ГЕПАТИТ С ПРИ БЕРЕМЕННОСТИ – СОВРЕМЕННЫЕ ПОДХОДЫ К СКРИНИНГУ, ЛЕЧЕНИЮ И ПРОФИЛАКТИКЕ ОСЛОЖНЕНИЙ


Мозес К.Б., Мозес В.Г., Захаров И.С., Елгина С.И., Рудаева Е.В.

Аннотация


Цель исследования – провести аналитический обзор современных источников научной литературы, освещающих вопросы скрининга, лечения и профилактики осложнений у беременных с гепатитом С.

Материалы и методы. Проведен анализ 56 отечественных и зарубежных источников литературы по данной теме.

Результаты. По результатам анализа научных данных обновлено представление о распространенности гепатита С при беременности в Российской Федерации и в мире. В обзоре описаны возможные осложнения беременности и родов, ассоциированные с гепатитом С, проведена оценка риска вертикальной передачи инфекции, освещены вопросы эффективности скрининга данного заболевания и тактика ведения беременности у инфицированных женщин.

Заключение. Высокая распространенность гепатита С при беременности делает его актуальной проблемой. Проведенный анализ свидетельствует, что оперативное родоразрешение беременных с гепатитом С не снижает риск вертикальной передачи инфекции, и поэтому не может быть рекомендовано, тогда как запрет ранней амниотомии, профилактика длительного безводного промежутка, снижение частоты использования инвазивного фетального мониторинга и эпизиотомии являются эффективными способами профилактики инфицирования плода и новорожденного. Современная противовирусная терапия препаратами прямого противовирусного действия совершила революцию в лечении гепатита С, однако препараты, позволяющие лечить заболевание во время беременности, находятся в стадии разработки и клинических исследований.


Ключевые слова


Вирус гепатита С; гепатит С; беременность; роды; послеродовый период

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Литература


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