scholarly journals Features during labor in women with chronic hepatitis B

2015 ◽  
Vol 96 (1) ◽  
pp. 10-12
Author(s):  
N D Shoonaeva

Aim. To examine the course of labor in women with chronic hepatitis B.Methods. The course of labor was studied in 391 female patients with chronic viral hepatitis B, included in the study group (mean age 22.7±2.5 years), who delivered off in the National Maternity Hospital (Bishkek). The control group included 59 healthy women in labor (mean age 22.5±1.3 years).Results. The vast majority of patients - 53 (89.8%) of the control group and 328 (83.9%) of the study group - had delivered off at term. Post-term births were registered in both groups. Operative delivery by cesarean section was performed in 13.0% of chronic viral hepatitis B cases - by 4.5% higher compared to control group. In the study group, planned cesarean section was performed in 21 (5.4%) patients, the main indication was burdened obstetric history - in 8 (2.0%) patients; 5 (1.3%) patients had multiple indications. Emergency operations were conducted in 30 (7.7%) patients. Indications were premature rupture of membranes - 15 (3.8%) of cases, fetal hypoxia during labor and multiple indications - 10 (2.6%) cases each. The average blood loss at cesarean section in the group of patients with chronic viral hepatitis B was 870±15.2 ml, compared to 700±10.2 ml in the control group, which can be associated with low coagulation seen in hepatitis. Comparative analysis of the complications rate in the control group revealed that delayed rupture of membranes was the most frequent - 11 (18.6%) cases, followed by intrauterine fetal hypoxia - 5 (8.5%) cases, early postpartum bleeding - 4 (6.8%) cases, hypertensive disorders at labor and retained placenta - 3 (5.1%) cases each. In the group with chronic viral hepatitis B, premature rupture of membranes occurred in 51.5% of cases, (relative risk 2.8). Early postpartum bleedings were seen in 38.9% of the cases at the main group (relative risk 5.7).Conclusion. The above data gives us every reason to include women with chronic viral hepatitis B at high-risk group for possible bad pregnancy and childbirth outcomes both for the mother and the fetus.

2013 ◽  
Vol 18 (5) ◽  
pp. 15-20
Author(s):  
L. V Pogorelskaya ◽  
I. N Khlopova ◽  
S. S Grigoryan ◽  
I. P Tryakina ◽  
N. A Rick ◽  
...  

Despite the fact that over the last few years downward trend in the incidence of acute forms of viral hepatitis B continues, the incidence of chronic hepatitis B (CHV) has increased by 2.5 times since 1998. To date, there are a sufficient number of antiviral drugs, but their use is associated with a set of contraindications, as well as the development of resistance. In this study there was performed an evaluation of a new national drug " Stimforte " in patients with chronic viral hepatitis B (CVHB - DNA positive, HBsAg - positive) at the stage of exacerbation. In the study there were included 28 patients with chronic hepatitis B (HBsAg positive), at different grades of activity, at a stage of viral replication. The diagnosis of chronic hepatitis B was made on the presence in a history acute viral hepatitis for more than 1 year, complaints, hepatolienal, astenovegetative, cytolytic syndromes, the presence of DNA-HBV, anti-HBcore IgM, HBsAg. After 1 course of treatment with " Stimforte " the well-being of patients has improved: in 30% of patients asthenic- vegetative syndrome had disappeared, weakness, fatigue and dyspeptic symptoms were decreased. The use of "Stimforte" in chronic hepatitis B with positive HBsAg at the stage of exacerbation contributed to a more rapid normalization of such indices as ALT, AST, compared with those in the control group. Long-term biochemical and virological remission was achieved in 40 %. It is established that during the treatment the viral load was reduced progressively until the undetectable or low level of HBV DNA and anti-HBc IgM disappeared. In only one case an allergic reaction was observed, which has not hindered to perform a complete course of treatment. No other side effects were detected. The inclusion of the drug "Stimforte" in the complex therapy of patients with exacerbation of chronic hepatitis B reduces the time of recovery of immune status and functional activity of IFN system and contributes to reduction of the viral load or elimination of the virus.


