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Hepatitis and pregnancy: what precautions are required

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Hepatitis and pregnancy: what precautions are required
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There are many worries that pregnant women with hepatitis have, the most important being the one related to the risk of transmitting the disease to the child.

If the pregnant woman is diagnosed with hepatitis, the pregnancy will not affect the evolution of the disease, and with some preventive measures, there are minimal risks of the fetus contracting the hepatitis virus. However, prenatal tests and those during pregnancy are necessary to remove any risk.

Hepatitis A

Also known as the “disease of dirty hands”, hepatitis A is widespread and transmitted through contaminated objects, water and food. Worldwide, 1 in 1,000 pregnant women are carriers of this disease. In the case of the pregnant woman who has the disease, the fetus has minimal risks of contracting the virus. To protect him, the mother must be immunized and given immunoglobulins. If the pregnant woman has a heavy pregnancy, the hepatitis A virus can worsen the situation, producing miscarriage or premature birth.

Hepatitis B

If the pregnant woman is a carrier of the hepatitis B virus, the baby will receive specific human immunoglobulin and vaccine in the first 24 hours after birth in order not to contract the disease. Afterwards, the immunization must be repeated at 2, 4 and 6 months. In general, more than 95% of children vaccinated at birth against hepatitis B are protected from this condition.

Children whose mothers are carriers of hepatitis B are healthy, without congenital problems, but may be born with a lower weight.

Also, the immunized child can be breastfed by the mother infected with the virus.

Hepatitis C

During pregnancy, treatment with Interferon or Ribavirin is prohibited because it can negatively influence the baby’s health. Also, breastfeeding is not indicated for women undergoing such treatment. After the birth, the treatment must be resumed. It is considered that the risk of transmission of the disease to the fetus is 5%, because maternal antibodies offer protection to the child.

Possible complications

Although the pregnancy normally has a normal evolution, even if the mother is infected with the liver virus, there are also cases in which the overworked liver can negatively influence the health of the pregnant woman. In this sense, the following may occur:

  • gallstones – at the level of the gall bladder, stones are formed that cause jaundice, colic, fever and vomiting. Depending on how serious the disease is, the specialist doctor will determine the type of treatment.
  • – cholestasis of pregnancy – it is manifested by itching of the palms and soles, especially in the last trimester of pregnancy. The itching will disappear after birth.
  • acute fatty liver – it can appear in the 35-36th week of pregnancy and is manifested by nausea, vomiting, abdominal pain, fever, jaundice, digestive bleeding. The disease can have quite serious repercussions, because it endangers the life of the mother and the child.

Expert advice

Dr. Monica Pandrea, primary care physician in obstetrics-gynecology, Donna Medical Center, Bucharest

Hepatitis A does not change the course of pregnancy, transmission from mother to fetus is rare, and pregnancy does not worsen the disease except in malnourished women. The evolution of hepatitis A is always favorable.

Approximately 90% of hepatitis B are asymptomatic, so they can go unnoticed and the patient finds out by chance that she is infected with the hepatitis B virus. The risk of maternal-fetal transmission depends on the age of the pregnancy. Thus, in the first weeks of pregnancy the risks are zero, and in the third trimester they increase up to 80-100%. Most newborns infected with B virus develop asymptomatic forms of hepatitis in the first 3 months of life and remain chronic carriers of HbS antigen. Approximately 40% of children infected at birth will develop chronic hepatitis and liver cirrhosis during their lifetime. Hepatitis B prophylaxis can be done with immunoglobulins and immunization.

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