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乙型肝炎病毒母婴传播预防临床指南(2020)
2020 clinical guidelines on prevention of mother-to-child transmission of hepatitis B virus
文章发布日期:2020年06月08日  来源:  作者:中华医学会妇产科学分会产科学组, 中华医学会围产医学分会  点击次数:601次  下载次数:96次

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【摘要】:乙型肝炎病毒(HBV)母婴传播是我国慢性乙型肝炎(乙肝)的主要原因,预防HBV母婴传播是控制慢性乙肝的关键。本指南在《乙型肝炎病毒母婴传播预防临床指南(第1版)》基础上,更新了推荐建议,主要包括:(1)所有孕妇产前需筛查乙肝血清学指标;(2)HBsAg阴性母亲,其新生儿按“0、1、6月”方案接种乙肝疫苗,通常不需使用乙肝免疫球蛋白(HBIG);(3)HBsAg阳性母亲,其新生儿出生后12 h内(越快越好)肌内注射1针HBIG,并同时肌内注射第1针乙肝疫苗(越快越好),1月和6月龄分别接种第2针和第3针疫苗;(4)为进一步减少母婴传播,孕妇HBV DNA>2×105 IU/ml或HBeAg阳性,从妊娠28~32周可开始服用抗病毒药物,分娩当日停药;(5)不推荐以减少HBV母婴传播为目的的剖宫产术。
【Abstract】:Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is the main cause of chronic hepatitis B (CHB) in China, and the prevention of MTCT plays a critical role in controlling CHB. Based on Clinical guidelines for the prevention of mother-to-child transmission of hepatitis B virus (First Edition) issued in 2013, the current clinical guidelines have updated the recommendations, mainly including: (1) all pregnant women should undergo the prenatal screening for hepatitis B serological markers; (2) neonates whose mothers have negative HBsAg should receive hepatitis B vaccination according to the regimen of “0, 1, and 6 months”, and there is generally no need for hepatitis B immunoglobulin (HBIG); (3) neonates whose mothers have positive HBsAg need intramuscular injection of HBIG at one dose and the first dose of hepatitis B vaccine within 12 hours after birth (the sooner the better), followed by injection of the second and third doses of hepatitis B vaccine at the age of 1 and 6 months, respectively; (4) to further reduce MTCT of HBV, pregnant women with HBV DNA >2×105 IU/ml or with positive HBeAg may start to take oral antivirals at the 28-32 weeks of gestation until the day of delivery; (5) cesarean section, with the purpose to reduce MTCT of HBV, is not recommended.
【关键字】:乙型肝炎病毒; 传染性疾病传播,垂直; 免疫预防; 诊疗准则(主题)
【Key words】:hepatitis B virus; infectious disease transmission,vertical; immunoprophylaxis; practice guideline as topic
【引证本文】:Obstetrics Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association; Chinese Society of Perinatal Medicine, Chinese Medical Association. 2020 clinical guidelines on prevention of mother-to-child transmission of hepatitis B virus[J]. J Clin Hepatol, 2020, 36(7): 1474-1481. (in Chinese)
中华医学会妇产科学分会产科学组, 中华医学会围产医学分会. 乙型肝炎病毒母婴传播预防临床指南(2020)[J]. 临床肝胆病杂志, 2020, 36(7): 1474-1481.

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