U toku trudnoće saznali smo da je supruga nosilac HCV-a. Nema nikakvih komplikacija, transaminaze su u granicama normale (15-20) na svim, mesečno rađenim laboratorijskim nalazima, kao i ostale analize. Ulazi u deveti mesec trudnoće i u dilemi smo najpre oko porođaja, da li carskim ili prirodnim putem, kako bebu ne bi izložili opasnosti od zaraze. Iz istog razloga imamo i dilemu da li dojiti ili ne? Želeli bismo stručno mišljenje infektologa, kako bi doneli odluku.
Vertikalno prenošenje HCV s majke na dete je samo oko 5%. eVo nekih preporuka iz relevantne literature: We recommend that direct-acting antiviral regimens only be used in the setting of a clinical trial or that antiviral treatment be deferred to the postpartum period as direct-acting antiviral regimens are not currently approved for use in pregnancy (GRADE 1C). (5) We suggest that if invasive prenatal diagnostic testing is requested, women be counseled that data on the risk of vertical transmission are reassuring but limited; amniocentesis is recommended over chorionic villus sampling given the lack of data on the latter (GRADE 2C). (6) We recommend against cesarean delivery solely for the indication of hepatitis C virus (GRADE 1B). (7) We recommend that obstetric care providers avoid internal fetal monitoring, prolonged rupture of membranes, and episiotomy in managing labor in hepatitis C virus-positive women (GRADE 1B). (8) We recommend that providers not discourage breast-feeding based on a positive hepatitis C virus infection status (GRADE 1A).
Pitanje broj: #164055
U toku trudnoće saznali smo da je supruga nosilac HCV-a. Nema nikakvih komplikacija, transaminaze su u granicama normale (15-20) na svim, mesečno rađenim laboratorijskim nalazima, kao i ostale analize. Ulazi u deveti mesec trudnoće i u dilemi smo najpre oko porođaja, da li carskim ili prirodnim putem, kako bebu ne bi izložili opasnosti od zaraze. Iz istog razloga imamo i dilemu da li dojiti ili ne? Želeli bismo stručno mišljenje infektologa, kako bi doneli odluku.
Odgovoreno: 04. 10. 2019.Vertikalno prenošenje HCV s majke na dete je samo oko 5%. eVo nekih preporuka iz relevantne literature: We recommend that direct-acting antiviral regimens only be used in the setting of a clinical trial or that antiviral treatment be deferred to the postpartum period as direct-acting antiviral regimens are not currently approved for use in pregnancy (GRADE 1C). (5) We suggest that if invasive prenatal diagnostic testing is requested, women be counseled that data on the risk of vertical transmission are reassuring but limited; amniocentesis is recommended over chorionic villus sampling given the lack of data on the latter (GRADE 2C). (6) We recommend against cesarean delivery solely for the indication of hepatitis C virus (GRADE 1B). (7) We recommend that obstetric care providers avoid internal fetal monitoring, prolonged rupture of membranes, and episiotomy in managing labor in hepatitis C virus-positive women (GRADE 1B). (8) We recommend that providers not discourage breast-feeding based on a positive hepatitis C virus infection status (GRADE 1A).
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