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Hepatitis C virus screening in pregnancy
Katherine G Koniares1, Hasan Fadlallah2, Diana S Kolettis1
1Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA.
American Journal of Obstetrics & Gynecology MFM
|December 21, 2020
Summary
Universal screening for hepatitis C virus (HCV) in pregnancy may be more effective than risk-based screening. Many obstetricians and gynecologists struggle to consistently identify HCV risk factors, potentially leading to missed diagnoses.
Area of Science:
- Hepatology
- Infectious Diseases
- Obstetrics and Gynecology
Background:
- Hepatitis C virus (HCV) infection incidence is rising among pregnant women in the US.
- Maternal-to-infant HCV transmission risk is 4-7%.
- Guidelines differ on universal versus risk-based HCV screening in pregnancy.
Purpose of the Study:
- To evaluate current HCV screening practices among obstetricians and gynecologists.
- To assess provider knowledge of HCV risk factors in pregnancy.
- To compare screening approaches in a high-prevalence area.
Main Methods:
- An electronic survey was distributed to obstetric care providers at a tertiary care center.
- The survey assessed attitudes towards universal vs. risk-based screening.
- Provider practices and knowledge of risk factors were evaluated.
Main Results:
- A majority of respondents favored risk-based screening (54.1%) over universal screening (43.2%).
- Less than half (41.9%) correctly identified all recommended HCV risk factors.
- Only 13.9% reported screening all pregnant patients, while 77.8% used risk-based screening.
Conclusions:
- Risk-based HCV screening may be less effective due to inconsistent identification of risk factors.
- Universal screening could reduce undiagnosed HCV infections in pregnant individuals.
- Improved provider education on HCV risk factors is warranted.
