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Master Thesis

Évaluation du dépistage et de la prise en charge materno-fœtale de l'hépatite B pendant et après la grossesse au centre hospitalier d'Annecy

Abstract : The management of hepatitis B during pregnancy in France is barely evaluated in the literature, whether in terms of screening or as preventive treatment of the materno-foetal transmission. In addition, new treatment recommendations in case of high viral load in the mother exist only recently. This cross-sectional epidemiological monocentric study retrospectively analyzed all deliveries in the motherhood Annecy Hospital in 2013 (2549 and 2624 mothers and newborns). The objective is to evaluate screening for HBsAg during pregnancy and check the diagnostic and therapeutic management of women with positive HBsAg and their newborns. The prevalence of HBsAg is 0.43% (11/2549). In 2 cases, hepatitis B is a discovery. Serology is entered into the computer medical records in 95.5% of cases (2434/2549). Only one patient carrying HBsAg is not assessed on the HBV viral load and 50% (6/11) of patients benefit from an expert advice in hepatology. Only one has received treatment for 3rd quarter because of a high viral load. Only 50% (6/11) of patients were reviewed at 1 year. The 12 newborns of mothers with positive HBs Ag received optimal serovaccination at birth but its effectiveness at 9th month (dosage of anti HBs Ab) is verified only for 50% of them (6/12). Despite the low prevalence, good screening results can be explained by the proper use of computers, a trained team and the existence of an easily accessible protocol. The combination with other serologies screened during pregnancy could further improve these results. Regarding monitoring, the social isolation appears to be a factor associated with less well followed patients. The importance of a specialist consultation during pregnancy should be highlighted The improvement of communication of medical data between the city and the hospital would be necessary and a clear and understandable information adapted to the patient to facilitate adherence to the subsequent monitoring for her and her child.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01167313
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Submitted on : Wednesday, June 24, 2015 - 11:30:47 AM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
Long-term archiving on: : Tuesday, April 25, 2017 - 8:09:47 PM

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  • HAL Id : dumas-01167313, version 1

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Hélène Roehrich. Évaluation du dépistage et de la prise en charge materno-fœtale de l'hépatite B pendant et après la grossesse au centre hospitalier d'Annecy. Médecine humaine et pathologie. 2015. ⟨dumas-01167313⟩

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