Reducing the risk of infection for obstetricians

Article Abstract:

Needlestick injury poses a risk for developing infection with hepatitis B virus (HBV) or human immunodeficiency virus (HIV). HBV is very infectious and is the most common occupational infection among health care workers. Although HIV infection has the least favorable prognosis, HBV is a more resilient virus and is more readily transmitted by needlestick injury. It is estimated that exposure to HBV from a puncture injury with a needle previously used on infected patient results in HBV infection in 25 percent of the cases, while HIV infection results in only 0.2 percent of the cases. The rate of transmission of HBV and HIV by skin contact and mucous membrane contact is lower than for needlestick injury. HBV vaccination of health care workers should be encouraged; 90 percent of the cases of HBV infection could be prevented. Other preventative measures that should be taken include wearing gloves, waterproof gowns, and protective eye glasses. Wearing two pairs of gloves is recommended to reduce the risk of tearing. Persons exposed to HBV should wash the infected area with disinfectant, be treated with hyperimmune globulin within 72 hours, or they can be given an HBV vaccine. Exposure to HIV should be treated with zidovudine within one hour and no later than 24 hours following exposure. The standard treatment involves giving a high dose of zidovudine given for six weeks. Counseling should be provided to estimate the risk of developing an infection, and blood samples should be taken to determine if infection has occurred. It is recommended that the cautionary procedures outlined above be followed to reduce the risk of infection with HBV and HIV. (Consumer Summary produced by Reliance Medical Information, Inc.)

Injuries, HIV infection, HIV infections, HIV (Viruses), HIV, Accidents, Injections, Hypodermic, Subcutaneous injections, editorial

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Perinatal transmission of hepatitis B virus infection: a recommended strategy for prevention and control. A review

Article Abstract:

Based on a survey conducted in 1978, it was estimated that 5 percent of the world's population (200 million people) have chronic hepatitis B virus (HBV) infection. The incidence of HBV infection is much higher in South-East Asia, Africa, and the Middle East, where it is estimated to occur in 10 to 20 percent of the population. In Western countries, HBV is estimated to occur in 0.2 percent of the population. Also, in South-East Asia, Africa, and the Middle East, HBV infection occurs at a younger age and, as a result, is more likely to cause liver disease. HBV infections that occur early in life are more likely to cause the development of hepatitis B surface antigens (HBsAG), which causes the infected person to become a carrier of HBV, i. e., he can transmit the virus to others. HBV can be transmitted from person-to-person or from mother to infant. It is estimated that 85 to 90 percent of the infants born to mothers who are carriers will develop HBV infection. The infection can be transmitted from mother-to-infant during pregnancy or after birth. It is recommended that pregnant women be screened to determine if they are carriers of HBV. The standard treatment for babies born to mothers who are carriers is administration of hepatitis B immunoglobulin within 12 hours of birth and HBV vaccination within seven days of birth. In countries where HBV is widespread, the best method for reducing the rate of infection is to vaccinate all newborn infants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Virus diseases, Disease transmission, Pregnancy, Virus diseases in pregnancy, Hepatitis, Neonatal, Neonatal hepatitis

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How obstetricians manage the problem of preterm delivery with special reference to the preterm breech

Article Abstract:

In most cases of childbirth, the fetus is in position to come out head first. However, in some cases, the fetus is turned around; when this happens, it is called a breech delivery. In cases of breech delivery, where there are no other apparent complications, a normal vaginal delivery is possible. However, many obstetricians elect to perform a cesarean section (delivery of the baby through an incision or cut made in the abdomen) for preterm (premature) breech deliveries. A survey was conducted to determine the attitudes and practices of obstetricians regarding preterm deliveries. Questionnaires were answered by 130 obstetricians practicing in England and Whales. Twelve percent of the obstetricians said that they routinely performed cesarean sections for preterm deliveries between weeks 26 and 32 of pregnancy when the fetus is in the normal position. Only 35 percent felt that cesarean sections should be used for uncomplicated preterm breech deliveries. However, 76 percent said that they performed cesarean sections for preterm breech deliveries. Many of the obstetricians reported that fear of malpractice suits influenced their medical decision on how to proceed with preterm breech deliveries. (Consumer Summary produced by Reliance Medical Information, Inc.)

Management, Cases, Surveys, Cesarean section, Breech delivery, Breech birth, Perinatology

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