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如何阻断三大母婴传播疾病?
2010年06月21日 出处：太平洋亲子论坛 责任编辑：解丽娟
导读：经过长达一年准备，一对“艾滋夫妇”产下一名女婴。与以往不同，这对“艾滋夫妇”是在已经知道其病情后主动选择阻断艾滋病毒母婴传播技术怀孕生育，这在沪上目前艾滋病人中尚属首例。截至发稿时，宝宝胃口和精神状态都很好，与健康婴儿没有区别。
关键词：母婴传播疾病 艾滋病 乙肝 破水 怀孕40周 孕期
看到上面这则消息，着实令人感到很欣慰。但是，虽然母婴阻断技术出现重大突破，却并不意味着现在医学技术能保证艾滋病人百分百安全生产。
其实，母婴传播疾病绝对不止艾滋病一种。为了保证后代的健康，准爸妈们应该尽力避免疾病的母婴传播。下面，介绍几种最常见的母婴传播疾病，希望对准爸妈们有帮助。
一、艾滋病
母婴传播是艾滋病3种传播途径之一。孕产妇艾滋病病毒感染者，如果不及时进行母婴阻断，传染给孩子的几率很大。对于检测出的阳性孕妇，疾控部门采取恰当的干预措施，及时控制了艾滋病的二代传播。
提醒：
孕妇在怀孕早期发现感染艾滋病病毒，可自愿选择是否继续怀孕。如果选择继续妊娠，应到当地承担艾滋病抗病毒治疗任务的医院或妇幼保健机构，在医生的指导下，采取服用抗病毒药物、住院分娩以及产后避免母乳喂养等预防传播的措施，可大大减少将艾滋病病毒传染给胎儿或婴儿的机会。对所生婴儿实行人工喂养，避免母乳喂养，杜绝混合喂养。并在婴儿第12和第18个月进行免费艾滋病病毒抗体检测。
国内外研究显示，发展中国家的艾滋病感染孕妇如果不做有效的干预，其母婴传播率可达30%至40%。 接受全程干预的艾滋病孕妇，包括妊娠早期的检查和咨询，孕期的服药和化验，分娩期的产妇和新生儿处理，产后的母子用药和人工喂养等，将有可能将母婴传播率降低到2%至3%。
二、乙肝
只有先了解主要的传播途径，才能有效地预防。乙肝病毒的母婴传播主要包括4种途径：
1.妊娠期：乙肝病毒通过胎盘，使胎儿受到宫内感染。
2.分娩期：胎儿在分娩的过程中，因为接触到母亲的血液、羊水和分泌物而被感染。
3.产褥期：婴儿在喂养的过程中被感染。
4.日常生活中：因为与母亲接触频繁，受到母亲的唾液、血液以及其他体液的感染。
在4种途径中，以第一种为主要途径，因为妊娠时间长，而且胎儿处于无任何免疫能力的状态，所以极易受到感染。所以女性在怀孕期间，应做全面体检，确认自身健康，健康的母亲最好接种乙肝疫苗，保护自己不受乙肝病毒的感染。
提醒：
携带乙肝病毒的孕妇可从怀孕7个月起，每月打1支乙肝高效免疫球蛋白。如果是临近生产的孕妇发现得了乙肝，在发现时可立即打1支乙肝高效免疫球蛋白。乙肝妈妈最好选择剖腹产为生产方式。
对新生儿即时进行联合免疫，新生儿在出生后6小时之内肌肉注射乙肝高效价免疫球蛋白(HBIG)0.5毫升，在生后1个月、2个月后再各注射0.16毫升/公斤体重，可使新生儿即刻获得被动免疫;初生儿出生后24小时之内、第2个月及6个月各肌肉注射乙肝疫苗30微克，则对婴儿的保护率可达95%以上。
三、性病
母婴传播是性病的传播方式之一，随着性病的广泛流行，育龄妇女，包括孕妇性病的发病率也逐渐上升，对下一代的健康影响越来越大。患有性病或生殖器官传染病的母亲，在自然分娩时，阴道内的病原体可感染产儿，致使产儿发生相应疾病，产儿受感染的组织与器官常见有眼、耳、尿道、生殖器官及皮肤。如性病性眼结膜炎、沙眼、阴道滴虫病、丘疹性皮炎等。
提醒：
1、首先夫妻双方要加强道德修养、洁身自爱，不搞婚外性关系，并注意个人卫生，防止感染性病。
2、不洁性行为时，要使用安全套。正确使用质量可靠的安全套，预防性病的有效性超过90%。性交后立即排尿、淋浴或冲洗生殖器，用酒精或其它皮肤杀菌剂涂擦或清洗，也可降低性病的传染性。
3、提倡婚前检查、尤其是性病检查。如一方发现性病，应及早规范治疗，避免传染给对方。
4、怀孕前，夫妇双方最好到医院做必要的身体检查，包括性病项目筛查，以排除有无性病的潜伏或隐匿性感染。如有感染需双方进行治疗，治愈前要避免性接触或使用安全套，治愈后才能怀孕。
5、孕妇应避免不必要的输血和注射;必须输血时一定要确认血液或血液制品是经过梅毒、艾滋病等严格检验的;如果一定要使用如针头、注射器这样一些刺穿皮肤的器具，要坚持对器械进行消毒处理;应使用一次性注射器，或者严格遵守一人、一针、一管和一用一消毒的规定;避免与他人共用注射针具进行静脉吸毒。
6、产前保健时，至少做一次性病项目的筛查，(目前我市对所有孕妇均实施梅毒及艾滋病的免费筛查)以便及时发现妊娠期的性病感染，一旦发现需及早进行正规治疗，以免胎儿感染及使已感染的胎儿得到有效治疗。必要时需终止妊娠。
7、孕妇性病治疗原则：诊断必须明确。越早治疗，效果越好。治疗剂量必须足够，疗程必须规则。治疗后要经过足够时间追踪观察，确保彻底治愈。传染源及性接触者需接受检查或治疗，治疗前及治疗期间禁止性交。所生婴儿需接受检查及随访，以确定有无感染。
8、对患有性病的新生儿应立即给予规范治疗，并注意定期追踪随访，确保完全治愈。
9、妊娠期要注意个人卫生，勤洗澡，勤换衣裤。妊娠晚期宫颈口略为扩张，为避免感染不要使用盆浴和进行性交。
10、临产破水后，要及时到医院待产卧床休息。必要时采取措施使胎儿尽快娩出，减少感染机会。因有些性病传给新生儿危险性的大小取决于分娩方式、羊膜破裂时间。羊膜破裂时间越短，小儿发病危险性越低。有些性病，产道分娩也会增加新生儿感染的机会，必要时要考虑剖腹产。
11、做好新生儿点眼，预防新生儿眼炎的发生。出生后应立即用1%硝酸银溶液滴眼或1%四环素眼膏、0.5%红霉素眼膏外搽预防。
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How to block the three mother to child transmission disease?
June 21, 2010 Source: Pacific Family Forum Editor: Xie Lijuan
