Hepatitis B in Pregnancy

Hepatitis B is a DNA virus that can be found in the blood, semen, vaginal fluids and saliva. HBV can cause liver damage (cirrhosis), liver cancer and even death. It is spread by:

  • Touching an object that has the virus on it (the virus can live for 7 days on surfaces).

  • Infected blood.

  • Body fluids.

  • Sexual intercourse.

  • Infected needles.

  • Childbirth.

People infected with HBV can spread the disease to others even if they are not sick.

All pregnant women should be tested for HBV even if they do not have symptoms. It is safe to give the HBV vaccine to a pregnant woman. They can pass the virus on to the baby at delivery. Women infected with HBV can also cause medical problems for herself. Pregnant women infected with HBV in the first trimester have a higher risk of loosing their baby (miscarriage).

Long-term (chronic) infection of the HBV is seen more often in babies and children. Infected babies have a high chance of being carriers of HBV and can pass the virus on to others. These babies also are at risk of dying from cirrhosis of the liver when they are adults.

CAUSES

People infected with HBV can infect others by contact with or through:

  • Poor hygiene.

  • Infected blood.

  • Infected needles.

  • Body fluids.

  • Sexual intercourse.

  • Childbirth.

SYMPTOMS

  • Weakness.

  • Tiredness.

  • Feeling sick to your stomach (nausea).

  • Loss of hunger (appetite).

  • Pain in the liver area (upper abdomen and stomach area).

  • Muscles pains.

  • Dark urine (brownish).

  • Gray or very light color stool.

  • Eyes and skin become yellow (jaundice).

  • Symptoms of severe hepatitis may cause blood clotting problems and damage to brain cells (encephalopathy).

DIAGNOSIS

HBV is diagnosed when a blood test for the virus is positive. If the test is positive, your caregiver will do more blood tests to see if your liver is infected with the virus. Family members and people you have been in contact with should also be tested for the HBV.

TREATMENT AND PREVENTION

  • All pregnant women who are HBV negative should get the HBV vaccine.

  • Anyone exposed to the HBV should get a Hepatitis B Immune Globulin (HBIG) and the HBV vaccine.

  • Pregnant women who have HBV should get the HBIG vaccine in the third trimester. This will protect the baby at birth.

  • Pregnant women who have HBV should have their newborn get the HBG vaccine within 12 hours of birth and the first dose of the HBV vaccine.

  • Pregnant women who do not have HBV should have their newborn get the first dose of the HBV vaccine before leaving the hospital. This will prevent the baby from getting HBV.

  • All newborns, children and teenagers who have not received the HBV vaccine should get it.

  • Wash your hands with hot water and soap after a using the toilet, changing the baby and before cooking and feeding the baby.

The HBV vaccine is made from only a part of the hepatitis B virus. Therefore, it does not cause an infection. It is usually given in 3 or 4 separate injections. Soreness at the site of injection and a mild fever (99.9° F [37.7° C] or a little bit higher) may happen. Serious problems are very rare.

PEOPLE AT RISK FOR HBV WHO SHOULD RECEIVE THE HBV VACCINATION

  • Health care workers, especially those exposed to blood.

  • People using and injecting illegal drugs.

  • People having unprotected sexual intercourse or have many partners.

  • Sex partners with one of the partners with the HBV.

  • Nursing home workers (or home for the disabled).

  • People with chronic liver or kidney disease (dialysis patients).

  • People who travel to foreign countries where there are high rates of HBV.

  • Prisoners.

  • Homosexuals.

PEOPLE WHO SHOULD NOT RECEIVE THE HBV VACCINE:

  • Anyone allergic to baker's yeast or other ingredients in the vaccine.

  • If you had an allergic reaction to a past HBV vaccine dose.

  • If you have any illness at the time of the vaccine injection.

HOME CARE INSTRUCTIONS

  • If you have never been tested for HBV or received the HBV vaccine, you should do it as soon as possible.

  • Tell your caregiver if you have any allergies before getting the HBV vaccine.

  • Do not have unprotected sexual intercourse.

  • Do not take and inject illegal drugs.

  • Only take over-the-counter pain medication for pain, discomfort or fever as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You think you have been exposed to the HBV.

  • You think you are having an allergic reaction to the vaccine.

  • You develop a fever of 102° F (38.9° C) or higher.

  • You skin and eyes start looking yellow (jaundiced).

  • You have dark brown urine.

  • You have gray or very light colored stool.

  • You have upper abdominal pain (liver and stomach area).

  • You feel sick to your stomach (nausea), weak and do not feel like eating.

Any severe allergic reaction to the vaccine should be reported by your caregiver or by you to the Vaccine Adverse Event Reporting System (VAERS) by calling 1-800-822-7967 or on the web site, www.vaers.hhs.gov.