2017 ◽  
Vol 22 (2) ◽  
pp. 64-68
Author(s):  
A. O Mikhailov ◽  
A. F Popov ◽  
N. S Ivanova ◽  
A. I Simakova

The investigation of the degree of the lymphocyte DNA damage in chronic viral hepatitis B (HBV) patients is of interest for several reasons. Firstly, it is possible to judge indirectly about the depth of the pathological process at the level of the whole organism, with bearing in mind features of the pathogenic replication of hepatitis B virus. Secondly, it is possible to give an estimation of the degree of genotoxic impact of the virus on blood cells that plays an essential role in the shaping of the immune response of the body. The study was executed on 50 blood samples from HBV patients, divided in 5 groups on the fibrosis grade according to METAVIR score: F0 (n = 10), F1 (N = 10), F2 (N = 10), F3 (n = 10), F4 (n = 10). The control group was consisted of 43 volunteers matched by the age and gender without concomitant diseases. From blood samples taken at the time of the admission to the hospital lymphocytes were isolated by density gradient on Ficoll-urografin. The degree of DNA damage in lymphocytes was determined by virtue of alkaline version of the DNA comet assay. There was noted the direct relationship between an increase in % DNA in the tail of comets and the grade of liver fibrosis. So in the control group, % DNA in the tail accounted for 3.75 ± 1.44. In the F0 group % of DNA in the tail was 5.07 ± 1.25, F1 - 6.79 ± 1.79, F2 - 7.65 ± 1.62, F3 - 8.05 ± 1.18, F4 - 9.84 ± 3.09. It is noteworthy that in groups F2, F3, F4 differences were statistically significant in comparison with the control group. Also there was noted the presence of apoptotic cells in F3, F4 groups: 1 and 0.88%, respectively. Identified changes are both important in the description of to molecular patterns of the pathogenesis of chronic hepatitis B associated with damage, and also can serve as an indirect indication of the stage of liver fibrosis.


2015 ◽  
Vol 128 (17-18) ◽  
pp. 658-662 ◽  
Author(s):  
Enver Yüksel ◽  
Erdem Akbal ◽  
Erdem Koçak ◽  
Ömer Akyürek ◽  
Seyfettin Köklü ◽  
...  

BMC Nursing ◽  
2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ying’ai Cui ◽  
Michiko Moriyama ◽  
Kazuaki Chayama ◽  
Yanhui Liu ◽  
Chunmei Ya ◽  
...  

Abstract Background Chronic hepatitis, mainly B or C, increases the risk of hepatocellular carcinoma and remains an emerging issue in the globe. China has high rates of liver cancer incidence and mortality in the world. To address such challenges, adequate management of chronic hepatitis is required. Self-management education is one alternative for improving the hepatitis patients’ knowledge of the disease, mental health, and clinical management. This study aimed to examine the quality of life (QOL), psychological effects, and behavioral changes of a self-management program which allows continuity of care for chronic hepatitis B and C patients. Method In a six-month, randomized controlled trial, we invited 73 chronic hepatitis B/C inpatients to receive (i) two face-to-face education sessions provided by a nurse during hospitalization, and monthly telephone counseling at home after discharge; (ii) or usual care treatment (control group). The primary endpoint (patients’ QOL) and secondary outcomes (including self-efficacy, depression symptoms, perceived cognition of illness and behavioral changes) were assessed. In addition, we conducted qualitative data analysis to facilitate the evaluation of the interventions. Results Sixty (82.2%) out of 73 eligible patients with chronic hepatitis B/C (aged 34.9 ± 8.9 years) participated in the study. The intervention group (n = 30) significantly improved on outcomes including QOL, self-efficacy, perceived cognition of illness, and behavioral changes, whereas the control group significantly decreased their healthy behaviors. In terms of behavioral changes, alcohol avoidance, dietary adherence, and stress management also improved in the intervention group. However, there were no significant improvements in symptoms of depression. Most participants (80%) in the intervention group stated that they benefited from the program. Conclusions This program contributed to patients’ acquisition of self-management skills to cope with their illnesses, and significantly improved their QOL. This program serves as a reminder for nurses who care for patients with chronic viral hepatitis to acquire these skills as it would help them address the daily needs of their patients. Trial registration UMIN000025378. Registered December 23, 2016.


Author(s):  
María José Amaro ◽  
Javier Bartolomé ◽  
Margarita Pardo ◽  
Teresa Cotonat ◽  
Antonio López-Farré ◽  
...  

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