Hepatitis & Pregnancy
An Overview of Hepatitis A, B, C, D, and E
Hepatitis is a viral infection of the liver. It is a coincidental finding during pregnancy. Pregnancy does not predispose to hepatitis. Viral Hepatitis affects people more in developing countries than in developed countries. Lack of public awareness, carelessness & insufficient health services contribute to Hepatitis.
Hepatitis can significantly impact pregnancy outcomes. There are five main types of hepatitis viruses - A, B, C, D, and E - each with different characteristics, modes of transmission, and implications for pregnancy. Let's discuss each type and it’s effects on pregnancy.
Hepatitis A
Hepatitis A is primarily transmitted through ingestion of contaminated food or water. It is RNA virus & highly contagious. It’s incubation period (time from contracting infection till appearance of symptoms) is 15 to 50 days. This is self-limiting infection and resolution occurs in 2 to 3 weeks.
In pregnant women, hepatitis A infection can lead to flu-like symptoms such as fever, fatigue, nausea, and jaundice (yellowing of the skin and eyes). It has no carrier state.
Hepatitis A Virus does not cross placenta & does not pose a risk to the fetus. Severe cases may require hospitalization.
Patients with hepatitis A can breast feed their babies.
Hepatitis B
Hepatitis B is spread through contact with infected blood, body secretions including breast milk & amniotic fluid. Chronic hepatitis B infection can increase the risk of liver cirrhosis and liver cancer.
During pregnancy, there is little chance of transmitting the virus to the fetus (baby inside you). The late in pregnancy the infection occurs, more are chances of transmission to fetus during pregnancy. Hepatitis B can be transferred to baby during child birth.
Management of patient with Hepatitis B requires multidisciplinary approach including Obstetrician, Medical specialist, Infection specialist and Pediatrician.
At Birth, all newborns of mothers with Hepatitis should be given should be given Hepatitis B immunoglobulin & Hepatitis B vaccination. It will significantly reduce the risk of transmission of infection to newborn. The Hepatitis B immunoglobulin works best when given in first 12 hours of birth. Hepatitis B Vaccine course should be completed according to schedule.
Women with Hepatitis B can BREAST FEED their babies if babies are given Hepatitis B immunoglobulin & vaccine with in first 12 hours of life.
Patients with Hepatitis B should consult their doctor for their own treatment.
Hepatitis C
Hepatitis C is primarily spread through blood-to-blood contact, often due to sharing needles or other equipment for injecting drugs. Chronic hepatitis C infection can lead to liver damage over time.
In Pregnant Women, the risk of transmition of Hepatitis C virus to the baby is relatively low (about 5-6%). However, the risk may increase if the mother has a high viral load of hepatitis C.
A multidisciplinary approach is needed for care of mother & baby.
Patient can safely Breast Feed her baby. If nipple cracks or bleed, avoid feeding from that side till it heals.
Hepatitis D
Hepatitis D, also known as delta hepatitis, is a rare & only occurs in those who already have Hepatitis B infection. It’s transmition is through contact with infected blood.
In pregnancy, the management focuses on preventing complications related to chronic hepatitis B infection, which is necessary to prevent hepatitis D as well.
Patient can Breast FEED her baby.
Hepatitis E
Hepatitis E infection occurs more frequently during pregnancy than in non-pregnant state. It is of great severity in pregnancy than in non-pregnant state. It has mortality rate of 15 to 20 percent during pregnancy.
It is usually transmitted through consumption of contaminated water, and it can cause acute hepatitis.
If it occurs during the third trimester, it has a higher risk of developing severe liver disease. In severe cases, there may be adverse pregnancy outcome like preterm birth and stillbirth. Hepatitis E does not lead to chronic infection like hepatitis B and C.
Managing Hepatitis in Pregnancy
No specific therapy is given to pregnant women with VIRAL HEPATITIS during pregnancy. The aim of management is to reduce the disease on liver as much as possible until recovery takes place. Hospital admission is not necessary but patient is advised to take rest until jaundice is resolved.
Take care of diet, it should be low in fat & avoid alcohol in any case.
For pregnant women with hepatitis, regular prenatal care is important to monitor liver function and assess any potential risks to the fetus. Blood tests for hepatitis markers and liver function tests are typically conducted to assess the severity of the infection and its impact on the mother's health.
Treatment options during pregnancy are often limited due to potential risks to the developing fetus, so management is focused on support and monitoring of mother & baby.
Preventive measures, such as vaccination for hepatitis A and B before pregnancy or early in pregnancy, are recommended to reduce the risk of infection. For women already infected with hepatitis B or C, antiviral medications may be considered to reduce the viral load and minimize the risk of transmission to the baby during childbirth.
In conclusion, hepatitis in pregnancy requires careful management to ensure the health and safety of both the mother and the unborn child. Understanding the specific characteristics and risks associated with each type of hepatitis is essential for healthcare providers to provide appropriate care and support throughout pregnancy and childbirth.
