Hepatitis C in a woman and pregnancy: treatment and consequences for the child. Hepatitis detected after childbirth: treatment, feeding and other important issues

Can hepatitis C be passed from father to child? This question worries many, especially those who are expecting a baby or planning a pregnancy. Some believe that this disease only spreads among drug addicts or among people who belong to the so-called risk group.

The main ways of transmission of the virus

There are several ways to acquire the virus, but the most common of them are the following transmission routes:

1. Drug use.
2. The use of insufficiently sterile instruments in manicure and tattoo parlors.
3. Working with infected blood.
4. Using dirty tools.
5. Non-compliance with sanitary standards in medical institutions.

There is a rather high risk of contracting HCV in places of deprivation of liberty. In some cases (probability about 4%), this is possible during a blood transfusion procedure. The risk of infection is especially high in developing and underdeveloped countries, in medical institutions with a low level of medical care and the use of non-sterile instruments, as well as in violation of all norms and rules of sanitation.

Can hepatitis C be passed from father to child? Cases of sexual transmission of the virus are not frequent, but they still exist (about 4%). In homosexual relationships, the likelihood of infection is even lower, but it increases in proportion to the increase in the number of sexual partners and casual relationships. In order to minimize the likelihood of infection through sexual intercourse, an elementary method of protection (use of a condom) is sufficient.

HCV is transmitted exclusively parenterally, that is, when the skin is damaged and a sufficient amount of the virus enters the bloodstream. It is transmitted sexually much less frequently than hepatitis B. For example, in married couples where one partner is infected, the probability of infection in 10 years is only 5%.

Hepatitis C and pregnancy

Is hepatitis C transmitted from mother to child? The probability that the unborn baby will be infected from the mother is extremely small, but this is possible in about 5% of cases, while infection can occur only in some cases:

• directly during childbirth;
• passage of the fetus through the birth canal.

Can Hepatitis C be passed from father to child? Transmission of HCV from an infected father to an unborn baby is not possible. In addition, in modern medical centers, specialists are able to vaccinate a child from an infected mother, which will prevent the further development of the disease.

Currently, a man and a woman can be vaccinated against hepatitis B (the HCV vaccine is not currently in demand): this will protect the unborn baby from infection.

Summing up, it should be noted that HCV is not terrible for the unborn baby, however, when planning a pregnancy, you should undergo the necessary examination and pass all the tests to identify the likelihood of infection of the child. In addition, if one of the parents has HCV, the baby can be vaccinated, which will prevent further development of the disease.

The virus sits quietly

The virus enters the body mainly through the blood, and can also be transmitted sexually. But the risk of infection exists both in beauty salons and in medical institutions, when manipulations are accompanied by damage to the skin or mucous membranes. Risk groups are people with a high risk of injury, including microtrauma.

The expectant mother may not know about her diagnosis - and this is the most difficult thing. Most often, the disease is detected during the initial screening of a pregnant woman.

Hepatitis C practically does not manifest itself in any way for a very long time, in rare cases, women report malaise, insomnia, fatigue and slight soreness in the right side, which mothers can attribute to fatigue or overeating. However, the virus is slowly evolving. In addition, pregnancy can become a provocateur of an exacerbation of hepatitis C. In such cases, the symptoms are pronounced, forcing expectant mothers to contact a specialist. Otherwise, the disease is detected before pregnancy planning (if a woman comes for examination).

To prevent hepatitis C from becoming an unpleasant surprise for a woman during gestation, it is necessary to be checked by a specialist and take all possible measures to diagnose and protect the body.

Precautionary measures
The risk of infection can be reduced by avoiding activities such as:
- giving unnecessary and unsafe injections;
- transfusion of unsafe blood products;
- joint use, collection and disposal of contaminated pointed objects and fragments;
- unprotected sex with persons infected with hepatitis;
- performing tattoos, piercings and acupuncture with contaminated equipment.
Source: based on materials from the World Health Organization (WHO)

If dad is sick

But what if the father is the carrier of the virus, and the expectant mother is healthy? What should be done in this case? Hepatitis C is not a genetic disease and therefore is not inherited. Reproductive technologies for conception (IVF) in this case are usually used at a high risk of infection of the expectant mother. But conception can occur naturally and without infection of the woman. The fact is that the infected fluid of a man alone is not enough for the virus to enter the female body.

