| BackgroundPregnancy with hepatitis b is currently a common high-risk pregnancy.Studies have confirmed[1-2]that it can cause DIC,postpartum hemorrhage and even death in pregnant women,while it can cause premature birth,stillbirth,mother-to-child transmission and neonatal death in perinatal babies.To explore the effect of pregnancy complicated with HBV infection and maternal and infant blocking transmission on maternal and infant outcomes is a hot topic of current research.In addition,although the intervention with antiviral drugs in patients with pregnancy complicated with chronic hepatitis b achieves good blocking effect,there are relatively few studies on the effect of antiviral drugs on maternal and infant outcomes,so it is very necessary to study the safety of these drugs.The purpose of this study was to provide theoretical basis for clinical treatment and prevention through the study of the influence of pregnancy complicated with hepatitis b virus infection and the implementation of maternal and infant blocking transmission on maternal and infant outcomes in this region.Objective(1)To explore the effect of pregnancy complicated with hepatitis b virus infection on pregnancy outcome;(2)To investigate the effect of blocking mother-to-child transmission therapy on pregnancy outcome in patients with pregnancy complicated with B virus infection.MethodThe first part Retrospective analysis of the data of 112 pregnant women with hepatitis b virus infection admitted to puyang maternal and child health hospital from February2014 to February 2016.There were 70 pregnant women with HBV-DNA viral load greater than 1.0×10~3IU/ml(positive group)and 42 pregnant women with HBV-DNA viral load less than 1.0×10~3IU/ml(negative group).Case data in the hbv-dna viral load positive group(70 cases)were divided into the uncomplicated group(41 cases)and the complication group(29 cases)according to the presence of complications.The second part discusses the effect of blocking mother-to-child transmission in pregnancy complicated with hepatitis b virus infection on pregnancy outcome.Sixty patients with HBV complicated with delivery in our hospital who were treated with tibifidine at 28 weeks of gestation were collected as the observation group.In addition,a randomized control group(60 cases)of patients with concurrent in-hospital delivery combined with HBV who were not treated with tibifidine during pregnancy was selected.Both groups were given active and passive immunization after delivery.The outcome of pregnancy and the effects of maternal and infant block were compared between the two groups.ResultsPart I results:(1)the incidence of hypertension,preterm delivery and PROM in the positive group(15.71%,25.71%,30.00%,respectively)was significantly higher than that in the negative group(2.38%,7.14%,9.52%,respectively),and the difference was statistically significant(P<0.05).The incidence of cesarean section and postpartum hemorrhage in the positive group(45.71%,8.57%)was compared with that in the negative group(42.86%,4.76%),the difference was not statistically significant(P>0.05).(2)The incidence of FGR,fetal distress,neonatal asphyxia and LBW in the positive group(20.00%,10.00%,27.14%,21.43%)was significantly higher than that in the negative group(2.38%,0.00%,7.14%,4.76%),and the difference was statistically significant(P<0.05).the incidence of stillbirth in the positive group(1.43%)was compared with that in the negative group(0.00%),the difference was not statistically significant(P>0.05).(3)The TBIL level[(336.58±48.09)mol/L]in the complication group was significantly higher than that in the uncomplication group[(66.58±20.56)mol/L],P<0.05.The albumin level in the complication group[(22.02±4.18)g/L]was significantly lower than that in the non-complication group[(29.82±3.38)g/L],and the difference was statistically significant(P<0.05).The ALT and AST levels[(138.58±18.09)U/L,(106.48±22.19)U/L]in the complication group were compared with those in the non-complication group[(129.58±28.11)U/L,(98.58±23.22)U/L],and the differences were not statistically significant(P>0.05).Part II results:(1)There was no significant difference in HBV-DNA and ALT levels between the two groups at 28 weeks of gestation(P>0.05).The levels of HBV-DNA and ALT in the observation group were significantly lower before delivery than at 28 weeks,[(3.05±0.82)Log copiees/mL,(24.32±5.72)U/L vs(7.58±1.41)Log copiees/mL,(33.10±6.82)U/L],P<0.05.Before delivery,HBV-DNA and ALT levels were significantly decreased in the observation group and the control group[(3.05±0.82)Log copiees/mL,(24.32±5.72)U/L vs(6.93±1.44)Log copiees/mL,(56.47±12.53)U/L],P<0.05.ALT levels in the control group were significantly higher before delivery than at 28 weeks[(56.47±12.53)U/L vs(24.32±5.72)U/L],the difference was not statistically significant(P>0.05).(2)the incidence of preterm birth and premature rupture of membranes in the observation group was significantly lower than that in the control group(P<0.05).The incidence of postpartum hemorrhage,pregnancy hypertension,cesarean section and intrauterine distress in the observation group was compared with that in the control group(P>0.05).(3)The incidence of HBsAg positive and HBV-DNA positive in the observation group was significantly lower than that in the control group(P<0.05).The block success rate in the observation group was significantly higher than that in the control group,P<0.05.ConclusionHBV-DNA viral load positive generation can cause premature birth of pregnant women,gestational hypertension,premature rupture of membranes,low-weight infants,neonatal asphyxia and other adverse pregnancy outcomes;Pregnancy combined with HBV infection can lead to increased total bilirubin and decreased albumin levels in pregnant women.At 28weeks pregnant women begin taking tibifidine,After delivery,the newborn is injected with hepatitis b vaccine and hepatitis b immunoglobulin,it can obviously improve the pregnancy outcome and increase the effect of blocking successfully. |
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