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Review paper
Published online: 2021-10-08
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Risk of vertical transmission of chronic viral infections after invasive prenatal procedures

Brindusa Cimpoca1, Anca Maria Panaitescu12, Nicolae Gica12, Alina Veduta1, Anca Ciobanu13
DOI: 10.5603/GP.a2021.0196
Affiliations
  1. Gynaecology Department, Filantropia Clinical Hospital, Bucharest, Romania
  2. Carol Davila” University of Medicine and Pharmacy, Department of Obstetrics and Gynecology, Bucharest, Romania
  3. Carol Davila” University of Medicine and Pharmacy, Department of Obstetrics and Gynecology, Bucharest, Romania, Bucharest, Romania

open access

Ahead of Print
REVIEW PAPERS Obstetrics
Published online: 2021-10-08

Abstract

Objectives: Invasive prenatal procedures including amniocentesis, chorionic villus sampling (CVS) can be prenatally indicated for diagnostic purposes. Chronic viral infections with Human Immunodeficiency Virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) are not uncommon in women of reproductive age.

The aim of this narrative literature review is to provide guidance on the best clinical practice in antenatal invasive testing and fetal surveillance in pregnancies with HIV, HCV, HBV and treponema pallidum infected women.

Material and methods: A review of the literature was conducted in the database of PubMed to select full-length articles published in peer-reviewed journals between 1990 and 2020. The keywords along with respective combinations included in the search strategy were invasive testing, prenatal diagnosis, amniocentesis, chorionic villus sampling, cordocentesis, fetoscopy, chronic viral infections, hepatitis B, hepatitis C, HIV, treponema pallidum, syphilis, vertical transmission, MTCT.

Results: For patients with hepatitis B infection, it is important to assess the HBeAg status and HBV DNA levels and for those patients with high viral load, antiviral therapy (Tenofovir) for a few weeks may be needed to reduce the viral load prior to the invasive procedure. In women positive for HCV, the viral load and HIV status should be assessed to establish the risk of vertical transmission; while for patients with HIV, highly active antiretroviral therapy administration and low viral load are predictive for reduced vertical transmission even after performing an invasive procedure. In all cases invasive procedure should be replaced by non-invasive prenatal testing if this is a feasible alternative and when invasive testing is indeed required, transplacental passage should be avoided.

Abstract

Objectives: Invasive prenatal procedures including amniocentesis, chorionic villus sampling (CVS) can be prenatally indicated for diagnostic purposes. Chronic viral infections with Human Immunodeficiency Virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) are not uncommon in women of reproductive age.

The aim of this narrative literature review is to provide guidance on the best clinical practice in antenatal invasive testing and fetal surveillance in pregnancies with HIV, HCV, HBV and treponema pallidum infected women.

Material and methods: A review of the literature was conducted in the database of PubMed to select full-length articles published in peer-reviewed journals between 1990 and 2020. The keywords along with respective combinations included in the search strategy were invasive testing, prenatal diagnosis, amniocentesis, chorionic villus sampling, cordocentesis, fetoscopy, chronic viral infections, hepatitis B, hepatitis C, HIV, treponema pallidum, syphilis, vertical transmission, MTCT.

Results: For patients with hepatitis B infection, it is important to assess the HBeAg status and HBV DNA levels and for those patients with high viral load, antiviral therapy (Tenofovir) for a few weeks may be needed to reduce the viral load prior to the invasive procedure. In women positive for HCV, the viral load and HIV status should be assessed to establish the risk of vertical transmission; while for patients with HIV, highly active antiretroviral therapy administration and low viral load are predictive for reduced vertical transmission even after performing an invasive procedure. In all cases invasive procedure should be replaced by non-invasive prenatal testing if this is a feasible alternative and when invasive testing is indeed required, transplacental passage should be avoided.

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Keywords

invasive testing; vertical transmission; hepatitis B; hepatitis C; HIV; treponema pallidum

About this article
Title

Risk of vertical transmission of chronic viral infections after invasive prenatal procedures

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Review paper

Published online

2021-10-08

DOI

10.5603/GP.a2021.0196

Keywords

invasive testing
vertical transmission
hepatitis B
hepatitis C
HIV
treponema pallidum

Authors

Brindusa Cimpoca
Anca Maria Panaitescu
Nicolae Gica
Alina Veduta
Anca Ciobanu

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