Dr. Mavani Jimesh Himatbhai
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My wife has hepatitis B. She does not have any complications, but she always feels tired. She has already given birth once, and now she is pregnant again after two years. How many times can she get pregnant? Is there any risk involved in this pregnancy? Her doctor told that there is no need for hepatitis medications, as the viral load is below the detection level. Please help.
Hello,
Welcome to icliniq.com.
The best thing you can do is to check the viral load now. And according to the report, there will be a high or low risk of transfer. In the case of low risk, it is same as the first pregnancy. She can continue the pregnancy, but the baby should receive an immediate injection of passive immunoglobulin and HBsAg (hepatitis B surface antigen) vaccine within 48 hours of delivery. This will minimize the risk of hepatitis B infection. The risk is same as was with the previous pregnancy. But, you have to take some precautions to reduce the risk by taking proper rest and avoid complications in this pregnancy as far as possible. Consult your gynecologist for proper guidance about pregnancy.
Patient's Query
Hi doctor,
Thank you for replying. Which test can I go?
Hi,
Welcome back to icliniq.com.
Viral load for HBsAg is a test which can detect the actual active virus in the blood. So, if viral load is more, then there are more chances of transfer. And if the viral load is low, then there is a lesser risk. It can be transmitted to the fetus's blood through the placenta. Normally, the mother's and baby's blood do not get mixed. But some minor trauma during pregnancy can transmit the virus. But yes, there is very low chance of this.
The main risk of transmission is during delivery because, at that time, the placenta gets separated and there is a greater chance of mixup. And that is why it is advisable to give immunoglobulin injection to fetus to cope with the virus, and the vaccine is to avoid future HBsAg vaccine. Her tiredness and weakness are due to pregnancy. Two to three years between two delivery is a good gap, just take medicines on time. Routine investigations in pregnancy and proper rest will help. Other than this, if you are more eager, then you can do double marker test to rule out some genetic disease at 11 to 13 weeks of pregnancy. But if your first baby is fine and has no problem, then no need to do these tests. Consult your gynecologist regularly, do take proper tablets and rest throughout the pregnancy to avoid any bleeding.
Be happy. Everything will be fine.
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Obstetrics and Gynecology
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