There are a number of important predisposing factors: the presence of a large number of copies of the virus in lubrication, semen, blood (including the period of the virus carrier); injuries of the mucous membrane of the genital organs (cracks, erosion, etc.); the presence of other sexual infections (pathogenic bacteria, viruses, fungi).

When such conditions exist and cannot be eliminated or controlled, a woman has a high risk of infection during sexual intercourse, including the possibility of subsequent infection of the child. If the expectant mother is concerned about these issues, it is necessary to consult an infectious disease specialist who will help determine the safest method of fertilization.

Examination before pregnancy
There is a standard examination for prospective parents. The examination begins in a woman with a gynecologist, in a man - with a urologist. Doctors prescribe tests for spouses for hepatitis C, B, syphilis and HIV testing. An important analysis is the blood for the TORCH complex for the timely detection of possible intrauterine infections (toxoplasmosis, rubella, cytomegalovirus and herpes). The expectant mother also needs to determine the blood type and Rh factor, donate blood for clotting and a general blood and urine test. A gynecologist takes a swab from a woman, conducts a study on urogenital infections by PCR (chlamydia, ureaplasmosis, candidiasis, mycoplasmosis, etc.). With a gynecologist, a woman needs to discuss taking folic acid and iodine preparations, this is useful for the unborn baby. In addition to testing for urogenital infections, a urologist may recommend that a future dad take a spermogram to determine the concentration, quantity, motility and structure of spermatozoa. If any structural changes in the prostate gland are detected, the urologist will offer the man a study of prostate secretion to detect inflammation. Both spouses may need a blood test for sex hormones and a biochemical complex, so in parallel, you can be examined by an endocrinologist and a therapist.

Will the baby get hurt?

Many mothers are concerned about two main questions: does hepatitis affect conception and can the virus be transmitted to the child?

The good news is that a viral infection does not directly affect a woman's reproductive system. But inflammatory processes can damage fertility (the ability of the female body to conceive and bear a child).

Infection of the fetus is possible in utero, but is more likely during childbirth and regardless of the method of delivery. However, operative delivery (cesarean section) is considered safer for the baby in terms of reducing the risk of hepatitis infection, as it excludes the passage of the child through the birth canal and reduces the time of his contact with the biologically hazardous environments of the mother. Therefore, doctors often recommend that women whose blood contains the virus should not give birth on their own. For the sake of the health of the child, the principles of natural parenting will have to be sacrificed.

It is also worth knowing that the presence of an infection in a future mother is not an indication for termination of pregnancy.

A woman diagnosed with hepatitis C during pregnancy should be observed by a hepatologist.

Breastfeeding infection is rare. Doctors prescribe artificial feeding if there is a violation of the integrity of the skin of the mammary glands in the mother and / or the skin and mucous membranes of the mouth in the baby.

Immediately after birth, the child takes blood for hepatitis. All newborns born from infected mothers (if there are no contraindications) are vaccinated and intramuscularly injected with hyperimmune gamma globulin during the first day, and then after 30 days.

Thanks to modern methods of prevention and drugs prescribed by a specialist, the likelihood of developing an acute process and complications of the disease is sharply reduced.

If an infected woman is pregnant, how do you know if the baby has hepatitis?

According to the website Gepatit.ru, the risk of transmitting the virus from mother to child is assessed as low and, according to various sources, does not exceed 5%. Maternal antibodies may prevent the development of chronic viral hepatitis in the child.

According to experts, such children often have antibodies to the virus in their blood, which can disappear by the middle of the child's second year of life. However, if they are detected after 18 months from the moment of birth, then this may mean infection. Hepatitis C in a baby will also be indicated by an increase in liver enzymes, which indirectly reflect inflammation of the liver tissue; twice positive test for RNA virus (performed at the age of three and six months). The same genotype of the hepatitis C virus in mother and child can serve as confirmation of perinatal infection.

What and how to treat?

