ACOG guideline addresses hepatitis in pregnancy

In a clinical practice guideline issued by the American College of Obstetricians and Gynecologists and published online Aug. 17 in Obstetrics & Gynecology, recommendations are presented for hepatitis B and C virus screening in pregnancy, for management of patients with infection, and for vaccination.

Brenna L. Hughes, M.D., from the American College of Obstetricians and Gynecologists, and colleagues developed guidelines for pregnant or postpartum women and individuals who screen positive for viral hepatitis infection.

The authors recommend early universal prenatal screening for hepatitis B surface antigen (HBsAg) of all pregnant patients, regardless of history of testing or vaccination status. Triple panel screening (HBsAg, anti-HBs, and total anti-HBc) is recommended for all pregnant patients who do not have a documented negative triple screen result after age 18 years, those who did not complete vaccination, or those with ongoing risks for hepatitis B infection, regardless of vaccination status or testing history. In each pregnancy, all patients should be screened for hepatitis C virus antibodies. Prepregnancy screening for hepatitis C virus infection and treatment is recommended before pregnancy when possible. Women with hepatitis B or C virus infection should have prepregnancy counseling, including the effects of pregnancy on maternal disease and risks to the fetus and neonate. Recommended groups should undergo vaccination for hepatitis A virus, hepatitis B virus, or both during pregnancy.

"Hepatitis screening during pregnancy is an opportunity to promote a dialog between pregnant patients and their clinicians about hepatitis transmission; ongoing and new risk factors; and, if not previously vaccinated, hepatitis B vaccination in pregnancy," Hughes said in a statement.

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