Guangzhou Daily News (All Media Reporter Zhou Jieying Correspondent Li Xiaoshan) The maternal and child transmission of hepatitis B virus is a challenge that hepatitis B pregnant mothers have to face.The number of hepatitis B positive for pregnant women in Guangdong reaches 180,000 per year, accounting for about 22.6%of the country’s total.Chen Mindheng, member of the Provincial Political Consultative Conference and Secretary of the Party Committee of the Southern Medical University, was listed as a key supervision proposal proposal at the provincial session. The Provincial Health and Family Planning Commission has begun to organize relevant investigations and plan to start the pilot work.
In an interview with the media, Chen Minsheng stated that Guangdong Province has gone through the country and the top in the country and the world in the scientific research and clinical management of hepatitis B maternal and baby."At present, it can be achieved from the technical level, which can completely block the spread of hepatitis B mother and baby." Recently, the reporter interviewed experts from the Southern Hospital of Southern Medical University, which brought the method of blocking maternal and infant communication to the mother and baby transmission.According to Liu Zhihua, deputy chief physician of the infection of the infection of the hospital, the mothers and infant transmission of maternal and infants can be used with confidence through standardized treatment.
Blocking and spreading must start from pre -delivery
Maternal and infant transmission is one of the most important ways to propagate the Hepatitis B Virus (HBV).Hepatitis B maternal and infant transmission means that the mother spreads hepatitis B virus to the fetus or baby, including prenatal dissemination, delivery time, and postpartum transmission.According to Liu Zhihua, deputy chief physician of the infection of Southern Medical University in Southern Medical University, blocking the spread of mother -to -child transmission is the most important link to reduce the infection rate of hepatitis B virus in the population.
He introduced that there are two main types of measures to block the spread of hepatitis B mother and baby: one is the newborn master and passive joint immunity: After the newborn is born, it is best to inject the first needle vaccine and hepatitis B immunity within 12 hours.Belly protein, the most important measure to block the spread of hepatitis B mother and baby.At present, the traditional solution of hepatitis B maternal and infant blocking is that the child’s immunoglobulin and hepatitis B vaccine will be injected immediately after the child is born, and three -shot vaccination is completed within 6 months.However, under this combination of immune schemes, 5%to 10%of the infection rate of baby B mothers still have a baby born.
The second measure is antiviral intervention during pregnancy: For pregnant women with high virus load (that is, HBVDNA> 106IU / ML), due to strong infectiousness, the possibility of maternal and infant transmission is high.quantity.Specifically, hepatitis B pregnant women with high virus load are taken in the late pregnancy, which is the three months before giving birth to take nucleoside antiviral drugs, which reduces the level of hepatitis B virus in the body and block the virus transmission of the fetus.
Caesarean section cannot reduce maternal and baby transmission
Can cesarean section reduce the spread of hepatitis B mother and baby?In the past, people believed that during natural delivery, the placenta was "squeezed" due to the shrinkage of the uterus, which would lead to the mother virus entered the fetus and cause intrauterine infection.
However, Liu Zhihua said that recent research has shown that after formal prevention, the comparison of hepatitis B infection and natural delivery in cesarean section and natural delivery are not large.In other words, cesarean section will not reduce the spread of maternal and baby.As long as the labor process is normal, and the newborn has been implemented in a timely manner after birth, the main and passive joint immunity is implemented, and its mother -to -child communication rate is not significantly different from the cesarean section.It is not recommended that pregnant mothers choose cesarean section to block the spread of hepatitis B mother and baby.
How to judge whether the child’s hepatitis B vaccination is blocked after vaccination?Liu Zhihua pointed out that detecting the hepatitis B surface antigen (HBSAG) and surface antibodies (anti-HBS) in the child’s blood after vaccination are judgment standards.If the surface antibody is positive, its cost is greater than 10 mLU / ml, which indicates that the immunization is successful; if the hepatitis B surface antigen is positive, it shows that the maternal and baby transmission occurs and the failure is blocked.
Breastfeeding does not increase the spread of maternal and infant communication
Many hepatitis B mothers are also worried that hepatitis B virus will spread through milk. Liu Zhihua explained that breastfeeding does not increase the incidence of maternal and baby transmission. There are three reasons: First, the detection rate of hepatitis B virus in milk is very low, and the content is very small;The second is that hepatitis B is hematological diseases, and hepatitis B virus cannot be transmitted through digestive tract; third, the baby is immune to hepatitis B vaccine and hepatitis B immunoglobulin, and there are protective antibodies in the body.As long as the baby is immune, even if the mother is a "big three Yang" carrier, it can be breastfeed.
