Hepatitis B in pregnancy

Facts about hepatitis B

Hepatitis B is the most common occupational disease among people working in the healthcare sector. It takes about ten percent of a chronic course with the risk of permanent liver damage. More than half a million people in Germany are carriers of the hepatitis B virus. In Germany, children have been vaccinated against this virus since the mid-1990s. Nevertheless, around 1000 new infections take place in Germany. 150 deaths from acute hepatitis B occur in Germany each year. According to the WHO, five to seven percent of the world’s population (350 million people) suffer from chronic hepatitis B.

Infection with hepatitis B

The main way to get infected with the hepatitis B virus is through unprotected sex. 60 to 70 percent of those infected contracted this virus through sexual intercourse. Injuries to the skin or mucous membrane are the transmission sites. The virus is often transmitted by drug addicts through the use of shared needles. In unclean tattoo studios, hepatitis can also be transmitted through a tattoo or a piercing.

Hepatitis test during pregnancy

A hepatitis test is performed after the 32nd week of pregnancy. If the result is positive, your child will receive a vaccination at birth. It is also possible to treat the child to prevent any damage caused by the virus.

Complications of hepatitis in pregnancy

• Hepatitis A can be passed to the baby during pregnancy or at birth. So far, however, no secondary diseases or injuries have been observed in the child. The children have all been unremarkable so far. However, even with hepatitis A, damage cannot be completely ruled out.
• Unlike hepatitis A, hepatitis B infection is rarely passed to the child during pregnancy. If this does happen, it can result in a low birth weight, and in the worst case even in a premature birth. According to the professional association of gynecologists, the probability of a premature birth over the entire course of pregnancy is around 16 percent. Unfortunately, if the pregnant woman falls ill at a late stage of pregnancy, the probability of a premature birth increases to 29 percent. The probability of a stillbirth is then at the same time 10 percent. However, thank God, surviving children usually do not show any late damage or malformations.
• However, the baby can easily contract hepatitis B at birth. It is also possible for the child to be infected after birth. Almost all infected children under the age of one year develop a chronic course of the disease.
• In order to prevent the child from being infected with hepatitis during pregnancy, early screening as part of the hepatitis test is an integral part of maternity care. If the mother is infected, the infant must be vaccinated against the virus within 12 hours of birth. If a child is immunized against hepatitis, it can even be breastfed after consultation with the doctor.
• If a pregnant woman comes into contact with an infected person, immunization against virus types A and B should be carried out according to the professional association of gynecologists.

Symptoms of hepatitis B

A distinction is made between acute and chronic hepatitis B.

• In the first phase of acute hepatitis B, loss of appetite, nausea, fever, and muscle and joint pain occur. In the second phase, the skin, mucous membranes and the whites of the eyes turn yellow. The stool becomes discolored and the urine becomes dark. It takes two to six months from infection to the onset of the disease.
• In 10 percent of adolescents and adults, hepatitis B takes a chronic course. In children it is around 30 percent and in newborns it is even 90 percent. Chronic hepatitis B can lead to liver inflammation. Fatigue, joint and muscle pain, feelings of pressure under the right costal arch, changes in the skin and mucous membrane, and a shriveled liver can be symptoms of chronic hepatitis B. Hepatitis B disease can also have long-term effects such as liver cirrhosis and liver cell carcinoma.

Treatment of hepatitis B in pregnancy

In the case of acute hepatitis B, only the symptoms are treated. Bed rest, physical rest, a ban on alcohol and avoiding medication that puts a strain on the liver, such as certain painkillers and the pill, are recommended. If the viral infection is severe, treatment with an anti-viral agent can be helpful.

Antivirals can also help alleviate the symptoms of chronic hepatitis B. Viral drugs inhibit the multiplication of hepatitis viruses. Therapy must be carried out over months so that it can lead to healing. In 75 percent of cases, hepatitis B heals in this way. The form of therapy for chronic hepatitis depends heavily on the amount of virus in the patient’s body and the intensity of the symptoms. If the liver is already severely damaged by the hepatitis virus, a liver transplant can help.

There is a vaccination against hepatitis B that is recommended by health insurance companies and is very effective. If you have been infected with hepatitis B, you can have antibodies against the virus injected by a doctor within six to 12 hours.