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Avatar universal

Oh Baby!!

I'm considering  haveing  another baby ,I already have 3 healthy kids  ,but my husband wants  THE BOY ... I'm 33yrs old  was planning on treating with new drugs . So my question  Would you  have baby first  or treat  first ..I'm just afraid  of the  possible birth defects  from treatment drugs ,,
38 Responses
Avatar universal
Personally I would treat first. You need to wait a minimum of 6 months after treatment because of the ribavirin. I haven't heard anything about the new drugs and their effect on the fetus though. Good luck whatever you decide.
1225178 tn?1318980604
I would have a biopsy to see how damaged my liver is in order to make an intelligent decision. If there is very little damage and you live a liver healthy life, I'd go ahead and try for the little boy first. I say this because I had my first child at 33 and my last 2 after 40... the difference in the amount of energy that I had was HUGE! The liver damage progresses pretty slowly in the 30s (for most people)... unless you have been infected since childhood that is.

That's my opinions anyhow.

Diane
Avatar universal
thanks  your answer makes a lot of sense to me ..now if I wasen't such a a scardy cat I would go for my biopsy .How does the fibrosure test  compare to biopsy ?
1225178 tn?1318980604
You will get much more accurate info from the biopsy. Think of it this way, a little discomfort from the biopsy is nothing compared to end stage liver disease and possibly having to have a transplant or death. Most people say that they didn't have any discomfort. I was a little sore for a day or two, but I would do it again in a minute if there was a chance that my liver condition had changed. I'm sure you want to make sure that you are still around until all of your children are grown and on their own... the way to make sure of that is to get over your fear and get that biopsy. They are worth it aren't they?

Diane
1420486 tn?1384793153
     Wow. there was a gal who posted here a few days ago about having a baby that never made it out of the hospito.. It happened I guess she said because her significant other had treated just prior to the conception. I cant find the post. But whew with that being said . I would definitally look into it. Im not sure how many studies have been done on that. Or if a person really wants to take that risk. I have been told (not sure if its accurate) that these meds leave your system 50 percent each month..How long will you be treat 24 or 48? How old do you want to be when you go for the boy? What effect will these new drugs have on conception? lots of research to do . good luck
Avatar universal
Personally, I would have a baby first, then treat. In fact, this is what I did. Got HCV from a blood transfusion when I was a newborn. Got my twins at the age of 31, started treatment when my kids were 2 years old. Today I can officially say I got my SVR! It's been 6 months post tx, my kids are now 3,5 y/o (cute as can be :)) and I don't rush to get pregnant again. I will probably wait for another 6 months or so before I even can dream of having one more baby. I just want that 100% guarantee that my body got rid of all that riba, pegasys and infergen stuff completely. They say 6 months is enough though. How much time do you think you can wait for a new baby?
Avatar universal
Well I'd get treating out of the way first.  6% chance or less I think it is that you could pass this on to the baby.  Guess each person decides, I'd not be wanting to take those chances.  When my kids went for their HCV tests after I got diagnosed....was a terrible time waiting for their results to see if I'd passed it on.  You're asking "what would you do" to just anyone who reads that question...so maybe you're not always going to hear what you want to hear...that's what I'd do.  I'd get the treatment out of the way first.  
206807 tn?1331936184
Tx first then see how your recovery goes. I couldn’t imagine tending to a New Born and going through the Sx of Tx. Especially if your Sx are bad.
Avatar universal
I agree with trish and R Glass about treating first. I wouldn't want to take a 5% chance of transmitting this to my child especially if I already had three children. Vertical transmission may be uncommon but it does happen. There are people on this forum who have passed it to their children. Most probably before they even knew they had hep c or it was able to be diagnosed.

Good luck,
Dave
374652 tn?1494811435
How can you even think of even with a small possibility of transmitting this disease to an innocent child?   Please think,,,, treat and make sure you are rid of the virus before trying for a "boy" you are so fortunate to have 3 healthy children, to put a child in harms way just to have a boy is beyond belief to me.  I am very opinionated about these things and I hope my reply does not seem to harsh,  but you did ask.
Avatar universal

In the following article it states that  neonatal transmission rates are low however it can happen ,and Personally I would not take the risk.

