Dealing With Hep B and C During Pregnancy

What is hepatitis?

Hepatitis is a group of viral infections. It affects your liver and causes swelling. There are three main forms: hepatitis A, B, and C. Though related, each form has its own specific virus. People can get hepatitis from diseases, drug use, alcohol abuse, and poisons.

Hepatitis A is mainly an acute (short-term) disease. People can be cured with or without treatment. Hepatitis B and C often are chronic (long-term) diseases. Hepatitis A and B can be prevented with vaccines. There is no vaccine for hepatitis C.

Path to improved health

Because hepatitis is viral, it is contagious. It is most often transferred through blood or body fluids. It also can be passed from mother to baby at birth. The chance of this is rare, but possible. The risk is higher for women who have hepatitis B and C. If a pregnant woman has hepatitis, she should tell her doctor.

The American Academy of Family Physicians (AAFP) recommends that all pregnant women be screened for hepatitis B at their first prenatal appointment. The AAFP only recommends hepatitis C screening for people who have a high risk of the infection. This includes women who:

  • have used drugs
  • have been exposed to needles
  • have received a blood transfusion
  • also have HIV (human immunodeficiency virus).

A pregnant woman who tests positive for hep B should get a dose of immune globulin (IG). This injection helps to treat the virus and protect your baby. After delivery, the baby should get a dose of IG, as well as the hep B vaccine. The Centers for Disease Control and Prevention (CDC) recommends that all babies receive the hep B vaccine at birth.

Unlike hep B, there is no medicine to help prevent a pregnant woman from passing hep C to her baby. Pregnant women who have hep B or C will receive extra prenatal care. This may include blood tests, liver tests, and medicine to reduce symptoms.

Things to consider

Women who have hep B or C while pregnant can have several problems. One is acute fatty liver. This is a rare disease that affects the liver’s ability to process fatty acids. It often occurs in late pregnancy and can be severe. In these cases, the doctor may want to deliver the baby right away. This allows treatment to start and helps prevent the baby from getting the virus.

Another potential problem is gallstones. These can occur if fluids from your liver build up in your gallbladder. The stones can cause pain, swelling, and jaundice, which is when your skin and eyes turn yellow. If the gallstones are severe, you may need surgery.

When to see your doctor

Pregnant women who have hep B or C should contact their doctor right away if they have any complications.

Women who use the medicine Rebetron (a combination of the medicines Rebetrol and Intron A) should not try to become pregnant. If you use this medicine and become pregnant, stop taking it and see your doctor. It can cause severe birth defects. It also should not be used by women who breastfeed. Talk to your doctor about other medicines that may be harmful. These include prescriptions and over-the-counter drugs.

Questions to ask your doctor

  • How do I know if I have hep B or C?
  • What is the cause of my hepatitis?
  • If I have hep B or C and am pregnant, what is the best form of treatment?
  • Are there any lifestyle changes I should make?
  • What is the risk that I will pass the virus to my baby at birth?

Resources

American Academy of Family Physicians, Hepatitis Clinical Recommendation

American College of Obstetricians and Gynecologists, Hepatitis B and Hepatitis C in Pregnancy