HEPATITIS B. IN PREGNANCY

Hepatitis B virus (HBV) infection has widespread implications and has already generated 350 million chronic carriers which can further progress to liver cirrhosis & hepatocellular carcinoma1. Out of total pool of chronic carriers, half have got infected vertically from their mothers, i.e. through mother - to - child transmission (MTCT). Vertically - acquired HBV infections become chronic in 90% of cases2.HBV can be transmitted Vertically during pregnancy, delivery or postpartum. HBV has the ability of placental transfer and reach the fetus but the exact impact of this mode is unclear. Transmission during delivery is the most common mode of MTCT, thus, the neonatal administration of HBIG with vaccination is able to prevent newborn HBV infection in more than 85 % of cases. In postpartum period the close contact between mother and baby is responsible for HBV transmission and includes breastfeeding which has potential either through ingestion of the virus or by contact with skin lesions on the mothers breastAll Pregnant women should undergo mandatory screening for Hepatitis B.If HBV viral load or HbeAg is found to be significantly high, then antiviral treatment tenofovir 300 mg should be started. Caesarean section should be performed only for obstetric indications only and not solely due to HBV infection. Every new born of hepatitis B mother should be mandatory given 0.5 ml hepatitis B immunoglobulin, along with zero dose Hepatitis B vaccination within twelve hours of birth and later on full course of HBV should be completed. Breast feeding is allowed for the new born.