Good Luck

WILL


http://www.standardofcare.com/mwiki/index.php?title=Hepatitis_C_(HCV)
Avatar universal
Just wonder what your potential unborn child would vote for.  Also, what would be in the best interest of your living children?  Your husband?  What does your gut tell you?
Avatar universal
I think you shouldn't be so harsh in your advice... or opinionated. Our opinions are just that - opinions and they should not hurt anyone, right? Vertical transmission chances can be virtually eliminated if you know what you are doing. My ob-gyn advised me to go through c-section delivery instead of regular one in order to eliminate risk of vertical transmission. And another thing to be careful about is nursing. I was allowed to breast-feed my kids, too, with some precautions. Both of my kids never contracted HCV from me. I am glad I didn't treat first. Knowing how hard tx could be on your body and all possible sx, and then how much time it can take to treat and then to recover... one might think that having a baby first would be a better choice.
Avatar universal
....

" My ob-gyn advised me to go through c-section delivery instead of regular one in order to eliminate risk of vertical transmission" "
------------------------------------------------------------------------------------------------------------------------------------
Sunshine...It would seem by the following article that your statement may be somewhat misleading. If you know of a more recent study that was done could you please post it.



Hepatitis C transmission not reduced by C-sections
.
November 2008

Planned cesarean sections do not help to reduce the chances of a pregnant mother with Hepatitis C (HCV) transmitting the infection to her unborn baby, according to new scientific findings by the UCD School of Medicine and Medical Science and the National Maternity Hospital in Dublin.
Hepatitis C is the most common cause of chronic viral infection in the Western World today. It affects an estimated 170 million people worldwide. It is a viral infection of the liver which is mainly transmitted through contact with contaminated blood or blood products.
Infant infection rates are linked to the number of mothers infected with the viral infection and the risk factors associated with the transmission of the infection to their unborn children in the womb.

The results of a new 5-year study of 559 mother-child pairs in Ireland, one of the largest such studies of its kind, published in the American Journal of Obstetrics & Gynaecology, show that vaginal delivery and planned cesarean among mothers infected with Hepatitis C display almost equal transmission rates of Hepatitis C from mother to child (4.2% and 3% respectively).
“The mode of delivery itself was not shown to have a significant influence on the transmission rate of hepatitis C from mother to child,” says Professor Fionnuala McAuliffe from the National Maternity Hospital and the UCD School of Medicine and Medical Science, one of the co-authors of the report.

“The main risk factor associated with the vertical transmission of hepatitis C was the presence of detectable hepatitis C virus in the mother’s bloodstream, a condition where viruses enter the bloodstream and hence have access to the rest of the body.”

“Mothers who demonstrated detectable hepatitis C virus had a significantly higher transmission rate (7.1%) to their infants compared to the transmission rate (0%) for those in whom the hepatitis C virus was undetectable during pregnancy,” explains Professor McAuliffe.
“According to these new findings, if the Hepatitis C virus is undetectable antenatally despite the mother being antibody positive the patient can be reassured that the risk of vertical transmission to their child is minimal, and this is a significant development for patient counseling.”

Avatar universal
I delivered in 2007, you are citing an article written in 2008 :)
The way my ob-gyn explained it to me - his main concern was transmission of HCV during delivery - C-section minimizes chances of newborn getting HCV from his mother during delivery. And it makes sense. Don't you think?
I was also told not to worry about my HCV during pregnancy, as my viral load was low - between 350,000 and 175,000 prior and during pregnancy. My hepatologist at the time seemed to believe that having a lower vl would also minimize the risk of transmission.
Finally, we used services of cord blood bank, which tested the cord blood samples from my twins and mine within hours of delivery. They found HCV in my sample but nothing in babies'. We later tested my twins for HCV antibodies when they were 10 months old - nothing was found. I tested them again when they were 16 months old - again, no virus, no antibodies were found.
When I was done with my tx and my kids turned 3 years old, we tested them again. No virus, no antibodies again. I feel good about my decision to have babies first and then treat. It wasn't easy to make, and I was concerned about that 5% chance. Yet, I was making my decisions based on stats and advices from quite a few medical professionals. The risk of my kids getting HCV from me was indeed minimal. To me, it didn't make sense to wait 3 more years to have a baby due to fear.
My final point in this discussion - not everyone achieves SVR, yet many of us do get some form of sx during and after tx. One should take this into consideration too - how soon will your body be ready to carry a baby after tx? You never  know, right?
374652 tn?1494811435
maybe we should ask the ones who weren't so lucky, who did get hcv from birth.  To each his own, and we all make our decisions based on our own logic or feelings or however we base our decisions.  
its indeed a dangerous world and so many things can happen.  I think the motivation behind having children is important, the motivation for doing anything is important, we all live with our decisions, and the fortunate children indeed have the advantage of having a good quality life.
this is a "hot' topic
Avatar universal

