Hepatitis B in pregnancy

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  Hepatitis B is a viral infection that affects the liver, caused by the hepatitis B virus (HBV). When it comes to pregnancy, hepatitis B can have significant implications for both the mother and the baby. Let's delve into the various aspects of hepatitis B in pregnancy:


Transmission:

Hepatitis B can be transmitted from an infected mother to her baby during childbirth. The risk of transmission is highest if the mother is positive for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) during pregnancy.


Clinical Implications for the Mother:

Pregnant women with chronic hepatitis B are at risk of complications such as liver inflammation (hepatitis), cirrhosis (scarring of the liver), and hepatocellular carcinoma (liver cancer). Pregnancy itself does not typically worsen the course of hepatitis B, but certain factors such as immune system changes and hormonal fluctuations may affect the severity of the disease.


Clinical Implications for the Baby:

Infants born to mothers with hepatitis B are at risk of acquiring the infection during childbirth. Without intervention, up to 90% of infants born to HBsAg-positive mothers will become chronically infected with HBV. Chronic hepatitis B infection in infancy increases the risk of developing liver complications later in life, such as cirrhosis and liver cancer.


Prevention:

Preventing mother-to-child transmission of hepatitis B is a key priority in managing the infection during pregnancy. The most effective measure is administration of hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) to the newborn shortly after birth. This intervention significantly reduces the risk of transmission and protects the baby from acquiring the infection.


Screening and Management:

Routine screening for hepatitis B is recommended for all pregnant women early in pregnancy. Women who test positive for HBsAg should receive appropriate counseling and medical management, including monitoring of liver function and viral load. Antiviral therapy with medications such as tenofovir or lamivudine may be recommended for pregnant women with high viral loads to reduce the risk of mother-to-child transmission.


Breastfeeding:

Breastfeeding is generally considered safe for infants born to mothers with hepatitis B, as long as the newborn receives hepatitis B vaccination and HBIG as recommended. Breast milk itself is not a significant route of HBV transmission.


Follow-up Care:

Infants born to HBsAg-positive mothers should undergo regular monitoring for hepatitis B surface antigen and antibodies to assess their immune response to vaccination. Additional doses of hepatitis B vaccine may be recommended if needed.


Hepatitis B in pregnancy presents unique challenges and requires careful management to prevent transmission to the newborn and minimize the risk of long-term complications. Screening, vaccination, and appropriate medical management are essential components of prenatal care for women with hepatitis B. By implementing comprehensive prevention and treatment strategies, the risk of mother-to-child transmission can be significantly reduced, leading to improved health outcomes for both mothers and babies.

This information does not replace expert opinion,seek skilled care for further information.

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