Pregnancy in HCV positive patients

Abstract: The HCV prevalence in the European Union and Economic Area countries is approximately 1.1% in total, which accounts for 5.6 million anti-HCV positive and 3.9 chronically infected individuals. According to the Polish regulations, every pregnant woman should be screened for HCV until the 10th gestational week. Repeat HCV screening is recommended between 33rd – 37th week of gestation among women from high-risk groups. Large population-based studies have proved higher incidence of certain adverse pregnancy outcomes, including gestational diabetes, preterm delivery, low birth weight, small for gestational age, and intrahepatic cholestasis of pregnancy in pregnancies complicated with chronic maternal HCV infection. In addition, one of possible complications is mother to child transmission. There is no evidence to support the use of elective caesarean section and recommend it as transmission prevention. Risk factors which should be prevented in order to decrease the transmission rate include: detectable viremia, especially exceeding 107 IU/ml, exposure to maternal blood, rupture of membranes and amniotic fluid leakage lasting over 6 hours, invasive prenatal diagnostic procedures, and maternal coinfection with HIV. Appropriate screening and viremia control seem to be most relevant in the antenatal management of HCV positive women.

Joanna Kacperczyk-Bartnik, Maciej Pawliszewski, Aleksandra Symonides, Pawel Bartnik, Agnieszka Dobrowolska-Redo, Ewa Romejko-Wolniewicz

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