The main thing is that during pregnancy, an infected woman needs to carefully monitor her health and be examined for the presence of antibodies to the virus and viral markers in the blood serum. This will identify the activity of the hepatitis C virus, prescribe the necessary therapy, which will make it easier to endure the disease during pregnancy and prevent the likelihood of infection of the child.

With hepatitis, a pregnant woman and a nursing mother should also pay attention to nutrition, in which it is forbidden to eat fried, spicy, fatty and salty foods, as well as drink alcohol.

When confirming the diagnosis of hepatitis, the appointment of any drugs individually. A woman should strictly follow all the doctor's instructions and in no case self-medicate!

Among the drugs that can be prescribed in the complex treatment of hepatitis C are antiviral agents and drugs aimed at strengthening the immune system. During pregnancy, women with hepatitis may also be recommended drugs to support liver function, improve digestion, and other drugs.

The doctor determines the need for their use, dosage, duration of administration and the period at which the pregnant mother can take drugs, taking into account contraindications.

An important point - the treatment of hepatitis C in pregnant women is prescribed only with pronounced signs of the disease, since the height of the disease is accompanied by severe intoxication, which can lead to the loss of the baby. In other cases, doctors adhere to the tactics of monitoring the condition of the mother and child.

Hepatitis is inflammation of the liver. The reasons can be a variety of factors, but the most relevant and dangerous for the mother and her baby are viral forms. What are the causes of hepatitis after childbirth and is it possible to infect a child? To feed or not to breastfeed with this disease?

Read in this article

Causes of infection with hepatitis after childbirth

Hepatitis is an insidious disease that may not manifest itself for a long time, even with a thorough examination.

Viral inflammation of the liver is characterized by such a concept as the "window period" - the time interval from the moment of infection to when the disease can be diagnosed. It can range from a few weeks to a couple of months. At this time, a sick person is already a source of infection for others, but does not know about it.

When the virus can enter the body

Given these characteristics of viral hepatitis, it is difficult to calculate the time of infection, unless the diagnosis is made after childbirth. An infection can develop in the following cases:

• Infection on the eve of pregnancy or during it. Unprotected sexual intercourse, non-observance of sterility and other procedures performed can cause the virus to enter the woman's body. Moreover, the presence of a “window period” will allow the pathogen to remain unnoticed during the entire period of gestation. After all, all pregnant women are tested for HIV and hepatitis once or twice during pregnancy.

It will be possible to detect them only after a few weeks or months after the appearance of the baby.

• Infection during childbirth (blood transfusion, surgery, manipulation). The process of giving birth to a child is always accompanied by microtrauma, and sometimes serious bleeding or even surgery. The slightest violation of asepsis rules can lead to infection of a woman with hepatitis.

Another aspect is that with a large blood loss, a blood transfusion is performed. Despite advanced technology, thorough testing of all biological fluids, the possibility of such a route of infection exists.

• Viral hepatitis can also be contracted after childbirth.

Ways of infection

Viral hepatitis A differs from others in the mechanism of infection, clinical course and prognosis. This is the least dangerous variant of the disease. The mode of transmission of hepatitis A is only fecal-oral, the source is a sick person. The entry of the virus into the body of a woman occurs with unwashed hands, fruits, vegetables, etc. The peak incidence occurs in autumn and late summer. This form rarely becomes chronic.

Viral hepatitis B and C are infections transmitted through the body fluids of a sick person. Often a small amount is enough for this.

You can get infected with viral hepatitis B and C in the following ways:

Route of infection	How infection occurs
Through the blood	In order to get sick, less than 1 ml of blood is enough, literally its traces. This is how infection occurs in tattoo parlors when all the rules for processing instruments are not followed, in dentists for the same reason, when performing trimming manicure and pedicure, when transfusing blood and its components with viruses, when using disposable syringes repeatedly in different people (more often these are drug addicts and etc.).
sexually	According to statistics, every third case of the disease occurs precisely after unprotected contacts. Viruses can accumulate in the vaginal and cervical secretions of a man.

Symptoms of hepatitis after childbirth

Viral hepatitis can occur in acute and chronic forms. To a greater extent, this determines the immunity of a woman.

The disease begins to manifest itself a week or a month after infection.

A woman's body temperature rises to 38 - 39 degrees, other symptoms appear, similar to the flu or food poisoning. These are weakness, lethargy, aches all over the body, abdominal pain, nausea, diarrhea, vomiting and others.

