Hepatitis B is transmittable to foetus
It is known that Hepatitis B is transmittable from mother to baby during pregnancy. In India the prevalence of HBV is 4% and the most frequent form of virus transmission is from mother to child, during pregnancy, and in early childhood.
The HBV infection is possible to occur during pregnancy on a healthy person and infect the foetus too, or it could have existed long before the mother got pregnant.
A North Indian study showed that HBV has no predilection for pregnant women. Of the pregnant and non-pregnant women that were involved in this study, 19% of the pregnant women were infected, and 18 % of the non-pregnant women were infected too. Also, the disease was not affecting pregnant women in a different way than affecting non-pregnant ones.
Some of the symptoms that come along with the prodromal stage of hepatitis can be mistaken with those for pregnancy: nausea, vomiting. Also fatigue, headaches, muscle ache, and low grade fewer can be mistaken with flu. In 2 to 10 days of the prodrome jaundice appears and the patient could accuse pain in the right side of the body, just beneath the rib cage. The doctor could sense hepatomegaly (meaning that the liver has swollen), and sometimes splenomegaly. In approximately 6 weeks these symptoms will disappear, and if not treated, in 6 months, chronic hepatitis could install.
Sometimes the installation of the disease could cause premature labour (in 31.6% of the infected patients), and post partum hemorrhages.
In diagnosing acute hepatitis B doctors use viral markers like: HBsAg and IgM Anti-HBc.
The treatment of HBV in a pregnant woman is similar to the one used for a non-pregnant woman: bed rest, vitamins, and high calorie diet. The vaccine is not recommended in pregnant women.
The chronic hepatitis does not manifest in its early stages but only when it affects most of the liver. The chronic hepatitis is diagnosed most frequently when the patient feels ill and asks the doctor for some tests, or when a woman gets pregnant and the obstetrician recommends her some usual blood tests. If the level of serum transaminases is high, this means chronic hepatitis is present. Sometimes the doctor can palpate the spleen and liver but if the pregnancy is in the last months that can not be done. Also, the palmar erythema could suggest hepatitis but this sign is found in pregnancy too.
Pregnant women with chronic hepatitis usually have a normal pregnancy, and complications appear only if cirrhosis develops. Cirrhosis leads to portal hypertension and esophageal variceal hemorrhage, which could lead to maternal mortality.
Treating chronic hepatitis B is made in similar ways with treating non-pregnant women. Interferon alpha is no used because it can lead to foetus malformations. Lamivudine is considered to be safe for pregnant women and foetus and it is administered daily in an oral dose of 100 mg.
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