World Hepatitis Day provides an opportunity to shed light on a vital subject: Hepatitis during pregnancy. In this blog let’s explore its causes, symptoms and treatment options related to hepatitis in pregnant women. So, join us as we raise awareness about the unique challenges faced by expectant mothers and delve into crucial information that can safeguard both maternal and fetal health.

Hepatitis During Pregnancy

Hepatitis is an infection that inflames the liver and can be transmitted from person to person. Pregnant women, in particular, need to take extra precautions as they can pass hepatitis to their babies. If left untreated, babies born to mothers with hepatitis have over 90% risk of contracting the infection. Therefore, it is crucial to take necessary measures to minimize the risk of transmission and protect the health of both the mother and the baby.

Causes Of Hepatitis During pregnancy

The causes of vertical transmission (from mother to baby during pregnancy) of viral hepatitis are as follows :

• Hepatitis A and E are caused by contaminated food and water due to poor hygiene and sanitation
• An infected pregnant woman can transmit hepatitis B and C viruses to her baby during childbirth through infected fluids or blood.

Symptoms Of Hepatitis During Pregnancy

Hepatitis during pregnancy can be asymptomatic or it can cause mild symptoms that can be diagnosed by a doctor.

Here are some of the symptoms that you might experience if you have hepatitis :

1. Jaundice (yellowing of the skin and eyes)
2. Nausea
3. Loss of appetite
4. Abdominal pain or discomfort
5. Fatigue
6. Feeling unwell (malaise)
7. Muscle aches (myalgia)
8. Dark urine (The colour of urine can vary from light yellow to dark amber)
9. Fever
10. Vomiting

Risks Of Hepatitis During Pregnancy

Here are the risks associated with each type of hepatitis during pregnancy :

1. Hepatitis A:

When a pregnant woman has hepatitis A, it can cause problems during pregnancy. It can cause premature contractions, placental separation, premature rupture of membranes (breaking of the amniotic sac before the onset of labour), and vaginal bleeding. Additionally, in severe cases, it may cause fetal ascites, which is fluid buildup in the baby’s abdomen during pregnancy. It can also lead to meconium peritonitis, an inflammation caused by leaked baby poop inside the abdomen.

2. Hepatitis B:

Hepatitis B can lead to complications such as placental abruption (separation of the placenta from the uterine wall before delivery), preterm birth (premature birth of the baby), gestational hypertension, and restricted fetal growth.

Chronic HBV during pregnancy also raises the risk of developing cirrhosis (a severe liver condition) and hepatocellular carcinoma (liver cancer). In some cases, vertical transmission to the baby can occur during delivery, especially if mother’s virus levels are high, necessitating appropriate neonatal vaccination strategies.

3. Hepatitis C:

Pregnant women with hepatitis C infection may experience complications that can affect the baby’s growth and development. This includes problems with growth, nerve injury in the shoulder area (brachial plexus injury), baby distress, bleeding on the baby’s head, seizures, and intracranial hemorrhage (bleeding in the brain) . Additionally, maternal hepatitis C infection may increase the risk of vertical transmission, particularly if the mother has high virus levels or co-infections.

4. Hepatitis D:

Pregnant women with chronic hepatitis D have a high chance of developing severe liver disease, including acute liver failure, which can be life-threatening. This condition may exacerbate other pregnancy-related complications, such as gestational hypertension and preterm labor. Co-infection with hepatitis B often worsens these risks and increases the likelihood of poor maternal and fetal outcomes.

5. Hepatitis E:

The Hepatitis E virus can lead to fetal complications, such as babies being born prematurely and having low birth weights. Pregnant women with hepatitis E are at risk of fulminant hepatic failure (sudden and severe liver failure), which may cause maternal mortality. The risk to the fetus includes intrauterine fetal demise (death of the baby in the womb) and poor neonatal health outcomes.

Treatment Of Hepatitis During Pregnancy

The treatment of hepatitis during pregnancy may involve the following measures :

1. Hepatitis A:

Pregnant women in contact with individuals with acute hepatitis A should receive Hepatitis A immunoglobulin. Newborns infected during the third trimester should receive Hepatitis A immunoglobulin within 48 hours of birth.

2. Hepatitis B:

Pregnant women with chronic hepatitis B should receive antiviral therapy to reduce the risk of transmitting the virus to the baby. Babies born to mothers with high viral load should receive hepatitis B immunoglobulin and the hepatitis B vaccine within 12 hours of birth. Follow-up vaccination doses should be completed as per the recommended immunization schedule to ensure long-term protection.

3. Hepatitis C:

Antiviral therapy for hepatitis C is generally not recommended during pregnancy due to limited safety data on available medications, such as direct-acting antivirals (DAAs). Routine antiviral treatment is typically avoided. After delivery, screening for hepatitis C in the newborn is recommended, as vertical transmission is possible.

4. Hepatitis D:

Treatment options for hepatitis D virus infection typically involve specific medications, but these treatments are unsuitable during pregnancy. Pregnant women with hepatitis D should consult their doctor to explore alternative management options and prioritise the safety of both the mother and the baby.

5. Hepatitis E:

Currently, no specific antiviral treatment is available for hepatitis E. Supportive care is the mainstay during pregnancy, given the teratogenic risks of antiviral agents, such as ribavirin or pegylated interferon. In cases of acute liver failure, urgent liver transplantation may be considered. Prevention relies on maintaining good sanitation, ensuring access to clean drinking water, and avoiding raw pork or venison. Pregnant women are counseled not to travel to regions where there is a known high incidence of hepatitis E.

Conclusion

Now that there is a better understanding of hepatitis during pregnancy, it is important to be aware that preventive measures and treatments are available for hepatitis A and B. However, it should be noted that treatment options are more limited for hepatitis C and D. Nonetheless, by providing proper care and maintaining open communication during pregnancy, the well-being of both the mother and baby can be prioritized. Raising awareness about these conditions is crucial for early detection and ensuring timely treatment.

FAQs

Q1. Can Hepatitis Be Passed From A Mother To Her Baby During Pregnancy?

Yes, a mother with hepatitis can pass it to her baby during pregnancy or childbirth. The chance of passing it depends on the type of hepatitis. Hepatitis B and C can be transmitted through infected fluids or blood during childbirth. Good medical care and preventive measures can lower the chance of passing it to the baby.

Q2. How Does Hepatitis Affect Babies?

Hepatitis can harm babies by raising their chances of having long-term liver problems. This includes liver damage, cirrhosis, or even liver cancer, depending on the type of hepatitis they get from their mother during pregnancy or childbirth.

Q3. Can Hepatitis Cause Birth Defects?

When a mother with hepatitis transmits the infection to her baby during pregnancy or childbirth, it can increase the chance of long-term liver complications in the baby. But hepatitis doesn’t directly cause birth defects.

Q4. What Are The Symptoms Of Hepatitis B In Pregnant Women?

Symptoms of hepatitis B during pregnancy can include fatigue, nausea, vomiting, loss of appetite, and yellowing of the skin and eyes (jaundice).

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