Hepatitis during pregnancy, what is the impact on mother and baby?

It is not surprising that many pregnant women are completely unaware that they have been infected with the hepatitis virus. Usually because the symptoms can only be felt vaguely, or may not appear at all. And of course, if you are diagnosed with hepatitis while pregnant, one of your biggest concerns is about its impact on the pregnancy itself as well as on your unborn child. This article will thoroughly discuss all your questions about hepatitis during pregnancy.

Why should pregnant women be aware of hepatitis?

Hepatitis is a serious inflammation of the liver that can easily be passed on to other people. This disease is caused by the hepatitis virus. There are several types of hepatitis viruses, including hepatitis A, hepatitis B, and hepatitis C. If not handled properly, hepatitis during pregnancy can cause severe disease, liver damage, and even death. Mothers can also spread the virus to their babies.

Hepatitis B and C are the most common types of hepatitis during pregnancy. Hepatitis B is the form of hepatitis most commonly transmitted from mother to baby worldwide, with an increased risk if you live in a developing country.

About 90% of pregnant women with acute hepatitis B infection will "pass" the virus to their babies. About 10-20% of women with chronic hepatitis B infection will pass it on. About 4% of pregnant women who are infected with the hepatitis C virus will pass it on to their babies. The risk of spreading the disease from mother to child is also related to how much virus (viral load) is in the mother's body and whether she is also infected with HIV.

How can a mother get hepatitis during pregnancy?

Hepatitis B and C are spread through infected blood and body fluids - for example, vaginal fluids or semen. That means you can get them from unprotected sex with an infected person, or by being pricked with used needles used by someone who is infected - whether drug needles, tattoo needles, or unsterile medical needles. However, the risk of getting hepatitis C through sex is low if you only have one partner for a long time.

Hepatitis C occurs most often in people born between 1945 and 1965. For this reason, everyone in this age group should be tested for hepatitis C infection.

What are the symptoms of hepatitis during pregnancy?

Symptoms of hepatitis include nausea and vomiting, constant fatigue, loss of appetite, fever, abdominal pain (especially on the upper right side where the liver is located), pain in muscles and joints, and jaundice, aka jaundice - yellowing of the skin and whites of the eyes. The problem is, your symptoms may not appear for months or years after infection, or you may have no symptoms at all.

What is the impact of hepatitis during pregnancy on the health of the mother?

Hepatitis B infection can be completely cured in a few weeks without treatment. Pregnant women who are free from the hepatitis B virus will become immune to it. They can't catch the virus anymore. But unlike hepatitis B virus infection, most adults who are infected with the hepatitis C virus (about 75% to 85%) become single carrier , aka the "host" of the virus. Most of them carrier hepatitis develops long-term liver disease. A handful of others will develop cirrhosis of the liver and other serious, life-threatening liver problems.

Pregnancy itself will not accelerate the disease process or make it worse, although if the liver is already burdened and injured with cirrhosis, this can increase the risk of pregnant women developing fatty liver. Fatty liver during acute pregnancy may be related to a deficiency of an enzyme normally produced by the liver that allows pregnant women to metabolize fatty acids. This condition can quickly become severe, and it can also affect the unborn child (who may also be born with a deficiency in this enzyme).

Another complication that can occur in mothers with hepatitis during pregnancy is gallstones, which often cause jaundice during pregnancy. It occurs in 6% of all pregnancies, partly due to changes in bile salts during pregnancy. In addition, the gallbladder empties more slowly during pregnancy, which means bile stays in the liver longer and increases the risk of gallstones.

If you got hepatitis B while pregnant, it is thought you may be more prone to premature rupture of membranes, gestational diabetes, and / or to experience heavy bleeding later in pregnancy. There is also an increased risk of childbirth complications such as placental abruption and infant death at birth.

What effect does hepatitis during pregnancy have on babies - both while still in the womb and after birth?

Infants in the womb are generally not affected by the mother's hepatitis virus during pregnancy. However, there may be certain increased risks during delivery, such as premature babies, low birth weight babies (LBW), or anatomical and functional abnormalities of the baby (especially in chronic hepatitis B infection).

Another risk is that your baby can become infected at birth. The baby may be infected with hepatitis B at birth if the mother is positive for the virus. Usually, the disease is passed on to children who are exposed to the mother's blood and vaginal fluids during childbirth. Hepatitis B virus infection can be very severe in babies. It can threaten their lives. If a child is infected with the hepatitis B virus as a child, most of the cases will progress to be chronic. Chronic hepatitis can have a negative impact on children's health in the future, in the form of liver damage (cirrhosis) and sometimes liver cancer (especially if accompanied by hepatitis C virus infection).

On the other hand, there is little chance of you passing the hepatitis C virus to your baby. Only 4-6% of babies born to hepatitis C positive mothers will be infected with the virus. This means that almost all babies born to mothers with hepatitis C will not catch the virus. The risk of transmitting hepatitis C from mother to new child increases if the mother has a high viral load or has HIV at the same time.

How to deal with hepatitis during pregnancy?

When you go to the doctor for your first prenatal visit, you will have a series of routine blood tests, including one to check for the hepatitis B virus (HBV). If you test negative for HBV and have not received the hepatitis B vaccine, your doctor may recommend that you get immunized, especially if you are at high risk of contracting the disease.

If you were exposed to hepatitis recently during pregnancy, you may also be given an immunoglobulin vaccine to prevent you from getting this disease. This vaccine is safe for pregnant women and developing babies. More advanced cases of hepatitis positive (high viral load) may need to be treated with an antiviral drug called tenofovir, which can lower the risk of transferring HBV to your baby.

Meanwhile, no vaccine is available to date to protect against the hepatitis C virus. Avoiding this type of risky behavior is the only way to prevent this type of infection. If you are hepatitis C positive, you will not be able to get the standard drugs used to treat hepatitis C while you are pregnant. Medicines for hepatitis C infection are not safe for your unborn baby. The main treatment is a combination of two drugs called pegylated interferon and ribavirin. Other drugs can sometimes be added: either boceprevir or telaprevir. However, none of these drugs have been proven safe during pregnancy and ribavirin can cause serious birth defects, or even death of the unborn baby.

Normal vaginal delivery and caesarean section are equally safe for hepatitis B and C patients. No difference in transmission rates was known when comparing the two methods of delivery. The risks are the same regardless of whether the birth occurred by normal delivery or by caesarean section.

Should my baby be immunized against hepatitis?

Yes. All babies are vaccinated against the hepatitis B virus. If you are not infected with the hepatitis B virus, your baby should still get the first dose of the vaccine before you leave the hospital. If it cannot be given at that time, the vaccine must be given within 2 months of birth. The remaining dose is given in the next 6-18 months. All three HBV injections are required for life-long protection, and the Centers for Disease Control and Prevention (CDC) recommends that all babies receive them, regardless of their condition.

If you have hepatitis B, your doctor will give your baby an injection of hepatitis B antibodies within 12 hours of giving birth. This vaccine is sufficient to provide a baby with short-term protection against the virus. Antibodies and vaccines together will be effective in preventing infection in infants by up to 85-95 percent.

If you are infected with the hepatitis C virus, usually babies can be tested from eight weeks of age using a PCR viral detection test. This should be followed by another PCR test in the next 4-6 weeks and a hepatitis C antibody test when the baby is 12-18 months old.

If your baby is hepatitis C positive, he will receive further treatment. He or she will need regular physical examinations, blood tests and possibly an ultrasound scan or other tests. Not all children with hepatitis C are given prescription drugs. Treatment of hepatitis C in children varies and depends on what is best for each child.

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