WAYS TO REDUCE THE NEGATIVE CONSEQUENCES FOR THE MOTHER AND NEWBORN IN WOMEN WITH HEPATITIS B DURING PREGNANCY
Keywords:
pregnancy, chronic hepatitis B, perinatal outcomes, immunoprophylaxisAbstract
Chronic hepatitis B (HBV) remains one of the leading infectious causes of adverse pregnancy outcomes and perinatal pathology. Viral replication, accompanied by cytolytic syndrome and impaired metabolic functions of the liver, leads to an increased incidence of gestosis, anemia, placental insufficiency, premature birth and the risk of vertical transmission of infection. The proposed comprehensive management of pregnant women with chronic hepatitis B ensured a reduction in viral load by more than 2.6 times (p<0.01), normalization of ALT, AST and bilirubin, and a reduction in the degree of fibrosis according to elastography (FibroScan CAP). The incidence of obstetric complications decreased by 1.5–2 times, and preterm births decreased from 16.1% to 8.1% (p<0.05). Cardiotocography results in the third trimester in patients in the study group showed a significant increase in heart rate variability and acceleration rate (p<0.01), a decrease in late decelerations, and normalization of the fetal condition index (FCI=1.10±0.25). The body weight and viability of newborns were higher, and the frequency of vertical transmission of HBV decreased to 1.2% versus 5.7% (p<0.05). Comprehensive management of pregnant women with hepatitis B helps reduce viral activity, stabilize liver function, improve fetoplacental circulation, and prevent neonatal HBV infection.
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