Can Hepatitis be Transmitted to an Unborn Child?| Blog By Dr. Surinder Kaur Gambhir, Parasbliss Panchkula

Can Hepatitis be transmitted to an unborn child?

Can Hepatitis be transmitted to an unborn child?

by: Dr. Surinder Kaur Gambhir
Sr. Consultant - Obstetrics & Gynecology Paras Bliss, Panchkula

Acute viral hepatitis is the most common cause of most viral infection is not affected by pregnancy. Jaundice is the characteristic feature of the liver disease. You have to differentiate between all types of hepatitis by biochemical testing because signs and symptoms are more or less same. Different types of hepatitis are Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D and Hepatitis E. It is important to know about each so that you can take precautions and measures to manage the same.

Know about Hepatitis:

Hepatitis A: This is the second most common form of viral Hepatitis, this is the RNA virus and is transmitted by local oral route. It occurs early in life where sanitation is poor and living conditions are crowded. This is common in children and in countries having poor hygienic conditions. Vertical transfusion of HAV during the pregnancy is rare. HAV infection induces lifelong protection against re-infection. There is practically no materno-fatal transmission of HAV because anti-HAV IgG antibodies cross the placenta and provide protection to the infant after delivery. It poses minimal risk to fetus or newborn. Then no intervention is recommended.

Hepatitis B: This is the most common form of chronic Hepatitis around the world. Infection occurs very often and in early childhood where it is asymptomatic. The asymptomatic disease can make the infected person a carrier which can transmit the disease for many years before becoming symptomatic. Hepatitis B is coined as HBV, an enveloped virus containing a double stranded circular DNA. HBV does not cross the placenta because of its size and it cannot infect the fetus unless there is a break in the feto-placental barrier such as those occurring in amniocentesis. Women who are infected can transmit HBV to the infant during delivery. Unless adequate prophylaxis is provided, the newborn is at high risk to develop a chronic HBV infection. Prenatal transmission from the mother to her new born baby is the most important mode of infection. If a pregnant woman is an HBV carrier and is also positive for Hepatitis N “e” antigen (HbeAg) then her newborn baby has a 90% likelihood of becoming infected. Approximately 25% of infected infants become carriers. Most HbsAg carriers are asymptomatic, potentially they are the most constant source of new infections but the other less frequent modes include transfer through percutaneous or parental contact with infected blood, body fluids and by sexual intercourse. A break in the skin or mucosal carrier is required for transmission.

Hepatitis C: Hepatitis C virus is a major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma around the world. This disease has a slow onset of symptoms in 25% of patients. Approximately 75% of patients are chronically infected and may not be aware of the infection. These individuals are a source of infection to the others and are at risk for the chronic liver disease. Regarding the materno fetal transmission of the disease, it is only when women is HCV, RNA positive at delivery the average rate of infection is 6%. The risk is higher if a woman is co infected with HIV. The rate of mother to infant transmission is 4-7% per pregnancy among women with detectable variance.  Transfer of HCV infection is twice in females as compared to a male infant.

Hepatitis D: The delta antigen was first identified in the nucleus of hepatocytes infected with hepatitis B virus. Hepatitis D virus is caused by hepatitis delta virus, a defective RNA virus that can only cause hepatitis in individuals who are infected with hepatitis B. HDV is transmitted sub-cutaneously or sexually through contact with infected blood. The people who are not infected with HBV and not immunized against HBV are also at increased risk of infection. The population at high risk is IV drug users, multiple sex partners; mother to fetus transmission is rare.

Hepatitis E: Hepatitis E is caused by the Hepatitis E virus. All waterborne hepatitis is due to hepatitis E infection. It is sporadic in industrialised countries. It spreads through fecco-oral route. The infection is usually mild and self-limited without any chronicity or clinical signal. The matero-fetal transmission does not occur in this case.

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