Hepatitis C Infection in Pregnancy

Last updated 15.01.14

 

Definition

-  Infection with or exposure to Hepatitis C virus during pregnancy

 

Features

- Low prevelance in Australia

-  Estimated 1-2% of women of child bearing age

- Routine serology in antenatal screening

-  Risk of transmission to fetus is low 5%

-  Dependant on presence of HCV RNA and degree of viral load

- Higher risk if prolonged rupture of membranes or invasive procedures

 

Causes

-  Hepatitis C virus

 

Risk Factors

-  IVDU

- Previous prisoner

- High risk sexual activities

- Blood transfusion prior to 1990

- Tattoos (low risk)

 

Complications

-     

 

Ix

-  Hepatitis C serology

-  Part of routine antenatal screening

- PCR for HCV RNA, viral load, genotype

- Screen for coinfection

- Should be part of antenatal investigations

-  Hepatitis B serology

- HIV serology

-  LFT

-  U&E

 

Mx

- No safe treatment in pregnancy

- Referral to Hepatology clinic if abnormal LFTs

- Not an indication for LUSCS - not shown to reduce risk of transmission

- Bath baby to remove any maternal body secretions & blood prior to IM injections: Vitamin K, Hep B

-  No breast feeding if bleeding or cracked nipples

- Express milk and discard until healed

- Screen infant at 18/12 old for Hepatitis C serology

- Notification to DHS (Notifiiable Disease) 

 

 

 

References

 

RANZCOG: Management of Hepatitis C in Pregnancy July 2013