Chronic Hepatitis in Pregnancy: Testing & Management Guidelines

In pregnancy, managing chronic hepatitis is crucial. Learn about prenatal testing, HBV & HCV implications, vertical transmission risks, prevention strategies, and follow-up recommendations. Stay informed for a healthy pregnancy.

• Chronic Hepatitis
• Pregnancy
• Prenatal Testing
• Vertical Transmission
• Hepatitis C

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Uploaded on Feb 14, 2025 | 0 Views

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Presentation Transcript

1. CHRONIC HEPATITIS IN CHRONIC HEPATITIS IN PREGNANCY PREGNANCY Donna D. Johnson, MD

2. PRENATAL TESTING PRENATAL TESTING Hepatitis B surface antigen Hepatitis C antibody Every adult at least once Prenatal labs

3. ACOG PB 86, 2021

4. HEPATITIS B sAg Positive ACOG PB 86, 2021

5. CHRONIC HEPATITS B Hep B sAg positive Hep B sAb negative

6. HEPATITIS B HBV DNA is > 200,000 IU/ml or 1,000,000 cps/ml Hep BeAg positive and > 20,000 IU/ml Treat with tenofovir from 28 weeks on May continue up to 3 months postpartum Contraindicated in breastfeeding

7. HEPATITIS B VERTICAL TRANSMISSION HEPATITIS B VERTICAL TRANSMISSION Hbig Vaccination <12 hours of age Can breastfeed if vccinated

8. HEPATITIS C HEPATITIS C Antibody is positive Reflex test for Hep C RNA If Hep C RNA is positive= chronic carrier

9. HEPATITIS C VERTICAL TRANSMISSION HEPATITIS C VERTICAL TRANSMISSION No newborn prevention strategies Controversial if viral load is associated with transmission risk Genotype of hep C does not increase transmission Co-infection with HIV increases transmission c/s is recommended based on HIV algorithm only Continue IVDA increases transmission

10. OB PREVENTION OB PREVENTION Invasive prenatal testing Prolong ROM FSE

11. HEPATITIS C Please arrange follow up during pregnancy 99% can be cleared Decrease risk of cirrhosis and cancer