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Published: 25/01/2012
Question
What is the best course of action regarding the management of a lady
who is P2, 29 weeks gestation who found to be HBsAg positive? She is
clinically asymptomatic.
Answer
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The following guidelines on the management of hepatitis B in pregnancy
were identified:
United Kingdom national guideline on the management of the
viral hepatitides A, B & C
Pregnancy and Breastfeeding
There is some evidence that treating the mother in the last month of
pregnancy with lamivudine may further reduce the transmission
rate if she is highly infectious (HBVDNA >=.2 x 10 9 geq/ml), but this
needs to be further substantiated.
Infected mothers should continue to breast feed as there is no
additional risk of transmission
HCV testing
Liver ultrasound
Results from these tests should be fed back to maternity services.
HIV results should be made available to the clinician by maternity
services. HIV testing should be re - ofered if this was declined during the
initial screening encounter.
www.basl.org.uk/media/uploads/referralguidelines.pdf Notifications
Reference: Health Protection (Notification) Regulations 2010. This can be
accessed at www.opsi.gov.uk/si/si2010/pdf/uksi_20100659_en.pdf The
regulation states that diagnostic laboratories must notify the HPA and sets
out the details of information to be transferred. This information includes
ways in which the spread of [hepatitis B infection] can be prevented or
controlled and should be supplied in liaison with a registered medical
practitioner where necessary. The woman should be informed that this
action should be taken.
References
American College of Obstetricians and Gynecologists. Viral hepatitis
in pregnancy. Washington (DC): American College of Obstetricians
and Gynecologists; 2007 Oct. (ACOG practice bulletin; no.
86). Summary
Clinical Efectiveness Group. United Kingdom national guideline on
the management of the viral hepatitides A, B & C 2008. London
(UK): British Association for Sexual Health and HIV (BASHH); 2008.
Search date
January 2012
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