CLINICAL AND BIOCHEMICAL MANIFESTATIONS IN PREGNANT WOMEN WITH CHRONIC VIRAL HEPATITIS B AND C IN THE THIRD TRIMESTER AND THEIR RELATIONSHIP WITH THE ACTIVITY OF INFECTIOUS PROCESS

Objective: the study of clinical and biochemical manifestations in pregnant women with chronic viral hepatitis B and C in the third trimester and their relationships with the activity of infectious process. Material and Methods. The study included 50 pregnant women with chronic viral hepatitis (group I), 83 women with chronic viral hepatitis C (group II), and 36 healthy women (group III). Complaints, clinical manifestations, biochemical parameters, and viral load (VL) were evaluated in pregnant women with chronic viral hepatitis. Results. In pregnant women with chronic viral hepatitis in the third trimester compared with healthy pregnant women, higher numbers of complaints and clinical symptoms were recorded. In healthy pregnant women, only heartburn, bloating, and swelling in the legs (8.34%) were observed. Heartburn (p≤0.05), pain in the right hypochondrium (p≤0.05), palmarerythema, and spider veins (p≤0.05) were detected more often in pregnant women with chronic viral hepatitis B compared with those who had chronic viral hepatitis C. Women with chronic viral hepatitis C more often had anxiety (p≤0.05), weakness (p≤0.05), tongue coating (p≤0.05), and swelling in the legs (p≤0.05). Loss of appetite, joint pain, and headache were found only in pregnant women with chronic viral hepatitis C. 92% of women with chronic viral hepatitis В had НВеАgnegative chronic viral hepatitis; women with chronic viral hepatitis C had genotypes 1 and 3 of the virus with the same frequency. In all pregnant women with chronic viral hepatitis, low VL<106 copies/mL occurred predominantly: in 68% of those with chronic viral hepatitis B and 71% of those with chronic viral hepatitis C. Conclusions. Pregnant women with chronic viral hepatitis in the third trimester had more often greater numbers of complaints and clinical manifestations compared with healthy controls. Low VL, НВеАg-negative forms in chronic viral hepatitis В, genotypes 1 and 3 in chronic viral hepatitis C, and reduced total protein and a moderate increase in alanine aminotransferase in pregnant women with chronic viral hepatitis C were predominant. The number of clinical manifestations increased along with an increase in VL.

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