Zusammenfassung
Die virale Hepatitis stellt eine der schwerwiegenden infektiösen Erkrankungen in der
Schwangerschaft dar. Dabei sind die fünf Hepatitisviren A bis E für mehr als 90 %
der Infektionen der Leber verantwortlich. Dieses Manuskript beschreibt klinische Symptome
der Erkrankung, präventive und therapeutische Ansätze in der Schwangerschaft. Auf
die perinatalen Übertragungswege sowie Differenzialdiagnose der Hepatitis-Erkrankung
wird besonderes Augenmerk gelegt. Eine Reihe offener Fragen wird bei der Betrachtung
der Hepatitis-Erkrankung in der Schwangerschaft angesprochen.
Abstract
Viral hepatitis is one of the most serious infections in pregnant women. There are
now at least five hepatitis viruses. This educational review describes the various
types of hepatitis, clinical manifestations, their impact on mother and fetus, prevention
and treatment options, risks of perinatal transmission and differential diagnosis.
Several open questions regarding vaccination as well as perinatal transmission have
been addressed.
Schlüsselwörter
Hepatitis - Schwangerschaft - klinische Symptome - Übertragung - Differenzialdiagnose
Key words
Hepatitis - pregnancy - clinical manifestations - perinatal transmission - differential
diagnosis
Literatur
- 1
Snydman D R.
Hepatitis in pregnancy.
N Engl J Med.
1985;
313(22)
1398-401
- 2
Simms J, Duff P.
Viral hepatitis in pregnancy.
Semin Perinatol.
1993;
17(6)
384-93
- 3
Magriples U.
Hepatitis in pregnancy.
Semin Perinatol.
1998;
22(2)
112-7
- 4
Niesert S, Messner U, Tillmann H L, Gunter H H, Schneider J, Manns M P.
Prevalence of hepatitis B in pregnancy and selective screening.
Geburtshilfe Frauenheilkd.
1996;
56(6)
283-6
- 5
Sandhu B S, Sanyal A J.
Pregnancy and liver disease.
Gastroenterol Clin North Am.
2003;
32(1)
407-36
- 6
Denis F, Tabaste J L, Ranger-Rogez S.
Prevalence of HBsAg in about 21,500 pregnant women. Survey at twelve French University
Hospitals. The Muticentric Study Group.
Pathol Biol (Paris).
1994;
42(5)
533-8
- 7
Wong S, Chan L Y, Yu V, Ho L.
Hepatitis B carrier and perinatal outcome in singleton pregnancy.
Am J Perinatol.
1999;
16(9)
485-8
- 8
Ip H M, Wong V C, Lelie P N, Reesink H W, Schaasberg W, Yeung C Y, Ma H K.
Hepatitis B infection in infants after neonatal immunization.
Acta Paediatr Jpn.
1989;
31(6)
654-8
- 9
Xu D Z, Yan Y P, Choi B C, Xu J Q, Men K, Zhang J X, Liu Z H, Wang F S.
Risk factors and mechanism of transplacentral transmission of hepatitis B virus: a
case-control study.
J Med Virol.
2002;
67(1)
20-6
- 10
Xu D Z, Yan Y P, Zou S, Choi B C, Wang S, Liu P, Bai G, Wang X, Shi M, Wang X.
Role of placental tissues in the intrauterine transmission of hepatitis B virus.
Am J Obstet Gynecol.
2001;
185(4)
981-7
- 11
Grosheide P M, Quartero H W, Schalm S W, Heijtink R A, Christiaens G C.
Early invasive prenatal diagnosis in HBsAg-positive women.
Prenat Diag.
1994;
14(7)
553-8
- 12
Alexander J M, Ramus R, Jackson G, Sercely B, Wendel G D Jr.
Risk of hepatitis B transmission after amniocentesis in chronic hepatitis B carriers.
Infect Dis Obstet Gynecol..
1999;
7(6)
283-6
- 13
Davies G, Wilson R D, Desilets V, Reid G J, Shaw D, Summers A, Wyatt P, Young D.
Amniocentesis and women with hepatitis B, hepatitis C, or human immunodeficiency virus.
J Obstet Gynaecol Can.
2003;
25(2)
145-48, 149 - 52
- 14
Hill J B, Sheffield J S, Kim M J, Alexander J M, Sercely B, Wendel G D.
Risk of hepatitis B transmission in breast-fed infants of chronic hepatitis B carriers.
Obstet Gynecol.
2002;
99(6)
1049-52
- 15 ACOG educational bulletin. Viral hepatitis in pregnancy. Number 248, Juli 1998
American College of Obstetricians and Gynecologists. Int J. Gynaecol Obstet 1998 63(2):
195-202
- 16
Schroter B, Chaoui R, Meisel H, Bollmann R.
Maternal hepatitis B infection as the cause of nonimmunologic hydrops fetalis.
Z Geburtshilfe Neonatol.
1999;
203(1)
36-8
- 17
Ohto H, Terazawa S, Sasaki N, Hino K, Ishiwata C, Kako M, Ujiie N, Endo C, Matsui A.
et al .
Transmission of hepatitis C virus from mothers to infants. The Vertical Transmission
of Hepatitis C Virus Collaborative Study Group.
N Engl J Med.
1994;
330(11)
744-50
- 18
Bart P A, Jacquier P, Zuber P L, Lavanchy D, Frei P C.
Seroprevalence of HBV (anti-HBc, HBsAg and anti-HBs) and HDV infections among 9006
wopmen at delivery.
Liver.
1996;
16(2)
110-6
- 19
Lee S D, Lo K J, Tsai Y T, Wu T C, Yang Z L, Ng H T.
Role of caesarean section in prevention of mother-infant transmission of hepatitis
B virus.
Lancet.
1988;
2(8615)
833-4
- 20
Lin H H, Kao J H, Hsu H Y, Mizokami M, Hirano K, Chen D S.
Least microtransfusion from mother to fetus in elective cesarean delivery.
Obstet Gynecol.
1996;
87(2)
244-8
Priv.-Doz. Dr. med. Marek Zygmunt
Universitätsfrauenklinik
Klinikstraße 32
35385 Gießen
Phone: 0641-99 45 284
Fax: 0641-99 45 209
Email: marek-zygmunt@gyn.med.uni-giessen.de
