How to prevent AIDS, syphilis, and hepatitis B mother-to-child interruption

Hepatitis B

1. Pregnant women: Measure the concentration of hepatitis B virus DNA in the mid-term. If it is higher than 500meq/ml, you can inject high-efficiency drugs in the 7th, 8th and 9th trimester respectively. The price of hepatitis B immune globulin is 200IU. During the medication, liver function and hepatitis B virus DNA concentration should be observed.

If the hepatitis B virus DNA concentration is less than 500meq/ml, those with abnormal liver function and other types of hepatitis viruses can be excluded, they can also be passively immunized according to the above method. However, if liver function is normal, this treatment is not necessary. In the early stages of pregnancy, traditional Chinese medicine can be treated according to the advice of a specialist. An Hongbin, Department of Obstetrics and Gynecology, Faku County Central Hospital

2. Newborns: In addition to taking necessary obstetrical measures, newborns should be injected with 200IU hepatitis B immune globulin at 0, 1, and 6 months of age after birth. Then, 10 micrograms of recombinant hepatitis B vaccine will be injected at 0, 1, and 6 months of age.

Then the protective antibody of hepatitis B virus will be tested at 7 months of age and followed up for three years. If the protective antibody of the child is observed Below or close to 10IU/ML, 10 micrograms of recombinant hepatitis B vaccine can be injected again.

3. Respect the choice of pregnant women in terms of delivery method. For pregnant women with severe ejaculation, caesarean section is recommended. When a newborn is born, maternal blood, amniotic fluid and secretions should be promptly removed from the newborn's skin and mucous membranes, nasal cavity, oral cavity, etc., and the respiratory tract should be cleaned with a suction ball to reduce damage to the respiratory mucosa. After handling the umbilical cord, take a warm bath.

4. After the newborn is born, umbilical cord blood and venous blood are collected for six hepatitis B and DNA tests.

AIDS:

1 When a newborn is born, maternal blood, amniotic fluid and secretions should be promptly removed from the newborn's skin and mucous membranes, nasal cavity, oral cavity, etc. Use a suction ball to clean the respiratory tract and reduce the risk of respiratory tract infection. Mucosal damage.

2 Artificial feeding

3 No BCG vaccination

4 Application of antiretroviral drugs.

Preferred option

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Postpartum neonatal (zidovudine (AZT) combined with nevirapine (Vitamin, NVP)) regimen during pregnancy and delivery: pregnant women start taking AZT 300mg, orally, twice a day from 28 weeks to During labor; take AZT 300mg orally every 3 hours during labor until the end of labor; pregnant women should take NVP 200mg after labor

The baby should take NVP 2mg/kg (or suspension) once within 72 hours after birth 0.2ml/kg), up to 6mg (or suspension 0.6ml); after birth, the newborn takes AZT 2mg/kg, once every 6 hours. If the mother takes the medicine for 4 weeks or more, the baby takes AZT 1 weeks; if the pregnant woman takes the medicine for less than 4 weeks, the baby should take the medicine for 6 weeks.

Whether the baby is infected with HIV will be determined after 18 months.

Syphilis

1. Inject penicillin for 10 days before 12 weeks of pregnancy and after 28 weeks of pregnancy.

2. Newborns are injected with 100,000 or 200,000 penicillin according to their body weight, twice a day for 10 days. Review at full moon, 3 months, and 6 months.

3. Because the transmission route of syphilis is not very clear, reduce close contact with RPR and TPPA positive mothers.

Pregnant women with airborne respiratory diseases such as measles and tuberculosis

No special treatment before delivery. After delivery, the newborn and the mother will be observed in isolation, accompanied by a dedicated person, and cannot cross. Newborns infected with measles will develop measles symptoms on the third day and should be closely observed. Newborns of mothers with tuberculosis need regular check-ups and the onset of tuberculosis is slow.

Medical staff’s self-protection:

Standard precautions, occupational exposure handling procedures.

Please follow standard precautions and don’t leave anything to chance. Disposable visors are more practical than goggles and can protect the entire face and the neck that we cannot protect.

Please layer the cuffs of the gloves and surgical gown on top of each other (layering as I demonstrated during the UC class), lengthen the gloves and surgical gown.

For vaginal delivery, try not to perform lateral incisions to reduce the chance of invasive procedures and sharp instrument stabbings.

When cleaning equipment, wear a face screen to prevent sewage from splashing into your eyes.

During respiratory isolation, the mask should be changed every 4 hours, and once for accompanying and pregnant women