The risk of placental abruption and placenta previa in pregnant women with chronic hepatitis B viral infection: A systematic review and meta-analysis

Huang, Quan; Chen, J.H.; Zhong, Ming; Xu, Yikai; Cai, Cuixia; Wei, Shanshan; Hang, Lifeng; Liu, Q.; Yu, Yinhua

doi:10.1016/j.placenta.2014.05.007

Cited by 24 publications

(23 citation statements)

References 30 publications

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“…Chronic HBV infection does not seem to be a risk factor for maternal complications such as placental abruption, preterm labor, and preeclampsia. It appears to even have a protective effect, probably owing to the impaired immune response and/or increased immune tolerance caused by the virus; however, this was only observed in the Asian population [ 26 – 28 ]. Some studies also reported that chronic HBV carriers have a slightly increased risk of preterm birth and low birth weight [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Acute-on-Chronic Liver Failure in Pregnant Patients with Chronic Hepatitis B: A Retrospective Observational Case Series Study

Wang

Xiong

Luo

et al. 2020

Gastroenterology Research and Practice

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Background and Aims. Acute-on-chronic liver failure (ACLF) is common in patients with end-stage liver disease and chronic hepatitis B (CHB) or hepatitis B virus- (HBV-) related cirrhosis. To date, no uniform definition and management strategy are available for ACLF. Although a considerable number of studies on ACLF has been published, there are few reports on ACLF in pregnant women with CHB. This study retrospectively reviewed five patients who were diagnosed with ACLF during pregnancy in the past 10 years. We aimed at investigating their clinical characteristics, treatment, biochemical test results, and maternal and fetal outcomes. Results. Asthenia, anorexia, and jaundice were the main initial clinical manifestations in these patients during the second or third trimester of pregnancy. All patients received antiviral therapy. None of the pregnant women died after treatment. Patient #4 was treated with an artificial liver support system, and patients #2 and #5 underwent transfusion therapy. The acute insult in all patients was HBV DNA reactivation. Except for patient #3, who chose an actively induced vaginal delivery because of intrauterine fetal demise, the remaining four patients underwent a preterm delivery via a cesarean section. The four neonates were alive, although all were small for gestational age. Conclusion. Asthenia, anorexia, and jaundice during mid-late pregnancy should be immediately investigated. Before and during the pregnancy, hepatologists or obstetricians should actively screen pregnant women with CHB for HBV DNA status and alanine aminotransferase levels. Reactivation of HBV replication in pregnant women with CHB may lead to ACLF, especially in multiparous women. Once ACLF is diagnosed, antiviral therapy should be considered as soon as possible to protect maternal and fetal health.

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Section: Discussionmentioning

confidence: 99%

Acute-on-Chronic Liver Failure in Pregnant Patients with Chronic Hepatitis B: A Retrospective Observational Case Series Study

Wang

Xiong

Luo

et al. 2020

Gastroenterology Research and Practice

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“…Pela seleção das publicações, constituíram o corpus de análise, o total de sete [6][7][8][9][10][11][12] artigos, sendo um do LILACS 6 e seis da PUBMED. [7][8][9][10][11][12] Os artigos foram publicados em periódicos variados, um 6 nacional e seis [7][8][9][10][11][12] internacionais, todos de autoria médica.…”

Section: Resultsunclassified

“…[7][8][9][10][11][12] Os artigos foram publicados em periódicos variados, um 6 nacional e seis [7][8][9][10][11][12] internacionais, todos de autoria médica. Em relação ao ano de publicação, a maioria dos artigos é dos anos de 2014 [7][8] No que concerne à via de parto, a literatura não possui um consenso, mas a cesariana é o procedimento mais realizado nesses casos, por se tratar de uma emergência obstétrica de alto risco materno-fetal. Em relato de caso sobre gestante japonesa, com 40 semanas de gestação, colo uterino favorável, sinais vitais maternos estáveis e ausência de batimentos cardiofetais, optou-se pelo parto vaginal induzido com ocitocina, para evitar uma intervenção mais invasiva.…”

Section: Resultsunclassified

Produção científica acerca do descolamento prematuro da placenta

et al. 2017

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RESUMOObjetivo: analisar as produções científicas disponíveis na literatura, sobre descolamento prematuro da placenta (DPP). Métodos: trata-se de uma revisão integrativa de literatura. A busca foi realizada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e MEDLINE pela Pubmed, a partir da questão norteadora "Quais as evidências científicas sobre descolamento prematuro da placenta?". Resultados: predominaram estudos que não apresentam fortes evidências para aplicação clínica e a totalidade é de autoria médica. Os estudos analisados têm como foco a associação de DPP com patologias, alterações genéticas e comportamentais na gestação. Considerações finais: percebe-se a escassez com níveis de evidência altos, bem como, ausência de produções na área de enfermagem. Descritores: Enfermagem obstétrica; Descolamento prematuro da placenta; Complicações na gravidez. ABSTRACT

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“…With regard to maternal complications, chronic HBV infection does not seem a risk factor for many of them, as derived by research syntheses. A meta-analysis collecting data on 9088 placenta previa cases and 15571 placental abruption cases failed to demonstrate an association with HBV, implicated as a driver of an inflammation state able to induce dysfunction of trophoblasts: Odds ratio (OR) equal to 0.98 with 95%CI equal to 0.60-1.62 and OR = 1.42 with 95%CI: 0.93-2.15, respectively[ 27 ]. A further meta-analysis involving 439514 subjects showed that HBV was not associated with increased risk of gestational diabetes mellitus (adjusted OR = 1.11, 95%CI: 0.96-1.28), a link suggested by the potential role played by the virus in inducing insulin resistance[ 28 ].…”

Section: Hbv Infection In Pregnancy: From the Perspective Of Gravid Wmentioning

confidence: 99%

Current evidence on the management of hepatitis B in pregnancy

Maraolo

Gentile

Buonomo

et al. 2018

WJH

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Hepatitis B virus (HBV) infection is one of the main public health problems across the globe, since almost one third of the world population presents serological markers of contact with the virus. A profound impact on the epidemiology has been exerted by universal vaccination programmes in many countries, nevertheless the infection is still widespread also in its active form. In the areas of high endemicity (prevalence of hepatitis B surface antigen positivity > 7%), mother-to-child transmission represents the main modality of infection spread. That makes the correct management of HBV in pregnancy a matter of utmost importance. Furthermore, the infection in pregnancy needs to be carefully assessed and handled not only with respect to the risk of vertical transmission but also with respect to gravid women health. Each therapeutic or preventive choice deserves to be weighed upon attentively. On many aspects evidence is scarce or controversial. This review will highlight the latest insights into the paramount steps in managing HBV in pregnancy, with particular attention to recommendations from recent guidelines and data from up-do-date research syntheses.

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The risk of placental abruption and placenta previa in pregnant women with chronic hepatitis B viral infection: A systematic review and meta-analysis

Cited by 24 publications

References 30 publications

Acute-on-Chronic Liver Failure in Pregnant Patients with Chronic Hepatitis B: A Retrospective Observational Case Series Study

Acute-on-Chronic Liver Failure in Pregnant Patients with Chronic Hepatitis B: A Retrospective Observational Case Series Study

Produção científica acerca do descolamento prematuro da placenta

Current evidence on the management of hepatitis B in pregnancy

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