HBV in pregnancy (Complete) Flashcards
When is HBV screened for in pregnancy?
Screened for during booking appointment (usually 10 weeks gestation)
Transmission of HBV from mother to child occurs at which stages of pregnancy?
Occurs during delivery via vertical transmission
Can be transmitted in both vaginal and C-section delivery
What investigations are done during pregnancy screen to check for HBV?
Bloods:
HBsAg: Confirms active infection
HBeAg: If positive alongside HBsAg, increases risk of transmission from 20% to 90%
anti-HBc IgM: Confirms acute infection if present
anti-HBc IgG: Confirms chronic infection
What labratory findings confirm an active acute infection?
HBsAg: Positive (active infection)
anti-HBc IgM: Positive (acute phase)
What labratory findings confirm an active chronic infection?
HBsAg: Positive (active infection)
anti-HBc IgG: Positive (chronic phase)
anti-HBc IgM: Negative
What is the management plan for mothers with confirmed HBV infection?
If viral load >10^7 IU/ml:
Start Tenofovir disoproxil at 28 weeks
Stop Tenofovir disoproxil between 4-12 weeks post delivery
Name the medication given to pregnant women to reduce risk of vertical transmission
Tenofovir disoproxil
Woman with HBV are given Tenofovir disorpoxil only if viral load exceeds what levels?
When in gestation period is it given?
> 10^7 IU/ml
Given at 28 weeks
When is Tenofovir disoproxil stopped after pregnancy?
Between 4-12 weeks
What is the preffered mode of delivery for HBV positive pregnancies?
No preferrence UNLESS co-infection with HIV in which C-section is required
What advice is given regarding breastfeeding?
Can continue to breastfeed normally as HBV not transmitted via breastmilk compared to other infections like HIV
What is the management for neonates
Medicine:
HBV IgG and HBV vaccination: Given within 24 hours of delivery
Repeat vaccines at 4 weeks, 8 weeks, 12 weeks, 16 weeks, and 1 year.
Conservative:
HBV serology test at 12 months
When is HBV Ig and HBV vaccination given to neonates born from HBV positive mothers?
Given within 24 hours
Infants born from HBV mothers should be given HBV vaccinations across which timeframes?
1) 24 hours of birth
2) 4, 8, 12, 16 weeks
3) 1 year
Newborns born to non-HBV positive women also receive HBV vaccines in the 6-in-one vaccine, but only at 8 weeks, 12 weeks, and 16 weeks
When should infants be offered HBV serological testing?
At 1 year
What clinical features can arise in infants with HBV infection if not treated?
Asymptomatic until later life:
Jaundice
Abdominal pain
Dark urine
Pale stool
