PIG Meeting: 24th June 2021
33yo female for repeat CS
- HBV – reactivated during pregnancy. Risk of vertical transmission
- Albumin 30
- Ferritin 45
- Hb and platelet normal.
- Implications of HBV in pregnancy
- Not uncommon for reactivation due to immunosuppressive state of pregnancy
- As per RANZCOG:
- Method of delivery shouldn’t be affected by HBV status
- Invasive procedures which may breech the maternal/foetal blood barrier should be avoided (e.g., foetal scalp clip)
- Breast feeding is not contraindicated provided appropriate immunoprophylaxis has been given at birth.
- With high viral load in third trimester, appropriate to commence antiviral therapy to reduce risk of transmission to baby
- Arrangements for passive (HBIG) and active immunisation of baby need to be in place.
- HBV testing
- Noted that titres are reported in log multiples, therefore increasing levels represent exponential increase.
- Universal precautions should be used. Patient will still have high HBV titres and therefore high infectivity at time of CS.