Hepatitis viral y embarazo / Viral hepatitis in pregnancy. Yahoo / Buzón

Noviembre 28, 2017. No. 2916

Actualización sobre hepatitis viral y embarazo Update on viral hepatitis in pregnancy. Shao Z1, Al Tibi M2, Wakim-Fleming J3. Author information Cleve Clin J Med. 2017 Mar;84(3):202-206. doi: 10.3949/ccjm.84a.15139. Abstract Pregnant women with acute viral hepatitis are at higher risk of morbidity and death than pregnant women with chronic viral hepatitis. The risk of death is highest with acute viral hepatitis E, and the rate of transmission to the baby may be highest with hepatitis B virus (HBV) infection. Managing viral hepatitis in pregnancy requires assessing the risk of transmission to the baby, determining the gestational age at the time of infection and the mother's risk of decompensation, and understanding the side effects of antiviral drugs. PDF Conocimiento, educación y prácticas de obstetras y ginecólogos con respecto a la hepatitis B crónica en el embarazo. Obstetricians' and gynecologists' knowledge, education, and practices regarding chronic hepatitis B in pregnancy. Niu B1, Marzio DH2, Fenkel JM2, Herrine SK2. Author information Abstract BACKGROUND: In pregnant women with high viral loads, third-trimester initiation of antiviral agents can reduce the risk of vertical transmission. We aimed to assess obstetricians' and gynecologists' (OB-GYN) knowledge and clinical practice when treating pregnant women with chronic hepatitis B virus (HBV). METHODS: All program directors (PDs) from 250 US OB-GYN residency programs were invited to anonymously complete an 18-item questionnaire. Descriptive statistics were calculated and analyzed. RESULTS: A total of 323 participants responded, including both PDs (n=51, response rate 21%) and residents (n=272, response rate 11%). Responding PDs (62% university-based vs. 32% community-based) came from various practice types. All PDs and 95.2% of residents reported screening for chronic HBV in pregnant patients on the first prenatal visit. A majority of PDs (85.5%) and residents (85%) correctly interpreted HBV serologies. Referral patterns showed that 66.7% of PDs and 65.5% of residents refer to a specialist regardless of viral load. A minority of respondents (19.6% PDs and 12.6% residents) knew that third-trimester antiviral therapy is recommended for women with high viral loads (>200,000 IU/mL). Few respondents had prescribed HBV antivirals (9.8% PDs and 6.0% residents), with residents more commonly prescribing tenofovir and less frequently lamivudine. Half the PDs believed trainees from their programs were comfortable managing HBV in pregnancy, but only 41.8% of residents reported being comfortable managing pregnant patients with HBV. CONCLUSION: OB-GYNs report screening almost all pregnant patients for chronic HBV, though significant gaps still exist in practitioner comfort and training regarding the management of HBV during pregnancy. KEYWORDS: Hepatitis B virus; education; obstetricians and gynecologists; practice; pregnancy; survey PDF Hepatitis vitral aguda durante el embarazo Enrique Valdés R., Alvaro Sepúlveda M., Paula Candia P., Karina Lattes A. Rev Chil Infect 2010; 27 (6): 505-512 PDF Jornadas de Trabajo Social y Psicología en los Cuidados Paliativos Dicienbre 7-8, 2017. Guadalajara, México Informes en tszoquipan@hotmail.com XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo International Anesthesia Research Society Annuals Meetings USA Informes / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Embarazo y hepatitis viral / Viral hepatitis and pregnancy

Junio 15, 2017. No. 2720

Actualización de hepatitis viral y embarazo Update on viral hepatitis in pregnancy. Shao Z1, Al Tibi M2, Wakim-Fleming J3. Cleve Clin J Med. 2017 Mar;84(3):202-206. doi: 10.3949/ccjm.84a.15139. Abstract Pregnant women with acute viral hepatitis are at higher risk of morbidity and death than pregnant women with chronic viral hepatitis. The risk of death is highest with acute viral hepatitis E, and the rate of transmission to the baby may be highest with hepatitis B virus (HBV) infection. Managing viral hepatitis in pregnancy requires assessing the risk of transmission to the baby, determining the gestational age at the time of infection and the mother's risk of decompensation, and understanding the side effects of antiviral drugs. PDF Hepatitis B en la detección, tratamiento y prevención de la transmisión vertical en el embarazo. #38: Hepatitis B in pregnancy screening, treatment, and prevention of vertical transmission. Society for Maternal-Fetal Medicine (SMFM), Dionne-Odom J1, Tita AT1, Silverman NS1. Am J Obstet Gynecol. 2016 Jan;214(1):6-14. doi: 10.1016/j.ajog.2015.09.100. Epub 2015 Oct 8. Abstract Between 800,000-1.4 million people in the United States and more than 240 million people worldwide are infected with hepatitis B virus (HBV). Specific to pregnancy, an estimated prevalence of 0.7-0.9% for chronic hepatitis B infection among pregnant women in the United States has been reported, with >25,000 infants at risk for chronic infection born annually to these women. Vertical transmission of HBV from infected mothers to their fetuses or newborns, either in utero or peripartum, remains a major source of perpetuating the reservoir of chronically infected individuals globally. Universal screening for hepatitis B infection during pregnancy has been recommended for many years. Identification of pregnant women with chronic HBV infection through universal screening has had a major impact in decreasing the risk of neonatal infection. The purpose of this document is to aid clinicians in counseling their patients regarding perinatal risks and management options available to pregnant women with hepatitis B infection in the absence of coinfection with HIV. We recommend the following: (1) perform routine screening during pregnancy for HBV infection with maternal HBsAg testing (grade 1A); (2) administer hepatitis B vaccine and HBV immunoglobulin within 12 hours of birth to all newborns of HBsAg-positive mothers or those with unknown or undocumented HBsAg status, regardless of whether maternal antiviral therapy has been given during the pregnancy (grade 1A); (3) In pregnant women with HBV infection, we suggest HBV viral load testing in the third trimester (grade 2B); (4) in pregnant women with HBV infection and viral load >6-8 log 10 copies/mL, HBV-targeted maternal antiviral therapy should be considered for the purpose of decreasing the risk of intrauterine fetal infection (grade 2B); (5) in pregnant women with HBV infection who are candidates for maternal antiviral therapy, we suggest tenofovir as a first-line agent (grade 2B); (6) we recommend that women with HBV infection be encouraged to breast-feed as long as the infant receives immunoprophylaxis at birth (HBV vaccination and hepatitis B immunoglobulin) (grade 1C); (7) for HBV infected women who have an indication for genetic testing, invasive testing (eg amniocentesis or chorionic villus sampling) may be offered-counseling should include the fact that the risk for maternal-fetal transmission may increase with HBV viral load >7 log 10 IU/mL (grade 2C); and (8) we suggest cesarean delivery not be performed for the sole indication for reduction of vertical HBV transmission (grade 2C). KEYWORDS: antiviral therapy; breast-feeding; chronic hepatitis; hepatitis B; immunoprophylaxis; vertical transmission; viral load PDF Hepatitis viral durante el embarazo Valdés R E1, Sepúlveda M A, Candia P P, Lattes A K. Rev Chilena Infectol. 2010 Dec;27(6):505-12. doi: /S0716-10182010000700003. Epub 2011 Jan 7. Abstract Acute hepatitis has a very low incidence disease during pregnancy. However, it may be an important cause of jaundice during gestation which in cases of viral etiology can have a very high morbidity and mortality risk to the mother and the fetus. The purpose of this review is to update the available knowledge regarding viral hepatitis during pregnancy including description of the main etiologies, transmission route, maternal-fetal risk and possible management. PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org