It is certainly great news that in your case your children were amongst the aprrox.95% of babies born to mothers that while pregnant are know to have HCV were not infected.

The OP was asking the folks here their personal opinion about what they thought in regards to having a child in relation to the timing of  undergoing treatment..

Your opinion was one of many...that some may agree with and others not so much,however my only reason for asking you for clarification on you statement about minimal risk by C-section,is only because I had never heard that before and was curious enough to look it up and could find nothing to support that...actually there were a few articles that refuted that statement....

It sounds like you were advised by your medical team at the time and made your decisions based on that...thats all any of us can do.

However if currently (like the OP) anyone is basing their decisions in such an important matter  it would seem prudent to base these on facts by studies and articles .

All the Best

WILL
179856 tn?1333547362
I can only imagine the next question in 10 months to be "when can I get my child tested" and "what do I do my child has HCV".

Avatar universal
Check out the old discussin thread on this site where c-section vs vaginal delivery for HCV patients is discussed. Also, notice the mention of the standard practice... :

http://www.medhelp.org/posts/Hepatitis-C/is-c-section-a-safer-way/show/89727

Also, here is a link to UW's site where the same problem is mentioned:
http://depts.washington.edu/hepstudy/hepC/prevention/hcvpnt/1.html

I am from Seattle, most of the docs on my team were from UW, which is one of the best medical schools in the country. I have trust in their opinion :)
Avatar universal
Seek advice both from your ob-gyn and hepatologist, they will base it on your medical history, lifestyle, vl, current condition, etc.
Avatar universal

Well again..you have really cited no proof that C-section is any safer than Vaginal birth.
The first link you cited is just a bunch of us folks talking (all laymen) about their own experiences   and the second link you cited actually says the same thing as the study that I had previously put up .. that there is no difference in vertical transmission stats from either type of birth.

As I said ,, you relied on your medical team,the fine one that it is , and  thankfully your children were in the 95% category that were not infected.

All the best


WILL

Avatar universal
This is the link you provided above



Perinatal Transmission of Hepatitis C Virus
You answered:

Compared with vaginal delivery, elective Cesarean section has been documented as an effective method to decrease vertical HCV transmission. Thus, elective cesarean section is recommended for all pregnant women with HCV infection and a detectable HCV RNA level.

This answer is incorrect. Prospective cohort studies comparing Cesarean section with vaginal delivery as a contributing factor for mother-to-child HCV transmission have shown contradictory results. Because there is no clear-cut benefit of performing elective Cesarean section in this setting, in the United States, elective Cesarean section is not recommended for prevention of vertical HCV transmission.

412873 tn?1329174455
Please don't ignore the risk of transmission when nursing.  Babies teethe, nipples can become chapped, ect.  I don't know whether I passed it to my daughter through delivery, or at some point after during the 13 months I nursed, but I can tell you that it was the absolute worst day of my life when the results came back positive.  

Not quite the legacy I had hoped to pass on.  6% is a small percentage, unless you're part of it.

Isobella

Avatar universal
The information your ob-gyn had in 2007 - perhaps not accurate or up-to-date.  I tend to wonder what her opinion would be if she had access to the current information that says vertical transmission is not due to the method of birth but the baby being in the womb and HCV being in the blood.
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