During pregnancy, a woman’s body allocates most of its resources to the development of the fetus. She shares with the baby what she experiences and sometimes some illnesses that don’t affect the mother might affect the baby. Viral hepatitis and pregnancy are one such complicated issues. Plus, there are different types of hepatitis that can be caused by different viruses and can cause hepatitis A, B, C, D and E. Hepatitis is a disease that leads to liver inflammation. The symptoms, treatment and prevention vary depending on the type of hepatitis. Read below to learn more about viral hepatitis, its symptoms, treatment and more.
Viral hepatitis complicating pregnancy is common knowledge when you contract hepatitis during pregnancy. But there is also a possibility that pregnancy can complicate hepatitis. In some rare cases, pregnancy can lead to chronic hepatitis flares and cause liver damage. The best possible option, then, is to undergo hepatitis treatment so that the chances of transmission to the baby are reduced.
As mentioned earlier, Hepatitis can be caused by different types of viruses. Here are some of the different types of hepatitis:
● Hepatitis A: This is an illness that can be prevented by a vaccine. New infections with Hepatitis A are linked with an increase in preterm birth, rupture of membranes, premature birth and placental abruption. In a few rare cases, Hepatitis A can cause liver damage to the fetus.
● If you are infected with Hepatitis B and C then there is a high risk of preterm delivery. If you are infected with Hepatitis C then there are chances of miscarriage or spontaneous abortion. There is a chance of Hepatitis C being transmitted to the baby during pregnancy. However, the transmission of Hepatitis B is based on the viral load pregnancy test. A woman who is considering having a baby should get vaccinated for Hepatitis B to prevent it from being transmitted or causing any side effects to the fetus.
● The most common viral hepatitis in pregnancy is Hepatitis E and this illness while pregnant is extremely dangerous. Apart from pregnant women being at risk of this illness, it is bad for the fetus too. There is a great risk of preterm birth, stillbirth and acute liver failure in babies. There is a high risk of transmission from the mother to the baby and the range is estimated to be from more than 30% to 100%.
● Among all the various hepatitis types, transmission of hepatitis D during pregnancy is rare. There is very little evidence of this type of hepatitis being transmitted during pregnancy. There is also not much known about whether pregnancy enhances the progression of liver disease in women with hepatitis D. But there is a need for the liver's health to be monitored.
● Another rare disease of the liver is autoimmune hepatitis, which happens due to immune system overactivity. Pregnant women with this condition have a poor outcome and there is a great risk of fetal growth restriction, preterm birth and even liver damage.
The treatment depends on the cause and the degree to which it has affected the expectant mother’s health.
● Hepatitis A is not usually treated during pregnancy. However, a treatment called post-exposure prophylaxis is provided for women who are not immunised. This is a treatment where the vaccine is administered post-exposure to hepatitis.
● When it comes to treating Hepatitis B, many treatments are found to be safe, even in pregnancy. Antiretroviral medicines are considered a safe and preferred choice during the first trimester. For those who have a high viral load, treatment may be recommended at the time of the baby’s birth.
● Hepatitis C should be cured before a woman gets pregnant. Since there is not enough proof of good outcomes for hepatitis C treatment, antivirals that are direct-acting may not be safe. So treatment for this illness is not recommended.
● Hepatitis D and E are not treated in pregnancy as the treatments available are not considered safe for the baby. If there is a need for treatment, it is for liver failure.
Pregnant women with this illness should know the signs to determine if it is a new infection or if the liver disease has progressed. These symptoms are:
● Yellowing of the eyes or skin
● Jaundice
● Urine becomes dark-coloured
● Bleeding or bruising under the skin, which can be a symptom of conditions that affect the clotting of blood.
It is essential that expectant mothers do regular follow-up which includes liver function monitoring. If there is a flare-up, it can be treated before it becomes dangerous.
The postpartum period sees many hormonal changes that can have an impact on viral hepatitis. There can be small changes in liver function during this period, which are related to immune system changes. In general, there is no great impact on recovery during the post-partum period. However, there can be some complications, like postpartum haemorrhage linked to hepatitis, that can increase the recovery period.
There is no risk of transmission during breastfeeding, so there is no need to restrict it. However, if there are bleeding or cracked nipples, you should stop feeding until they heal. A woman who is receiving hepatitis treatment should talk to their healthcare provider if the medication affects breastfeeding. Hepatitis C treatment is not recommended until you complete breastfeeding.
Poor sanitation and hygiene are the major reasons for getting viral hepatitis. It can be transmitted through food and water contamination, sexual contact and during a blood transfusion.
Antiviral therapy is the first line of treatment that is recommended starting at 28 weeks of pregnancy. Some types of viral hepatitis are not treated during pregnancy.
Preterm birth, fetal growth restriction, placenta abruption and gestational hypertension are some of the complications of viral hepatitis.
Hepatitis E is the most dangerous virus and has a high mortality rate in pregnancy.
