Hepatitis and pregnancy – what happens?
One of the most common questions for any pregnant woman when she has a medical condition is ...
“How will this illness affect my growing baby?”
A woman’s pregnancy itself shouldn’t cause any major concerns or aggravate hepatitis symptoms. The nature of hepatitis will determine effects on the body and a growing baby. Not all types of hepatitis will have a disastrous effect on a developing foetus. All cases, however, must be monitored and treated by a medical professional.
- Hepatitis A: A doctor will recommend that a pregnant woman rest at home and adjust her diet to help her body heal on its own, clearing the virus. She should be clear of the virus within 1 to 2 months. An infection can affect a baby, but is typically mild and rarely happens. A baby shouldn’t experience any life-long complications once recovered should an infection occur. There are risks associated with the condition which can include placental abruption, premature uterine contractions and premature rupture of uterine membranes. This places a woman at risk of premature labour. Any and all risks should be carefully monitored.
- Hepatitis B, C, D and E: Transmission from mother to child during birth occurs when the new-born child is exposed to infected blood and fluids during the delivery process. A positive hepatitis B diagnosis during pregnancy will be treated with hepatitis B immune globulin (during pregnancy, as well as during the delivery). Treatment is not a guaranteed preventative measure, but can help to reduce the transmission rate. A new mother will also be given a hepatitis B vaccine at 1 week, 1 month and 6 months following the birth of her baby, reducing the risk of the baby developing an infection. In many countries, a new-born is likely to receive a hepatitis B vaccination as well.
No matter the type of hepatitis infection, a woman will be required to have frequent liver function tests during her pregnancy and the results will be monitored by a medical professional.
If a woman’s liver is already severely damaged, the additional demands that pregnancy places on the organ can lead to complications of acute fatty liver (associated with liver disease). When there is a deficiency in the enzymes usually produced in the liver, a pregnant woman’s body isn’t able to sufficiently metabolise fatty acids. This can escalate quickly and become quite serious, affecting the unborn baby, whereby he or she may be born with the same deficiency.
If a pregnant woman is diagnosed with an acute fatty liver, a doctor may recommend a quick delivery if the mother is near to full term. Both mother and child will be hospitalised and treated in intensive care. A mother should recover quickly following the birth, depending on how severe the damage to her liver is in the first place. The baby will be carefully monitored and treated.
A pregnant woman can also develop gallstones due to her hepatitis infection. One of the first indications her liver is taking strain due to the illness may be symptoms of jaundice. A woman’s gallbladder typically empties at a slower pace during pregnancy.
Bile and bile salts remain in the system for longer, increasing a woman’s risk for the development of gallstones. If this is determined within the first 6 months of pregnancy, a doctor may be able to perform a laparoscopic procedure (a less invasive surgery with minimal trauma to the body and a faster recovery rate) to remove the gallstones. The final trimester is tricky as the uterus is too enlarged for the procedure to be done.
Can hepatitis be prevented?
One of the best means to avoid contracting hepatitis, particularly the viral types, is by practicing good hygiene. Particularly in areas where infection rates are high, you should be wary of drinking unbottled water and eating ice, as well as consuming raw fruits and vegetable or seafood.
Hepatitis that is transmitted through blood places risk associated with sharing needles for drug use, as well as body piercings and tattoos. You should be mindful of this, no matter where you are in the world. Sharing personal hygiene products such as razors and toothbrushes should also be avoided. If you come into contact with spilled blood, you should be mindful of touching this as well. It will also be recommended that you take extra precaution when it comes to your sexual activity which may put you an increased risk.
There are vaccinations available for preventing hepatitis A and hepatitis B infections. Vaccines for hepatitis C, D and E are still in development and aren’t yet safely available for the public. In areas where vaccines are given or highly recommended, they are administered as 2 shots for hepatitis A and as a series of 3 shots for hepatitis B. There are no known directly related serious side effects with either of these vaccines.
What is hepatitis C viral load?
Viral load refers to the amount of virus present in your bloodstream at any given time. Blood tests (specifically a HCV RNA qualitative test) will be used to determine this amount, as well as distinguish between a previous infection from an active one.
A doctor may recommend a third test, known as viral genotyping, to determine the specific virus in the body. This is especially important when it comes to diagnosis and recommending treatment.
In some instances, a higher viral load may determine the severity of your illness. This is not always strictly true for hepatitis C infections. The severity is determined by the nature of damage to your liver. Viral load is, however, an important indication of how well your treatment plan is likely to work. A doctor will still test your viral load, even during treatment, as a measure of treatment progress. A reduced viral load can indicate to your doctor that your course of treatment is getting the better of the viral infection.
Viral load testing typically doesn’t give your doctor detailed information about your symptoms or if your liver is functioning as it should. Liver function tests or a biopsy will shed relevant light in this instance and combined with your viral load results, will help determine the best course of action for your treatment.