pregnancy, preeclampsia of moderate severity and severe, fetoplacental insufficiency, which leads to chronic fetal hypoxia, intrauterine growth retardation of I and II degrees, and in the early neonatal period the development of cerebral ischemia of I and II degrees, moderate asphyxia or severe, impaired course of the adaptive reactions of the newborn, impaired neurological status of the newborn. This proves that the problem of the course of pregnancy against the background of viral hepatitis in a woman has not only important medical, but also social significance. The teratogenic effect of drugs used in the treatment of viral hepatitis C and the lack of drugs that are safe for use during pregnancy emphasize the integral role of pregravidar preparation to exclude or minimize the risk of complications during the gravidar period, childbirth, and unfavorable perinatal outcomes.
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