After 1 - 2 days, icteric staining of the skin and mucous membranes appears. This is most noticeable on the sclera of the eyes. Urine becomes dark, and feces almost colorless. All this is due to a change in the functioning of the liver and the processing of bilirubin.

Symptoms may persist for 2 to 3 weeks, gradually subsiding.

It can occur in an acute form and in a chronic (latent) form. The clinical picture may be unexpressed. Since vaccination against hepatitis B is carried out, including for children, scheduled according to the calendar, the number of new detected cases of the disease is small.

The acute form appears 2 to 12 weeks after infection. Symptoms are very similar to hepatitis A, but even more pronounced. In addition, itching of the skin, bleeding, joint pain, and in difficult cases even impaired consciousness up to coma join.

Jaundice may be mild. This explains why hepatitis goes unnoticed. And after some time, during the examination, the woman finds out that she has a hidden form of the flow.

If hepatitis B is detected in the acute stage, there is a high probability of a full recovery. But if signs of inflammation remain after 6 months from the onset of the disease, the likelihood of a transition to a chronic form is high. In this case, the virus slowly destroys liver and human cells.

A distinctive feature of hepatitis C is that the acute period passes almost imperceptibly. Most often, the symptoms are mistaken for SARS, flu, mild intestinal upset, etc. The virus continues its activity, destroying liver cells. As a result, every third patient develops cirrhosis - the replacement of an organ with connective tissue, after which it ceases to perform its functions. Therefore, hepatitis C is often called the “gentle killer”.

However, only by the symptoms of hepatitis it is impossible to say which form a person has. Additional laboratory testing is always required.

Watch the video about the treatment of hepatitis:

Diagnosis of hepatitis after childbirth

Viral hepatitis can be suspected based on the history and clinical examination. But for confirmation, modern diagnostic methods are needed.

ELISA research

ELISA is the oldest diagnostic method, which has not lost its relevance today. With it, you can determine both the antigens of the virus (its parts) and antibodies to it (formed as a result of activation of the immune system). This is important for establishing a diagnosis, as well as for determining the form of the disease.

For viral hepatitis A, the following markers are determined:

• Antigens in the faeces of patients.
• Antibodies of class M (Ig M), which is especially important, as well as Ig G, Ig A.

For viral hepatitis B, the range of studies is wider. It includes:

• Antigens HBS, HBC, HBC. Each of them is important both for subsequent treatment and for the prognosis of the transition to a chronic form.
• Antibodies to HBS, HBC, HBC - the response of the immune system to the virus.

For viral hepatitis C, antibodies Ig M, Ig G, Ig A are mainly determined. Each of them is responsible for a certain stage of the disease.

The detection of some antibodies or antigens does not always indicate viral hepatitis. Often, after a disease, immunity can be maintained, which will give positive reactions.

PCR diagnostics

Modern types and methods of PCR diagnostics have significantly advanced the detection and treatment of viral hepatitis forward. This method allows you to define the following:

• The presence of the viruses themselves in the blood, which confirms the disease. In 99% of cases, when the ELISA is positive, and PCR is negative, there is no virus in the body and the disease itself.
• It is possible to determine the quantitative content of the virus in 1 ml of blood. This is extremely important for assessing the effectiveness of treatment, for resolving the issue of delivery and breastfeeding, and the danger to people around.
• The presence and amount of antibodies to viral hepatitis.
• Determine the type of virus. There is great diversity for both hepatitis B and C. This is fundamental to the choice of treatment regimen.

General laboratory tests

In addition to the KLA, OAM, it is imperative to take a biochemical analysis. In the latter, the liver enzymes ALT and AST should be determined, the increase of which will indicate the ongoing destruction of liver cells.

A coagulogram is necessary in order to monitor changes in blood clotting. In case of violation of the liver, hypocoagulation occurs - a delayed formation of a blood clot, hence the risk of bleeding.

ultrasound

Ultrasound examination is necessary to monitor the functional state of the liver. It will help to identify signs of cirrhosis, decrease or increase in size, etc.

