As OB providers, there is much we can do to stop the perinatal transmission of hepatitis B.
• Screen all pregnant women for hepatitis B (HBsAg). This is usually included in the prenatal panel.
• Order baseline hepatitis B testing if the parent is HBsAg positive.
• Order HBV DNA at 28 – 32 weeks gestation to evaluate the need for antiviral therapy.
• Counsel HBsAg+ pregnantparents on methods to prevent HBV transmission. Talk about importance of hepatitis B birth dose vaccination and HBIG administration as well as post-vaccine serology testing (PVST) for infant at 9 - 12 months of age.
• Refer to a hepatic specialist for management as indicated.
• Report perinatal hepatitis B cases to the DC Perinatal Hep B Program for case management. (Link to Notifiable Disease in Pregnancy Form)
• Advocate for updated policies and procedures in your birthing facility. Use the guide (Link Suggested Points to Include in Hospital Perinatal Hep B Policy)
Watch:
A case management study of a hepatitis B positive mother and child:
Helpful links for OB providers:
- Hepatitis B Serology Video
- AASLD Hep B Practice Guidelines Chronic Hepatitis B (pregnancy section)
- Hep B and pregnancy CDC
- Perinatal Transmission of Hepatitis B virus | CDC
- Viral Hepatitis in Pregnancy
- Perinatal Hepatitis B Update (2023)
- USPSTF Recommendation: Hepatitis B Virus Infection in Pregnant Women: Screening
- Hepatitis B Online (CMEs)
- Procedures to Prevent Perinatal - Hepatitis B Virus Transmission at Delivery (cdc.gov)
- Procedures to Prevent Perinatal - Hepatitis B Virus Transmission at Delivery - Maternal Surface Antigen (HBsAg) Test Results UNAVAILABLE at admission or from retesting at delivery (cdc.gov)
- MMWR - A Comprehensive Immunization Strategy to Eliminate Hepatitis B