REVIEW: After a year-long preparation, a pair of "HIV wife" gave birth to a baby girl. Unlike in the past, which "HIV wife" is already aware of their condition by choice after blocking technology pregnant mother to child transmission of HIV on fertility, the people in Shanghai to present the first case of AIDS. As of press time, the baby had a good appetite and mental state, with no difference between healthy babies.
Key words: mother to child transmission of hepatitis B disease, AIDS, pregnancy 40 weeks pregnant water break
See above this message, really feel very happy. However, while PMTCT major breakthrough in technology, it does not mean that current medical technology can guarantee hundred percent safety of AIDS.
In fact, the infant transmission of AIDS is not restricted to a kind of disease. To ensure the health of future generations, prospective parents who should try to prevent mother to child transmission of disease. Next, introduce some of the most common maternal transmitted diseases, targeting parents who want help.
First, AIDS
AIDS mother to child transmission is one of three kinds of transmission. Maternal HIV infection, if not promptly PMTCT, great chance to-child transmission. For the detection of positive pregnant women in disease control departments to take appropriate interventions, and timely control of the second generation of AIDS transmission.
Reminder:
Pregnant women early in pregnancy found to be infected with HIV, may voluntarily decide whether to continue pregnancy. If you choose to continue pregnancy, should be to take HIV antiretroviral therapy to local hospitals or maternity and child care tasks, under the guidance of a doctor, to take antiviral drugs, hospital delivery and postpartum to prevent the spread of breast-feeding and other preventive measures can greatly reduce the HIV transmission to the fetus or babies. On the implementation of artificial feeding of babies born to avoid breast-feeding, mixed feeding stop. And in infants 12 and 18 months for free HIV antibody testing.
Domestic and international studies have shown that HIV-infected pregnant women in developing countries do not do effective intervention if their mother to child transmission rate of up to 30% to 40%. AIDS in pregnant women receiving full intervention, including early pregnancy testing and counseling, medication and testing during pregnancy, delivery of maternal and neonatal treatment, and post-medication and artificial feeding and other mother, it will be possible to reduce mother to child transmission rate to 2 % to 3%.
2, hepatitis B
Only first understand the major route of transmission can be prevented. Mother to child transmission of hepatitis B virus include four kinds of ways:
1. Pregnancy: hepatitis B virus through the placenta to the fetus by intrauterine infection.
2. Childbirth: the fetus in the birth process, because the access to maternal blood, amniotic fluid and secretions of infected.
