title: [Hepatitis B and pregnancy. Part 1. Thirteen practical issues in antenatal period].
abstract: In France, the prevalence of chronic hepatitis B is about 1% in pregnant women (usually asymptomatic carriers of HBsAg). The risk of maternal-fetal transmission of hepatitis B is particularly high when viral load measured by PCR is higher in mothers (above 7 log) or HBeAg is present. In case of maternal-fetal transmission of hepatitis B, the risk to the newborn of developing subsequent chronic hepatitis B is very high (90%), with long-term complications such as cirrhosis and hepatocellular carcinoma. The prevention of maternal-fetal transmission is based on systematic testing for hepatitis B during pregnancy, followed by serovaccination of the newborn at birth. If necessary, amniocentesis can be realised but will avoid the realization of a transplacental gesture. In case of high viral load, the establishment of a maternal antiviral treatment with lamivudine or tenofovir from 28SA can further reduce the risk of transmission. Given the low resistance it induces, tenofovir should be used preferentially.
authors.affiliation: Université Nord-de-France, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France. Electronic address: adriennefouquet@yahoo.fr.
authors.forename: A
authors.initials: A
authors.lastname: Fouquet
authors.affiliation: Gynécologie-obstétrique, centre hospitalier de Tourcoing, 59200 Tourcoing, France.
authors.forename: A-C
authors.initials: AC
authors.lastname: Jambon
authors.affiliation: Hépato-gastroentérologie, université Nord-de-France, CHRU de Lille, 59037 Lille, France.
authors.forename: V
authors.initials: V
authors.lastname: Canva
authors.affiliation: Virologie, pôle biologie-pathologie, université Nord-de-France, CHRU de Lille, 59037 Lille, France.
authors.forename: L
authors.initials: L
authors.lastname: Bocket-Mouton
authors.affiliation: Université Nord-de-France, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Gottrand
authors.affiliation: Université Nord-de-France, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 2694, PRES université Lille-Nord-de-France, 59000 Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Subtil
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy*
keywords: Amniocentesis; Amniocentèse; Antiviral treatment; Grossesse; Hepatitis B; Hépatite B; Maternal-fetal transmission; Pregnancy; Prevention; Prévention; Serovaccination; Sérovaccination; Traitement antiviral; Transmission materno-fœtale