Biopsy

Biopsy - tissue sampling with subsequent histological examination. It is used extremely rarely, mainly in unclear and doubtful cases, to clarify the cause, etc.

Treatment of hepatitis after childbirth

The question of the treatment of viral hepatitis after childbirth is always decided individually. It is clear that when taking medications, you will have to stop breastfeeding, since all drugs are toxic and dangerous for the baby.

There is no specific treatment. In most cases, diet and symptomatic therapy is sufficient. But you should not additionally load the liver with various drugs.

Infusions are carried out with a solution to accelerate the cleansing of the body, various hepatoprotectors and vitamin complexes are prescribed to maintain immunity.

Acute forms are subject to only symptomatic treatment, similar to hepatitis A.

For chronic inflammation, antiviral drugs are used, more often they are combined for greater effectiveness. The most used include the following: interferons, nucleoside analogues (eg, Lamivudine and others).

Treatment is expensive, so not everyone can afford it. But even it does not guarantee a complete cure, despite long-term regimens (often several years). There is only a decrease in the number of viral copies, cirrhotic changes in the liver are suspended.

In addition, various hepatoprotectors, means to increase immunity are used.

The treatment is very similar to hepatitis B therapy. Combinations of drugs are selected according to the type of virus, the degree of activity, etc.

New drugs are constantly being developed. For example, recently introduced Telaprevir and Boceprevir, which show high efficiency. But all these are expensive and not available drugs for everyone.

Breastfeeding with hepatitis after childbirth

The issue of breastfeeding should be decided on a case-by-case basis.

If hepatitis A occurs in the mother, she should be limited from the baby, as he can quickly catch the infection. Accordingly, breastfeeding for 3 to 4 weeks will be impossible.

As for hepatitis B and C, opinions differ, as do the tactics of managing women during lactation. The main postulates are as follows:

• When treated with antiviral drugs, breastfeeding is not possible. All medicines will be toxic to the baby.
• If serious therapy is not carried out, the issue of lactation is at the discretion of the mother.
• It has been proven that the risk of infecting a child during feeding is minimal. It rises if cracks form on the nipples, then the virus with blood can get to the baby. Therefore, it is allowed to feed, but it is necessary to monitor the condition of the breast.
• In women with a high viral load (more than 1*10 5 for hepatitis B and more than 700,000 IU/ml for C), breastfeeding is still not recommended, as the chances of the baby getting sick increase.
• If several hepatitis or HIV are combined, it is not recommended to maintain lactation.
• If the mother is sick with viral hepatitis B, but the baby has already been vaccinated, you can breastfeed. The child will not get sick, as he already has protection.

Can hepatitis be transmitted to a child after childbirth

The greatest probability of infecting a child with these diseases during childbirth. Therefore, preference should be given to performing a caesarean section, since the risk is significantly reduced. After childbirth, you can infect a baby in the following cases:

• If the baby somehow comes into contact with the mother's blood. When feeding, these are cracks in the nipples, when the woman's blood will enter the child.
• The risk of infection increases with a high viral load.

Hepatitis A can cause a child to get sick immediately, as the disease is transmitted by the fecal-oral route. The isolation of the mother is extremely important here.

Examination and monitoring of the child with hepatitis in the mother

There is no need for preventive treatment, as, for example, with HIV. First, the therapy is highly toxic. Secondly, there is a high probability that the baby is healthy.

• Take PCR to detect the virus at 1, 3, 6 and 12 months of a child's life.
• Determine the presence of antibodies to viral particles at the same time.

Hepatitis is a serious disease that can lead to such a consequence as cirrhosis of the liver. When identifying an ailment after childbirth, it should be borne in mind that infection could occur during pregnancy. Treatment of such inflammation of the liver often does not help to escape from the chronic form of the disease. Mom should be careful, as there is a possibility of infection from her baby.

Hepatitis C is currently one of the most pressing problems in hepatology due to its latent course, which results in difficulties in early diagnosis. Another danger of this disease lies in the rapid transition to cirrhosis or hepatocellular cancer. The incidence rate is increasing every year.

In obstetrics and pediatrics, due to the infection of the mother and her unborn child, viral hepatitis C during pregnancy and childbirth is of particular importance.

