INTRODUCTION. Many pregnant women may not even know that they are infected because infection sometimes causes no signs or symptoms. Not only does a pregnant woman face the risks of hepatitis herself, she also can pass the viruses to her baby. Antenatal Screening for HIV, Hepatitis B, Syphilis and Rubella Susceptibility in the EU/EEAWHO Prevention of Mother-To-Child Transmission of Hepatitis B Virus: Guidelines on Antiviral Prophylaxis in Pregnancy If the hepatitis B viral load test … Antiviral treatment begins at 28-32 weeks and continues 3 months postpartum. It is important for your doctor to be aware of your hepatitis B infection so that he or she can monitor your health and so your baby can be protected from an infection after it is born. Hepatitis is a group of viral infections that can seriously affect you and your unborn baby. Perinatal HBV transmission can be prevented by identifying HBV-infected (i.e., hepatitis B surface antigen [HBsAg]-positive) pregnant women and providing hepatitis B immune globulin and hepatitis B vaccine to their infants within 12 hours of birth. Second-line antivirals include treatment with telbivudine or lamivudine . You must make sure your baby receives the remaining shots of the vaccine series according to schedule to ensure complete protection.Although the U.S. CDC states that the medications can be given within the first 12 hours of life and the WHO states vaccine birth dose can be given within 24 hours, there is no second chance to protect an infant once this window of opportunity is missed. What extra risks are caused by hepatitis B and hepatitis C infections during pregnancy? Your physician should perform additional laboratory testing, including … Failure of the birth dose of the HBV vaccine and HBIG may occur in women who are HBeAg positive and have a very high viral load, allowing for the transmission of hepatitis B to your baby. If the hepatitis B viral load test is not available, WHO recommends that pregnant women are tested for the hepatitis B e-antigen (HBeAg), and if positive, an antiviral is recommended during the last trimester. In some cases, the laboratory test results may show a very high viral load. Here’s what to know about the different types of hepatitis and your pregnancy. HBIG is not recommended by WHO and may not be available in all countries. In these cases, your physician may recommend that you take an oral antiviral drug in your third trimester to reduce the risk of infecting your newborn at birth. If you are pregnant, be sure your doctor tests you for hepatitis B before your baby is born, ideally as early as possible during the first trimester.If you test positive for hepatitis B infection, then your newborn must be given proper prevention immediately in the delivery room, clinic or bedside:* Note: HBIG is recommended by U.S. CDC. What is most important is to make sure the hepatitis B vaccine birth dose is given as soon as possible!If these two medications are given correctly, a newborn born to a mother with hepatitis B has more than a 90% chance of being protected from a hepatitis B infection. First-line, antiviral therapy with tenofovir may be recommended. ALL pregnant women should be tested for hepatitis B. In these cases, your physician may recommend that you take an oral antiviral drug in your third trimester to reduce the risk of infecting your newborn at birth. And if you’re pregnant, you can pass it on to your newborn. Testing is especially important for women who fall into high-risk groups such as health care workers, women from ethnic communities or countries where hepatitis B is common, spouses or partners living with an infected person, etc. How is hepatitis B virus infection spread? It is possible to get pregnant if you or your partner has hepatitis C. If you are a man with hepatitis C, and your female partner does not have hepatitis C (throughout the entire pregnancy), then there is no chance that the baby will contract the virus from the mother. (A virus level greater than 200,000 IU/mL or 1 million cp/ml indicates a level where the combination of the birth dose of the vaccine and HBIG may fail. If you live outside of the U.S. and are unsure of your hepatitis B status, please ask your doctor to test you for hepatitis B.Failure of the birth dose of the HBV vaccine and HBIG may occur in women who are HBeAg positive and have a very high viral load, allowing for the transmission of hepatitis B to your baby.All women who are diagnosed with hepatitis B in pregnancy should be referred for follow up care with a physician skilled at managing hepatitis B infection. Regardless of viral load levels or HBeAg status, the hepatitis B vaccine birth dose and completion of the vaccine series is essential to protect your infant from infection with the hepatitis B virus. Chronic hepatitis B (CHB) in pregnancy is a prevalent and important problem with unique challenges. A hepatitis B infection should not cause any problems for you or your unborn baby during your pregnancy. Your physician should perform additional laboratory testing, including hepatitis B e-antigen, HBV DNA level, and liver function tests (ALT).