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Dr. CHUANG Shuk Kwan, JP: Hepatitis B, syphilis, and HIV; these three diseases all can transmit from mothers to their babies. If diagnosis and appropriate interventions are missed, these diseases can affect the baby for life! Dr. CHUANG Shuk Kwan, JP: In Hong Kong, various institutions offer pre-pregnancy and antenatal checkups, including testing for hepatitis B, syphilis, and HIV. Even if any of these conditions are diagnosed, there is no need to worry too much, as current medication treatments are very effective. There are a series of disease-specific measures that not only protect the mother's health but also significantly reduce the risk of mother-to-child transmission, ensuring that the baby is not affected by the infection. Voice Over: What is hepatitis B? Prof. CHAN Lik Yuen, Henry: Hepatitis B is a liver disease caused by infection with hepatitis B virus. The most common mode of transmission is mother-to-child transmission. Prof. CHAN Lik Yuen, Henry: If a baby is infected at birth, nine out of ten will not be able to clear the virus and develop chronic hepatitis B. Prof. CHAN Lik Yuen, Henry: Without treatment, four out of ten people with chronic hepatitis B could develop cirrhosis or liver cancer. Voice Over: How do I know if I have hepatitis B? Prof. CHAN Lik Yuen, Henry: Hepatitis B could be asymptomatic. A blood test is required for diagnosis. Prof. CHAN Lik Yuen, Henry: If family members, such as parents, siblings or spouse, have chronic hepatitis B, the risk of infection is higher than the others. Prof. CHAN Lik Yuen, Henry: If a blood test indicates that you do not have hepatitis B infection and you have never been vaccinated, it is recommended to get vaccinated when planning a pregnancy to protect yourself. Voice Over: If I am infected with hepatitis B, will it affect my plans to have children? Dr. LEUNG Wing Cheong: Women with hepatitis B can rest assured that there are well established, safe, and effective measures, where pregnant women with hepatitis B can have healthy, hepatitis B-free babies, just like other pregnant women. Dr. LEUNG Wing Cheong: Hepatitis B itself does not affect pregnancy safety, and the vast majority of pregnant women with hepatitis B can go through the entire pregnancy safely. International guidelines do not state an indication for cesarean delivery solely because of hepatitis B. Voice Over: What should I do if I am diagnosed with hepatitis B during pregnancy? Dr. LEUNG Wing Cheong: As long as proper preventive measures are taken before and after birth, the risk of the baby being infected with hepatitis B virus can be reduced to a very low level. Dr. LEUNG Wing Cheong: The highest risk of transmitting hepatitis B virus to the baby is during childbirth, when the newborn is exposed to infected blood, amniotic fluid, or vaginal secretions. Dr. LEUNG Wing Cheong: If a high viral load is detected, doctors will arrange for the pregnant woman to take the oral antiviral, tenofovir, during middle to third trimester. By lowering the viral load, the risk of mother-to-child transmission can be reduced. Dr. LEUNG Wing Cheong: Tenofovir is a very safe medication with minimal side effects. From over 20 years of use in pregnant women, there is no evidence that it increases the risk of obstetric complications or congenital defects in the baby. Voice Over: If I have hepatitis B, what follow-up is needed after my baby is born to ensure they are not infected? Prof. ROSA DUQUE, Jaime S: The most important thing to protect your baby from hepatitis B virus infection is to ensure they receive all three doses of the hepatitis B vaccine as scheduled. Prof. ROSA DUQUE, Jaime S: Like all other babies born locally, the first dose of the hepatitis B vaccine is usually administered in the hospital. Yet, the baby also has to receive the second and third dose at one month and six months old, respectively, to complete the vaccination series. Prof. ROSA DUQUE, Jaime S: Moreover, babies born to mothers with hepatitis B would receive a hepatitis B immunoglobulin injection within 24 hours of birth, offering short-term and immediate extra protection. Voice Over: As the baby grows, do they need regular hepatitis B testing? Are there any other considerations during development? Prof. ROSA DUQUE, Jaime S: If the mother has hepatitis B, the baby should undergo post-vaccination serologic testing between 9 and 12 months old after completing the three-dose hepatitis B vaccination. Assess baby’s immune response to the vaccine and check for hepatitis B infection status. Prof. ROSA DUQUE, Jaime S: If the baby’s antibodies are inadequate after three doses of the hepatitis B vaccine, a second series of three doses would be arranged. The vast majority of babies will confer an immune response after the second vaccination series. Prof. ROSA DUQUE, Jaime S: Regarding breastfeeding, hepatitis B virus cannot be transmitted through breast milk. As long as the baby has received the hepatitis B vaccine and immunoglobulin, breastfeeding is safe with peace of mind. Prevent mother-to-child transmission, starts now. |