КЛИНИКО-ЛАБОРАТОРНАЯ ХАРАКТЕРИСТИКА НОВОРОЖДЕННЫХ ОТ МАТЕРЕЙ, ПЕРЕБОЛЕВШИХ ОСТРЫМ ВИРУСНЫМ ГЕПАТИТОМ В И ОСОБЕННОСТИ РЕАБИЛИТАЦИИ

Abstract

Relevance. Viral hepatitis in women during pregnancy is characterized by etiological diversity and has the entire spectrum of manifestations characteristic of HB infections. In the structure of viral hepatitis in pregnant women, viral hepatitis B accounts for up to 70 %. In case of a woman's illness, infection of newborns during pregnancy is a leading factor for the development of HB and HC - a viral infection in children. At the same time, the nature of specific immunological markers in the blood of the mother and child is of particular importance for the development of neonatal NV or HC-viral infection. Objective: assessment of the rehabilitation of children from mothers with acute viral hepatitis B at various stages of pregnancy based on the study of the clinical and laboratory characteristics of this infection. Materials and methods.The study included 45 children whose mothers suffered from acute viral hepatitis during pregnancy. The diagnosis was verified in all children according to the data of clinical and laboratory studies with the determination of HBsAg, HBeAg, DNA, RNA of viral hepatitis. Results. The first group consisted of 16 (35.5%) children whose mothers had HBsAg in their blood. HB viral infection developed in the third trimester of pregnancy, childbirth took place in the acute period of the disease at the end of the third week of the icteric period. The second group – 19 (42.3 %) newborns, whose mothers also fell ill in the third trimester of pregnancy, but childbirth took place later on the third week of the icteric period 15 (33.3 %) or in the period of early convalescence 4 (8.8 %). At the same time, HBsAg in the blood of all mothers continued to be determined during the early and late period of convalescence. Unlike the newborns of the first group, only 2 (4.4 %) children in the second group had HBsantigenemia at the 2nd week of life. In 2/3 of the examined newborns, antibodies to HBsAg were detected in cord blood or in serum taken in the first days of life. At the same time, the mothers had no antibodies, despite the presence of HBsAg. It is necessary to pay special attention to the fact that in the presence of antibodies to HBsAg in the umbilical cord blood in these children of HBsAg, there was no antigenemia during the follow-up during the year. Antibodies to HBsAg were re-detected at the age of 5-6 months and only in 3 (6.6 %) children at the age of 12 months. Mothers of 10 (22.2 %) newborns of the 3rd group were ill with HBV infection in the 2nd trimester of pregnancy and childbirth took place during the period of convalescence, after 6-7 months after clinical recovery and release from HBsantigenemia. However, these infants had anti-HBs in the absence of HBsAg, which persisted for 3-6 months after birth. Conclusion: the above requires rehabilitation measures in newborns from mothers who have had acute viral hepatitis B during pregnancy in order to prevent the development of complications and chronicity of the process.