Hepatitis B Screening

The hepatitis B virus is the major cause of acute and chronic hepatitis and cirrhosis of the liver. If the mother carries this virus or has one of these diseases, the baby can easily become infected. Clinician need to know this early in the pregnancy so that the baby can be vaccinated within 12 hours of delivery. Here is the list of main high risk groups, though there may be others:

• Women from Asian, Pacific Island or Alaskan Eskimo descent.
• Women worn in Haiti or sub-Saharan Africa
• Women with histories of:
1. Acute or chronic liver disease
2. Work or treatment in hemodialysis unit
3. Work or Residence in an institution for the mentally retarded
4. Rejection as a blood donor
5. Blood transfusion on repeated occasions
6. Frequent occupational exposure to blood in medical-dental settings.
7. Household contact with an HBV carrier or hemodialysis patient
8. Multiple episodes of sexually transmitted diseases
9. Percutaneous use of illicit drugs (by injectin)

Because accurate medical histories are often difficult to obtain some clinician routinely screen all their pregnant patients for Hepatitis B.

Other type of Hepatitis which may affect the mother and the baby are:

• Hepatitis A: It is spread by person to person contact or by being exposed to contaminated food and/or water. The virus that cause Hepatitis A is rare in pregnancy; the virus is not passed on to the fetus. If you should be exposed to Hepatitis A during pregnancy you should take immune globulin within two weeks of exposure.

• Hepatitis C is transmitted through sexual contact, intravenous drug use and blood transfusion. Only a small percentage (less than 10%) of Hepatitis C positive, pass infection to their baby. A woman positive for Hepatitis C should not breastfeed.

Sexually Transmitted Disease (STD)

A blood sample is also taken to test for syphilis. The overwhelming number of cases of syphilis is spread through sexual activity with an infected partner or a carrier of the disease. Occasionally, it can be transmitted by kissing (if there is an open sore in the mouth of the infected person). An infected mother can also pass the disease to her child. One of the problem of syphilis is that you may be unaware of the disease because the symptoms may take years to surface.

But even if you don’t have symptoms, the disease can still be very dangerous, even deadly, to your baby. In the middle of trimester of a pregnancy, the disease can pass through the placenta to the fetus. If the baby is then premature, it can be born dead. If not, the infected baby will carry the horrible effects of syphilis throughout its life. However, treating the infected mother for the disease can also help the child, and if the treatment is started early enough, chances are good for a healthy baby free of disease.

Two most common STDs are Gonorrhea and Chlamydia.

• Gonorrhea, if left untreated in the mother, may attack the eyes of the newborn as it travels through the birth canal. This is why antibiotic ointment or eye drops are placed almost in all newborns’ eyes, to prevent blindness caused by a gonorrheal infection. Like syphilis, gonorrhea can be treated and cured in most of the cases, thus helping to prevent complications compromising the health of the newborn.

Genital herpesis caused by a virus called herpes simplex and is transmitted by direct contact during sexual activity. An active infection is characterized by blisters and open sores primarily around the sex organs. Genital herpes is associated with miscarriage as well as with physical and mental disabilities.

It is important to tell the clinician if you ever had Genital herpes or had sexual contact with anyone who had this disease. Although not common, it is possible for a baby to become infected with the virus during a vaginal birth.

Another sexually transmitted disease that is very prevalent, particularly in younger women is Chlamydia it too can cause eye infections in the newborns as well as other illness such as pneumonia. Chlamydia can be cured with antibiotic, but must consult to your clinician who is aware of your pregnancy, to determine which antibiotic to take.

Acquired Immune Deficiency Syndrome and Human Immune Deficiency

Both acquired immune deficiency (AIDS) and human immune deficiency are caused by HIV virus. Once this virus gets into the blood stream it destroys the cells of the immune system. The immune system is the body’s natural defense against infection.

HIV infected women who are pregnant, including those who have no symptoms of AIDS, treated with the drug Zidovudine(AZT), are much less likely to pass the AIDS virus on to the fetus. The drug is given to the HIV positive women during her pregnancy, labor and delivery, and the baby must be given the drug duringthe first six weeks of life.

HPV or human papilloma virus (also known as genital warts or condyloma) is another STD. it affects the genital area and is easily passed from one person to another during sexual intercourse or oral or anal sex. Sometimes treatment can be started during pregnancy; however if the warts are extensive, your doctor may want to wait until after your pregnancy to begin treatment.