The hepatitis C virus is an RNA-containing virus that has an envelope. Currently, 6 main genotypes of the virus are known. The main distinguishing feature of this virus is the tendency to mutate, because of this, several dozen subspecies can be formed in each genotype. The mutational ability of the hepatitis C virus causes the development of its persistence (long-term presence and reproduction) in the body and difficulties in diagnosis and treatment.

The hepatitis C virus (HCV) is transmitted through the blood (parenteral route of transmission). According to statistics, most often HCV occurs in people suffering from drug addiction when using injection drugs. Previously, hepatitis C was called post-transfusion hepatitis, since it was often transmitted through the transfusion of blood and its components. Currently, the possibilities of diagnosis are much higher and this route of infection transmission is no longer prevailing.

It is also possible to become infected in healthcare with insufficiently sterilized or reused instruments. In recent years, the number of people infected during acupuncture, salon procedures (manicure, pedicure), tattooing, piercing, etc. has increased.

In the diagnosis, the same methods and analyzes are used: biochemical blood markers, ELISA, RIBA, PCR.

Screening for HBV (HBsAg determination) is done for all pregnant women at registration. If necessary, the analysis is repeated during pregnancy.

Complications

Of the complications of pregnancy in the manifest (pronounced) form of the acute phase of hepatitis, intrauterine fetal death, miscarriage - miscarriages and premature delivery occur.

What else you should know about hepatitis B in combination with pregnancy and motherhood:

1. During childbirth and in the postpartum period, there is the possibility of massive uterine bleeding.
2. In the chronic phase of hepatitis, pregnancy complications are rare.
3. Antiviral therapy for hepatitis B is not given to pregnant women or children.
4. Features of obstetrics and the principles of breastfeeding are similar to those of hepatitis C.
5. In more than 80–90% of cases, children infected in the first year of life will develop chronic hepatitis.

Children born to HBV-positive women should receive hepatitis B immune globulin within 12 hours of birth. The hepatitis B vaccine for these children is given together with immunoglobulin or separately within a week. A month and six months later, the second and third doses are administered, respectively. Vaccination in 85-90% of cases prevents the development of infection and severe consequences caused by HBV.

Conclusion

To prevent the fatal consequences that can occur when HBV or HCV infection occurs during pregnancy, it is necessary to do tests that detect these and other viruses for both the expectant mother and her husband. If a husband or wife tests positive for hepatitis B or C, they must receive full treatment before pregnancy.

When planning a pregnancy, a married couple - husband and wife - should consult a doctor for the so-called preconception preparation. At the same time, the state of health of the future father and, especially, the mother is examined, recommendations are given, and if necessary, treatment is carried out.

Is it possible to infect a child with hepatitis C from a mother during pregnancy? This issue is relevant for women who are carriers of the virus and the wives of carriers of the virus who are expecting a child or are just planning to become pregnant. Often, expectant parents find out that one of them is infected with hepatitis C when the pregnancy has already begun. Those who received information about the diagnosis at the planning stage may decide that conception is impossible for them.

What is the danger of hepatitis C virus

The hepatitis C virus is called the "gentle killer" because of its ability to disguise itself as many other diseases. In the case of primary infection, it may not manifest itself for years. In this case, the carrier is already a source of infection.

The main factor in the transmission of the virus is blood. The gate of infection can be any microtrauma on the skin or mucous membrane. You can get infected wherever there is a possibility of injury with non-sterile reusable instruments. In 40% of cases, the source of infection remains unknown. In addition to blood, the virus is found in:

There is a risk that it can be transmitted through these media. The probability of infection depends on the tension of the recipient's immunity and on the intensity of infection of the carrier's organism.

The incubation period lasts from 2 to 25 weeks. Most often, the first clinical signs appear after 1.5-2 months after infection.

The acute form of the disease is accompanied by such non-specific symptoms:

It is important to detect hepatitis C in time, and not to treat its symptoms. In the majority of those infected, the disease becomes chronic, which in turn is replaced by fatty degeneration, cirrhosis, or hepatocellular carcinoma. Alcohol abuse increases the risk of complications by 100 times. At the same time, indicators of the functional activity of the liver can remain within the normal range. After treatment, relapses are possible, which are difficult to distinguish from re-infection.

