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Intrapartum hepatitis B screening

S Petermann1, J M Ernest

  • 1Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1066, USA.

American Journal of Obstetrics and Gynecology
|August 1, 1995
PubMed
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Intrapartum screening identified acute hepatitis B in 0.16% of laboring patients. This approach ensures timely hepatitis B immune globulin and vaccine administration for infected mothers with unknown status, improving infant protection.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis B virus (HBV) infection poses risks during pregnancy.
  • Prenatal screening may miss acute HBV infections presenting during labor.
  • Prompt intervention is crucial to prevent perinatal transmission.

Purpose of the Study:

  • To determine the prevalence of acute hepatitis B in intrapartum patients.
  • To evaluate the effectiveness of intrapartum screening for identifying acute HBV infections.
  • To describe the timing of hepatitis B vaccine and immune globulin administration in exposed newborns.

Main Methods:

  • Prospective screening of 8712 laboring patients for hepatitis B surface antigen (HBsAg) between July 1992 and January 1994.
  • Analysis of HBsAg-positive cases to identify acute infections.

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  • Measurement of the birth-to-administration interval for hepatitis B immune globulin and vaccine.

    • Main Results:

    • A prevalence of 0.16% for HBsAg positivity was found in the study population (14 out of 8712 patients).
    • Two cases were consistent with acute hepatitis B virus infection.
    • The average interval for administering hepatitis B immune globulin and vaccine was 18.6 hours for infants born to mothers with unknown HBsAg status during labor.

    Conclusions:

    • Intrapartum screening effectively identifies asymptomatic pregnant individuals with acute hepatitis B virus infection.
    • This screening strategy ensures that infants born to mothers with acute HBV infection receive timely prophylaxis, even if prenatal screening was negative or not performed.
    • Intrapartum screening enhances the prevention of perinatal hepatitis B transmission.