3. Puerperium: infant feeding in the process of infection.
4. Everyday life: because of frequent contacts with the mother by the mother's saliva, blood and other body fluids of infected.
In the four kinds of channels, was the main route to the first, as long pregnancy and the fetus is in a state without any immunity, so vulnerable to infection. Therefore, pregnant women, should do a comprehensive physical examination to confirm their own health, the health of the mother the best hepatitis B vaccination to protect themselves from HBV infection.
Reminder:
Pregnant women carrying hepatitis B virus can be played from 7 months pregnant, hit a monthly high of hepatitis B immune globulin. If it got close to the production of pregnant women found that hepatitis B is found to play immediately when a high hepatitis B immune globulin. Hepatitis B mother is the best way for the production of a cesarean delivery.
Combined immunization of newborn immediately, neonatal birth within 6 hours after intramuscular injection of high titer hepatitis B immune globulin (HBIG) 0.5 ml 1 month after birth, 2 months after the injection of 0.16 ml / kg body weight will enable immediate access to neonatal passive immunization; newborn child within 24 hours after birth, 2 months and 6 months, the intramuscular injection of 30 micrograms of hepatitis B vaccine, the protection rate for babies up to 95%.
3, STD
Mother to child transmission is the mode of transmission of sexually transmitted diseases, with the widespread sexually transmitted diseases, women of childbearing age, including pregnant women, the incidence of sexually transmitted diseases increased gradually for the next generation of health effects is growing. Suffering from venereal disease or genital infectious diseases, mother, natural childbirth, vaginal births can be infected by pathogens, resulting in the corresponding births occurring diseases, births of infected tissues and organs commonly has eyes, ears, urinary tract, reproductive organs and skin. Such as sexually transmitted diseases, ocular conjunctivitis, trachoma, vaginal trichomoniasis, papular dermatitis.
Reminder:
1, the first couple to strengthen morality and remains honest and refrain from sexual relations outside marriage, and pay attention to personal hygiene, prevention of sexually transmitted diseases.
2, dirty sex, to use condoms. Correct condom use and reliable quality, the effectiveness of prevention of sexually transmitted diseases, more than 90%. Urinate immediately after intercourse, shower or washing the genitals, the skin with alcohol or other antiseptic rubbed or washed, it can reduce infectious sexually transmitted diseases.
3, to promote pre-marital examination, especially venereal disease examination. If a party found to sexually transmitted diseases, should be standard treatment as soon as possible to avoid transmission to the other party.
4, pre-pregnancy, the couple best to the hospital for necessary medical examination, including screening for sexually transmitted diseases project to exclude the potential for venereal disease or occult infection. Both sides need to be treated if infected, avoid sexual contact before cure or using condoms, pregnancy can be cured.
5, pregnant women should avoid unnecessary blood transfusion and injection; to be sure to confirm blood transfusions or blood products is the result of syphilis, AIDS and other strict test; If we must use such as needles, syringes, so some of the skin piercing instruments, should adhere to disinfection of the equipment; should use disposable syringes, or strict compliance with one person, one needle, one and one with a disinfection requirements; avoid sharing needles with intravenous drug use.
6, prenatal care, at least do a one-time disease screening project, (currently the city are implemented for all pregnant women free screening for syphilis and AIDS) in order to detect sexually transmitted diseases during pregnancy, if found to be early for regular treatment, to prevent fetal infection and infection of the fetus to have been effectively treated. Be necessary to terminate pregnancy.
7, pregnant women, STD treatment principle: diagnosis must be clear. The earlier the treatment, the better. Dose must be adequate treatment must be rules. After treatment, over a sufficient period of observation, to ensure complete cure. Source of infection and sexual contact are required to accept the examination or treatment, treatment, prohibiting sex before and during treatment. Babies born to be inspected and follow-up to determine whether infection.
8 newborns who suffer from sexually transmitted diseases should be immediately given standard treatment and followed up at regular intervals to ensure a complete cure.
9, pregnancy should pay attention to personal hygiene and wash bath, Qinhuan underwear. Slight expansion of the cervix in late pregnancy mouth, do not use the bath in order to avoid infection and sexual intercourse.
10, in labor after the water break, to be produced in time to the hospital for bed rest. Necessary to take measures as soon as possible so that the fetus is delivered, to reduce chances of infection. Baby at birth due to some risk of sexually transmitted diseases depends on mode of delivery, amniotic membrane rupture time. The shorter the time of amniotic membrane rupture, the lower the risk of pediatric disease. Some sexually transmitted diseases, birth canal birth will increase the chance of neonatal infections, if necessary, to consider cesarean section.
11, good neonatal eye, preventing the occurrence of neonatal ophthalmia. Immediately after birth with a 1% silver nitrate eye drops or 1% tetracycline eye ointment, 0.5% erythromycin ointment Waicha prevention.
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