Experts admit that these six points must be kept in mind about the mother-to-child blocking of hepatitis B.
Hepatitis B mother's wish: to have a healthy baby.
Ms. Lu was infected with hepatitis B. When she handed over the test results of her 8-month-old son's hepatitis B to the doctor, she was both nervous and uneasy. After checking the results, Associate Professor Min Xiaohui told her that her son was HBsAg negative, and the HBsAg antibody was 369IU/ml, indicating that the child had no hepatitis B and the antibody was relatively high. Mother-to-child blocking of hepatitis B succeeded! Hearing the news, Lu couldn't hide his inner excitement.
It is difficult for ordinary people to understand the anxiety and pressure of hepatitis B mothers on their babies infected with hepatitis B. Only we can know how difficult it is for hepatitis B patients to encounter various difficulties in studying, making friends, finding a job and getting married. ? Ms. Lu said that giving birth to a healthy child is the strong desire and prayer of hepatitis B mothers.
Associate Professor Min Xiaohui said that since his team participated? Zero transmission of hepatitis B from mother to child? Over the past two years, Ms. Lu was the first 128 case to successfully block the mother-to-child transmission of hepatitis B. So far, the success rate of blocking the mother-to-child transmission of hepatitis B followed by the team has reached 100%, which truly achieved the goal of zero mother-to-child transmission of hepatitis B. At present, there are more than 300 pregnant women in the team who are managed and followed up according to the standardized mother-to-child blocking scheme of hepatitis B, and there will be more and more successful cases.
70-90% of newborns born to hepatitis B virus-positive mothers will be infected with hepatitis B if preventive measures are not taken. Associate Professor Min Xiaohui said that timely vaccination with hepatitis B vaccine and hepatitis B immunoglobulin (combined immunization) can greatly reduce the risk of mother-to-child transmission of hepatitis B, but there are still 5- 10% of newborns infected with hepatitis B, especially pregnant women with high viral load. For these pregnant women with hepatitis B, taking antiviral drugs in the middle and late pregnancy can significantly reduce the amount of hepatitis B virus and achieve? Zero? The preventive function of communication.
Mother-to-child blocking of hepatitis B is not just? Vaccinate? And then what? Take medicine?
In order to standardize and accurately manage pregnant women with hepatitis B and further reduce the risk of mother-to-child transmission of hepatitis B, the China Hepatitis Prevention Foundation, the Infectious Diseases Branch of the Chinese Medical Association and the Hepatology Branch have been launched nationwide since 20 16? Zero transmission of hepatitis B from mother to child? Nearly 130 hospitals including Sun Yat-sen University and Sun Yat-sen Memorial Hospital participated in the project. On July 26th, 20 19, Sun Yat-sen Memorial Hospital of Sun Yat-sen University was rated as one of the top ten advanced units in China, and Associate Professor Min Xiaohui was rated as one of the top ten advanced workers in China.
Associate Professor Min Xiaohui said that the standardized mother-to-child blocking scheme of hepatitis B is an all-round management of pregnant women and newborns with hepatitis B, not just? Vaccinate? And then what? Take medicine? As simple as that, it also includes 10 links in different periods of pregnancy, delivery and postpartum. Pregnant women with hepatitis B should follow the guidance of experts all the time to achieve the best blocking effect. ? Our team members come from infectious diseases and obstetrics. Obstetricians will refer pregnant women with hepatitis B to infectious diseases department for registration and follow-up management. ?
In order to improve the popularization efficiency of mother-to-child blocking knowledge of pregnant women with hepatitis B, in addition to various forms of health education, taking into account the inconvenience of pregnant women and the needs of patients in different places, the team also established a special follow-up system of WeChat and mobile APP to facilitate patients to communicate with doctors at any time, so that patients can get standardized technical guidance at any time. ? Mother-to-child transmission of hepatitis B? It is a public welfare project, and all team members can provide free science popularization, consultation and follow-up for hepatitis B mothers.
Knowledge of mother-to-child blocking of hepatitis B
1. Delivery mode: Under the guidance of the current mother-to-child blocking technology of hepatitis B, hepatitis B mothers can give birth naturally, and cesarean section cannot reduce the risk of mother-to-child transmission. Among the cases in which Associate Professor Min Xiaohui's team successfully blocked hepatitis B, 55% of pregnant women gave birth naturally.
2. Breastfeeding: The newborn can be breastfed normally by injecting hepatitis B immunoglobulin and hepatitis B vaccine within 0/2 hours after birth. In the case that Associate Professor Min Xiaohui successfully blocked hepatitis B, 63% of newborns were breast-fed. However, if the mother is still taking hepatitis B antiviral drugs after delivery, breastfeeding is not recommended; If the mother's nipple is chapped and bleeding, the newborn's oral ulcer and mucous membrane are obviously damaged, it is necessary to suspend breast milk.
3. Newborns born to pregnant women with hepatitis B should have blood tests at 7-8 months to judge the effect of mother-to-child blocking. 7-8 months after the third dose of hepatitis B vaccine, 1-2 months. This is the time when children have the strongest antibodies. If there are no antibodies at this time, it is necessary to vaccinate again in time to promote the production of antibodies as soon as possible. Otherwise, babies without antibodies are still at risk of being infected with hepatitis B, so it is very important to find out in time.
Injecting hepatitis B immunoglobulin into pregnant women can't reduce mother-to-child transmission! In the past, it was thought that injecting hepatitis B immunoglobulin (HBIG) into pregnant women in the 7th, 8th and 9th months of pregnancy could prevent mother-to-child transmission. This practice has no basis and has been eliminated. It is a correct and important measure to inject hepatitis B vaccine and hepatitis B immunoglobulin into newborns in time. 5. Whether the liver function is normal or not, the higher the level of hepatitis B virus, the stronger the infectivity. If there is hepatitis activity during pregnancy or high replication of hepatitis B virus is detected during pregnancy (especially greater than the sixth power of 10), hepatitis B antiviral drugs such as telbivudine or tenofovir should be taken orally at an appropriate time. These drugs are safe for pregnant women and will not have adverse effects on pregnant women and fetuses.
6. During pregnancy and postpartum, hepatitis B is easy to move, and the condition is prone to great changes. Therefore, during this period, liver function and HBV DNA should be closely tested according to the advice of specialists, so as to find out the changes of the disease in time and avoid delaying the disease.