Hepatitis and Pregnancy

Hepatitis is an inflammation of the liver that can cause fever, jaundice, abdominal pain, swelling, scarring of the liver, and, in some cases, permanent liver damage that can lead to life-threatening liver failure. It is most commonly caused by a virus, although drugs, alcohol, metabolic diseases, and autoimmune diseases can also cause it. It is dangerous because it may cause vague flulike symptoms or no symptoms at all, so you can be infected without realizing it. The virus can remain in your blood for months or years, causing liver damage.

Hepatitis can be confusing because various types exist. Each type is given a letter name to differentiate the virus that has caused it. Here's a quick look at the hepatitis alphabet:

A (also known as infectious hepatitis): Mild flulike symptoms such as nausea, a low-grade fever, headache, loss of appetite, and weakness. Passed via food or water contaminated by infected feces. Usually clears up on its own without treatment.

B (also known as HBV): Symptoms similar to those of hepatitis A or, in some cases, no symptoms at all. Can lead to cirrhosis, liver cancer, and liver failure. Spreads through contact with infected blood and body fluids. Can also be passed from a mother to her newborn. Infection can be sudden and acute or chronic and long-lasting. More than a million Americans carry the HBV virus in their blood, many without knowing it.

In pregnancy, hepatitis B causes the most concern. If a woman has the hepatitis B virus in her blood, there is a 75 percent chance that she will pass it on to her baby. Most babies who are infected by their mothers become lifelong carriers of the virus and are at high risk for liver diseases when they grow up. Doctors routinely test for hepatitis B early in pregnancy. If you test positive, immunoglobulin and vaccination of your newborn can prevent transmission of the virus to your baby.

C (also known as HCV): The most dangerous kind of hepatitis. Four million Americans have been infected with it. Spreads through contact with infected body fluids. More likely than other kinds of hepatitis to cause life-threatening liver diseases. Difficult to treat. Is the most common reason for liver transplantation in the United States.

Pregnant women are not routinely screened for hepatitis C, so if you think you might be infected, ask your doctor about being tested. The infection passes from mother to baby less than 10 percent of the time. Mothers who require treatment for HCV immediately postpartum are sometimes advised not to breastfeed.

D (also known as delta hepatitis): Uncommon. Affects people who already have hepatitis B. Can cause serious liver damage.

E (also known as epidemic hepatitis): Spreads through contaminated drinking water; more common in countries with poor waste disposal systems. Outbreaks have not occurred in the United States.

Originally published in You & Your Baby: Pregnancy.

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