The effect of chronic НBsAg carriage on the course of pregnancy, childbirth and the functional state of the liver of women with hepatitis B virus

Abstract

The problem of the hepatitis B virus (HBV) in pregnant women is complex and insufficiently studied, although it complicates the course of pregnancy and childbirth and worsens the perinatal consequences. It is important to conduct a multifocal examination of pregnant women with HBV with an assessment of the functional state of the liver, fetoplacental complex to minimize pathological conditions in the woman and the fetus.

Purpose - to retrospectively analyze the epidemiological, clinical, and laboratory characteristics of pregnant women with HBV; to identify any effects of viral infection on liver function, pregnancy, delivery, and early perinatal outcomes.

Materials and methods. A retrospective analysis was conducted with a comprehensive assessment of clinical and laboratory examinations of 320 pregnant women, who were divided into 2 groups: the Group I - 180 pregnant women with HBV, the Group II - 140 women with a physiological course of pregnancy. The anamnesis, clinical laboratory and instrumental studies of the functions of the liver, placenta and the course of pregnancy were evaluated.

Results. In pregnant women of the Group ІІ, the pathology of the gastrointestinal tract was at the level of 33.89%, gestosis of the first half of pregnancy - 27.22%, anemia of pregnancy - in 17.22% and the threat of abortion - in 15.00%, signs of the placental dysfunction were diagnosed in 51.67% of women. In the second half of pregnancy, preeclampsia was diagnosed in 19.44%, and the threat of premature birth - in 27.22%, anomalies of labor activity (22.78%), uterine bleeding (10.55%) and untimely discharge of amniotic fluid were three times higher (50.55%), fetal distress developed in 6.11% of cases.

In women of the Group I, intranatal asphyxia developed in 13.88%, intrauterine fetal development delay in 2.60%, the morbidity of infants was at the level of 23.33% (р<0.005), in particular, hypotrophy (8.88%), hemorrhagic syndrome (3.33%) and hyperbilirubinemia (11.11%). In the postpartum period, 20.00% had inflammatory complications.

Conclusions. The hidden course of HBV during pregnancy leads to negative antenatal consequences. Changes in the indicators of the main functions of the liver were detected, which in turn can lead to disability.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all institutions mentioned in the work. Informed consent of the women was obtained for the research.

No conflict of interests was declared by the authors.