World Hepatitis Day 2022: Hepatitis During Pregnancy, What Are The Ways To Prevent & Treat The Disease?

What is hepatitis? 

Hepatitis is inflammation of the liver. Largely can be asymptomatic or can present with nonspecific symptoms such as fatigue, loss of appetite, nausea, vomiting, and weakness or specific symptoms such as yellow discoloration of eyes and skin (jaundice), dark urine, and in some cases excessive itching of the skin.

Hepatitis during pregnancy:

Hepatitis in pregnancy, whilst relatively rare, has potentially significant consequences for maternal and fetal health. It can be caused by pregnancy or inter currently. 

There are women who suffer from Hepatitis caused by pregnancy which include:

• Pre-eclampsia which is associated with HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low Platelet count)

• Acute fatty liver of pregnancy

• Intrahepatic cholestasis of pregnancy

These conditions are generally picked up during regular antenatal screening checks and medications used to treat disease. Some conditions require early induction of delivery by the caesarian section to relieve the injury/stress to the maternal liver and also to improve fetal outcomes.

Those that occur inter currently are:

Viral hepatitis is the most common cause of jaundice/ hepatitis in pregnancy with infections due to hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E viruses.

The incidence of hepatitis in pregnancy varies greatly around the world; in developing countries, it can range from 3-20%.

Hepatitis A is an infection that is acquired through food and water. The disease is mostly self-limited and largely preventable through good hygiene and sanitation measures. Treatment is generally aimed at supportive care, whilst patients recover on their own. 

Hepatitis B infection is acquired via transmission through blood and blood products from infected donors, unsafe sexual practices with infected carriers, or transmission from mother to child during childbirth. HBV infection in pregnancy can occur in acute, subclinical, or chronic forms.

Sixty-five million women of childbearing age are infected with chronic hepatitis B virus (HBV) and have the potential to transmit the virus to the newborn at the time of delivery. HBV infection is largely preventable with vaccination. Acute hepatitis is treatable with effective medications during pregnancy which also reduces the risk of transmission during delivery. All women should now be offered hepatitis B screening as part of routine antenatal screening to pick the silent carriers and chronic infection in pregnant women.

Infants of HBV-infected women should receive hepatitis B immune globulin injections at birth and a hepatitis B vaccine. This regime can reduce the cases of hepatitis B vertical transmission up to less than 3%.

Hepatitis C infection prevalence is about 8% across the globe, fortunately, is less common in India and is acquired via infected blood and blood products and seldom via sexual transmission. Presentation as acute hepatitis is rare and no therapy has been shown to influence the neonatal transmission of HCV to the neonate. HCV is a treatable infection with a range of effective medications now available. 

Hepatitis E in India appears to be associated with a higher maternal mortality rate and worse obstetric and fetal outcomes compared with other causes of acute viral hepatitis in pregnancy. It is generally rare and a preventable infection through good hygiene and sanitation measures and practices. 

Autoimmune hepatitis(AIH) is a condition wherein the body's immune system attacks and causes inflammation of the liver. In pregnancy, it is associated with an increased risk of fetal complications and maternal complications. However, according to the data shown in various studies, the number of pregnancies reported in women with AIH is becoming more frequent. The early detection of the disease helps get better clinical management and high-quality prenatal and antenatal care. Currently, pregnancy and childbirth in AIH appear to be safe for both mother and child due to appropriate clinical management.

Authored by: Dr. Vidyasagar Ramappa, Consultant Gastroenterologist, Manipal hospital Yeshwanthpur

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.