Can hepatitis B patients still have healthy babies? Yes, but you need to break through the "three passes"

At a very young age, Kobayashi knew that she was "sick" because her classmates did not interact with her much.

It wasn't until junior high school that she didn't know she had hepatitis B. Mom said that she had a virus in her body, and only long-term medication could suppress it, and once the drug was stopped, it would continue to mess around in the body.

During college, she talked about a boyfriend, but the other person heard that there was hepatitis B and quickly proposed to break up.

Is it true that if you get hepatitis B, you really can't get married and have children?

First, half of the people infected with hepatitis B virus are women

It is estimated that there are about 93 million people carrying hepatitis B virus (HBV) on the mainland, of which 41.6% to 47.6% are women. [1]

Compared with male patients, female patients are more anxious. Because of the fear of not being able to give birth to a healthy baby, in order not to "affect the child's life", even some people choose not to have children.

Mother-to-child transmission is the most important route of HBV infection, and if timely intervention is not taken, about 40% of babies born to hepatitis B mothers are likely to be infected with HBV.

Infection may be in the mother's intrauterine infection or transmission at birth or after close contact after birth.

Second, to give birth to a healthy baby, you need to break through three passes

Can hepatitis B really not give birth to a healthy baby?

Actually, yes! As long as the mother-and-child blockade is standardized, the rate of mother-to-child transmission can reach more than 95%. [2]

However, compared with the average woman, the process of giving birth to a baby for hepatitis B patients will be more complicated.

The condition is assessed before pregnancy

Preconception testing is a prerequisite for ensuring the birth of a healthy baby. For hepatitis B patients, preconception tests can not only check for genetic diseases, but also assess the activity status of hepatitis B virus in their bodies.

It is recommended that pregnant women come to the liver disease clinic to do hepatitis B five items, liver function, hepatitis B virus DNA, hepatobiliary and spleen ultrasound and other tests, and comprehensively assess whether they are suitable for pregnancy.

In general, hepatitis B virus carriers or stable hepatitis B patients can normally try to conceive, but if the hepatitis B virus DNA test results are positive and the liver function is abnormal, it is necessary to follow the doctor's instructions for treatment until the liver function is normal.

During pregnancy, it is necessary to do a good job of disease monitoring

Due to changes in hormone levels and morning sickness reactions during pregnancy, liver function may be abnormal, and severe acute fatty liver disease during pregnancy or intrahepatic cholestasis during pregnancy may occur.

Therefore, the most important thing at this stage is to do a good job of monitoring, mainly monitoring hepatitis B virus DNA and liver function, and if there is a change in the condition during the follow-up process, timely treatment measures will be taken.

For example, if a hepatoviral DNA load is found to be greater than (2 ×10) IU/ml during pregnancy, antiviral therapy is required and it is recommended to start treatment at 28 weeks and not until the end of delivery to reduce the risk of mother-to-child transmission during pregnancy. [3]

Postpartum vaccinations and immunoglobulins are given

The postpartum period is the last and most critical step in interrupting mother-to-child transmission of hepatitis B.

After delivery, hepatitis B vaccine and hepatitis B immunoglobulin need to be completed within 12 hours, and the 2nd and 3rd doses of hepatitis B vaccine are given at 1 month and 6 months of age, respectively.

At present, the three doses of hepatitis B vaccine are free, and mothers should vaccinate their babies on time.

In addition, because the baby has more contact with the mother's life, the patient should also do the necessary protection to avoid exposing the baby to the mother's blood, saliva and so on.

Three myths of hepatitis B mother

1. Can hepatitis B mothers breastfeed?

Breastfeeding does not increase the infection rate of infant HBV, a number of studies have found that the probability of hepatitis B virus detection in maternal breast milk is 6.8%, and compared with artificial feeding, the rate of positive detection of infant hepatitis B virus is not statistically different, so hepatitis B patients are recommended to breastfeed at home and abroad. [4]

However, if there is hepatitis B activity, the mother's nipples are cracked and bleeding during breastfeeding, and the newborn canker sores and mucous membranes are damaged, breastfeeding should be stopped.

In addition, if the mother is taking antiviral drugs, tenofovir is recommended, as studies have shown that it has low drug content in breast milk, has limited toxicity and does not affect infant health.

2. Which mother-to-child transmission risk is smaller, vaginal birth or caesarean section?

Whether to have a vaginal birth or a caesarean section is decided by the doctor according to the situation of the mother and the baby, and in general, natural delivery is preferred as long as the situation allows.

In terms of the risk of infection, the probability of spontaneous delivery and caesarean section is comparable, as long as the timely blocking can reduce the chance of infection.

3. After the implementation of the blocking plan, how to judge whether the blocking is successful?

Newborns born to hepatitis B virus-positive mothers require an effect evaluation after vaccination, which is recommended to be 1 to 2 months after the completion of the third dose.

At this time, you can go to the hospital to test hepatitis B two and a half, liver function, HBV-DNA. If the hepatitis B antigen is negative and the hepatitis B surface antibody is positive, it means that the baby's blockade is successful; conversely, if the hepatitis B antigen is positive, it means that the mother and baby blockade have failed.

In response to this situation, it is necessary to re-inject the vaccine in time.

"Pregnant in October, give birth once" is simple to say, and the hardships are only understood by those who have been mothers.

And hepatitis B mothers, before and after childbirth, physically and psychologically have to bear greater pressure than ordinary people.

On this Mother's Day, let's pay tribute to mothers all over the world!