Viral HepatitisComplicatingPregnancy
Viral Hepatitis Complicating Pregnancy
General ConsiderationHepatitisvirusHAV,HBV,HCV,HDV,HEVHBV:commonIncidence of HV complicating pregnancy6 times than non-pregnancyIncline to develop severe HV
General Consideration • Hepatitis virus HAV, HBV, HCV, HDV, HEV • HBV: common • Incidence of HV complicating pregnancy 6 times than non-pregnancy Incline to develop severe HV
Pregnancy-related changes of hepatic functionAlbumin:20%decreaseAKP: twice normalCholesterol胆固醇：twicenormalSerumtransaminases转氨酶：no changeClotting factorsFibrinogen纤维蛋白原：20%elevationatterm2Factor V,VIl, VIll, IX,Xll: increase3.Factor Xl, Xlll: decreaseAntithrombotic factors: no changePT: no change
Pregnancy-related changes of hepatic function • Albumin: 20% decrease • AKP: twice normal • Cholesterol胆固醇: twice normal • Serum transaminases转氨酶: no change • Clotting factors 1. Fibrinogen纤维蛋白原: 20% elevation at term 2. Factor V,VII, VIII, IX,XII: increase 3. Factor XI, XIII: decrease • Antithrombotic factors: no change • PT: no change
Effects on mother andfetusEffectsonmotherPreeclampsia2.Postpartum hemorrhage3.DICEffectsronfetusMalformation(early pregnancy)2.Abortion,Prematurelabor, fetal deathstillbirth
Effects on mother and fetus • Effects on mother 1. Preeclampsia 2. Postpartum hemorrhage 3. DIC • Effects on fetus 1. Malformation↑(early pregnancy) 2. Abortion, Premature labor, fetal death, stillbirth
Effects on mother andfetus3.Verticaltransmission垂直传播HAV: seldom2)HBVtransplacental transmit, intrapartum transmitpostpartum transmitHCV:2/3HDV: seldomHEV:uncertain
Effects on mother and fetus 3. Vertical transmission垂直传播 1) HAV: seldom 2) HBV transplacental transmit, intrapartum transmit, postpartum transmit 3) HCV: 2/3 4) HDV: seldom 5) HEV: uncertain