If mom is sick

If at the stage of pregnancy planning a woman finds out that she is a carrier of the virus, doubts may arise about the possibility of conception. Hepatitis C does not affect the reproductive organs, but the clinical course of the disease can also adversely affect fertility. A woman's body weakened by the disease may not be able to conceive and bear a healthy child.

It is not uncommon for an expectant mother to learn about her diagnosis from the results of the primary screening. A woman attributes general malaise, weakness, insomnia, abdominal pain to pregnancy and toxicosis. An exacerbation of chronic hepatitis during pregnancy is likely, in which case the symptoms become more pronounced. There is a threat of premature termination of pregnancy, the birth of a premature baby due to the development of liver failure and the general physical condition of the mother.

The development of embryonic hypotrophy also occurs. Portal hypertension in 25% of cases can cause bleeding from the esophageal veins, increasing the risk of miscarriage. At the same time, the presence of an infection in the mother's body is not a reason for artificial termination of pregnancy, since there is no risk of congenital anomalies, miscarriage and stillbirth.

The use of antiviral drugs during pregnancy is not practiced due to the high teratogenicity of this group of drugs, especially ribavirin. If treatment is carried out before conception, pregnancy should be planned no earlier than 6 months after discontinuation of drugs.

If the mother has hepatitis, there is about a 5% chance that the baby will be infected. Transmission of the hepatitis C virus to a child from a mother is possible only during childbirth, regardless of the method of delivery. Intrauterine transmission is excluded - the virus cannot cross the hematoplacental barrier.

The virus can be transmitted to the child from the mother during the passage of the birth canal: the protective placental barrier is destroyed, the fetus is in direct contact with the mucous membranes and blood of the mother. Effective methods to prevent infection of the child during delivery do not currently exist.

It is believed that caesarean section reduces the risk of transmission of the virus. Treatment protocols for infected newborns have also not been developed to date. Immediately after birth, the baby's blood is examined for the presence of the virus, then, in the absence of contraindications, the child is vaccinated with hyperimmune gamma globulin for the first time on the first day after birth, the second time after 30 days. Maternal antibodies can protect the baby from the virus. They are found in his blood up to 2-3 years.

Hepatitis C cannot be transmitted through mother's milk. Such cases were not registered. If the mother has hepatitis, it is worth giving up breastfeeding in case of cracks and other injuries of the nipples.

A mother infected with hepatitis C should be informed about the possible risks of transmission of the virus to the fetus and the development of pregnancy pathology. Constant medical supervision is necessary to assess the condition of the expectant mother and the risks of infection of the child.

If the source of infection is dad

The next question that worries future parents is whether hepatitis C is transmitted from father to child. It can be said with accuracy that this is not a hereditary disease and cannot be transmitted during conception.

The hepatitis virus is quite rare. But this route of transmission is not ruled out. If the mother of the unborn child is healthy, and the father is a carrier of the virus, with a high risk of infection, women use in vitro fertilization. This method is resorted to if the virus is contained in the male body in too large quantities.

A variant is possible when a woman does not become infected during conception. This happens if there is little virus in the semen, there are no injuries to the mucous membrane of the genital organs, there are no concomitant infections, and the woman's immunity is quite strong. To choose the safest method of fertilization for the unborn child in each case, it is necessary to consult an infectious disease specialist.

The hepatitis C virus can be transmitted from the father to the child only through the blood after birth or through the mother if she becomes infected during pregnancy. Therefore, you should follow simple safety rules:

• sex during pregnancy should be protected - it is necessary to use barrier contraceptives;
• personal hygiene items, on which blood particles may appear, should be purely individual;
• in case of injury, it is important to adhere to the rules of asepsis and antisepsis, biological residues must be carefully destroyed.

The presence of the hepatitis C virus in the blood of the mother and father in most cases does not mean that the child will be infected. It all depends on how responsibly future parents approach the issue of conceiving and bearing a child.

A comprehensive examination, consultations of specialized specialists will determine the likelihood of infection of the baby and protect him from the virus. Responsible pregnancy planning involves early examination before conception. If one or both parents are diagnosed with hepatitis C as a result, treatment is best done before pregnancy occurs.